Hyperhydrosis

Primary hyperhidrosis is the condition characterized by abnormally increased perspiration, in excess of that required for regulation of body temperature. Some patients afflicted with the condition experience a distinct reduction in the quality of life. Sufferers feel at a loss of control because perspiration takes place independent of temperature and emotional state.

However, anxiety can exacerbate the situation for many sufferers. A common complaint of patients is that they get nervous because they sweat, then sweat more because they are nervous. Other factors can play a role; certain foods & drinks, nicotine, caffeine, and smells can trigger a response. There is controversy regarding the definition of hyperhidrosis, because any sweat that drips off of the body is in excess of that required for thermoregulation. Almost all people will drip sweat off of the body during heavy exercise.

Hyperhidrosis can either be generalized or localized to specific parts of the body. Hands, feet, axillae, and the groin area are among the most active regions of perspiration due to the relatively high concentration of sweat glands; however, any part of the body may be affected. Primary hyperhidrosis is found to start during adolescence or even before, and interestingly, seems to be inherited as an autosomal dominant genetic trait.

Primary hyperhidrosis must be distinguished from secondary hyperhidrosis, which can start at any point in life. The latter form may be due to a disorder of the thyroid or pituitary gland, diabetes mellitus, tumors, gout, menopause or certain drugs.

Primary hyperhidrosis is estimated at around 1% of the population, afflicting men and women equally. It commonly has its onset in adolesence.

Cause
It is not known what causes primary hyperhidrosis. One theory is that hyperhidrosis results from an overactive sympathetic nervous system, but this hyperactivity may in turn be caused by abnormal brain function.

Affected Areas

 * Palmar: Excessive sweating of the hands.
 * Axillary: Excessive sweating of the armpits.
 * Plantar: Excessive sweating of the feet.
 * Facial: Excessive sweating of the face. (i.e. not emotinal or thermal related blushing)
 * General: Overall excessive sweating.

Treatment
Hyperhidrosis can usually be treated, but there is no cure.


 * Aluminum chloride (hexahydrate) solution. While aluminum chloride is used in regular antiperspirants, hyperhidrosis sufferers need a much higher concentration to effectively treat the symptoms of the condition. Some suffer skin chaffing from the dryness in the area.
 * Surgery (Endoscopic thoracic sympathectomy or ETS): Select sympathetic nerves or nerve ganglia in the chest are either cut or burned (completely destroying their ability to transmit impulses), or clamped (theoretically allowing for the reversal of the procedure). The procedure often causes anhidrosis from the mid-chest upwards, a disturbing condition.  Major drawbacks to the procedure include thermoregulatory dysfuction (Goldstien, 2005), lowered fear and alertness (Teleranta, Pohjavaara, et al 2003, 2004) and the overwhelming incidence of compensatory hyperhidrosis.
 * Surgery (Sweat gland suction): A new technique adapted and modified from liposuction. On an out-patient basis with only local anaesthesia, the sweat glands are permanently removed in a gentle, non-aggressive manner. The sweat glands and armpits are first softened and anaesthetized with a special solution. After a short period, the sweat glands can then be removed in a manner similar to liposuction.
 * Botulinum toxin type A (Botox®): Injections of the botulinum toxin are used to disable the sweat glands. The effects can last from 4-9 months depending on the site of injections.
 * Iontophoresis: This method was originally described in the 1950s, and its exact mode of action remains elusive to date. The affected area is placed in a device that has two pails of water with a conductor in each one. The hand or foot acts like a conductor between the positively- and negatively-charged pails.  As the low current passes through the area, the minerals in the water clog the sweat glands, limiting the amount of sweat released.  Common brands of tap water iontophoresis devices are the Drionic®, Idrostar and MD-1A (RA Fischer). The device is usually used for the hands and feet, but there has been a device created for the axillae (armpit) area and for the stump region of amputees.
 * Oral medication: There are several oral drugs available to treat the condition with varying degrees of success.  A class of anticholinergic drugs are available that have shown to reduce hyperhidrosis. For some people, however, the drowsiness and dry-mouth associated with the drug cannot be tolerated.
 * Weight-Loss: Hyperhidrosis can be aggravated by obesity, so weight-loss can help. However, most people with hyperhidrosis do not sweat excessively due to obesity.
 * Relaxation and meditation: Relaxation techniques have been tried with limited success.
 * Hypnosis: Hypnosis has been used with limited success.
 * Percutaneous Sympathectomy: a minimally invasive procedure in which the sympathectomy nerve is blocked by an injection of phenol.
 * Talc/Baby Powder: One temporary treatment is talc or baby powder because the powder will absorb the sweat, the only problem is, after a while the powder may become a messy white coating on the place of application.
 * Accupuncture: Needles are placed on the hands