Hyperhidrosis is a common pathological condition characterized by increased sweating. In this case, the sweat glands exceed normal needs, which are sufficient to maintain the body's natural temperature. Normally a healthy person the main function of sweating is to maintain normal body temperature, but it is worthwhile to increase it, as the sweat glands begin to produce sweat in a sufficient amount to maintain the original temperature.
The main types of hyperhidrosis are: idiopathic hyperhidrosis (without a specific cause) and secondary hyperhidrosis (a symptom with a different pathological condition).
Increased sweating can be local (affects specific areas of the body) or generalized (affected the entire surface of the body).
Idiopathic hyperhidrosis is often local and, as a rule, manifests itself in the face, armpits, feet and palms with varying degrees of intensity.
Secondary hyperhidrosis can manifest as a generalized symptom (general) or local (local). With secondary hyperhidrosis, various pathological conditions can serve as causes, which include endocrine gland diseases, neurological diseases, oncological diseases, side effects of many drugs, dermatological syndromes, chronic infections. Rarely, the primary hyperhidrosis can manifest itself in the face or in the form of hyperhidrosis of gestational, due to complications after operations on the parotid and salivary glands, with diabetes .
The sweat glands in such patients who suffer from hyperhidrosis are practically no different from those in people with normal sweating functions.
Hyperhidrosis determines hyperfunction, not hypertrophy of the sweat glands. In those patients who have primary hyperhidrosis, there is a slightly elevated basal level of sweating and a pronounced response to normal stimuli with emotional and physical stress. There is evidence that patients with hyperhidrosis have a lower threshold of emotional sweating. It is also possible for hyperreactivity to thermal stimulation in such patients who suffer from hyperhidrosis. Often this is observed with hyperhidrosis axillary, less often with palmaris hyperhidrosis. Proceeding from the fact that hyperhidrosis in children can also be from early infancy, the cause of its occurrence is defined as a physiological disorder.
One of the possible mechanisms for reducing the threshold of excitability of the sweat glands and their enhanced response to stimuli in patients with hyperhidrosis may be an increased activity of the sympathetic nervous system. In patients with palm-plantar hyperhidrosis, less bradycardia is observed with a cooling of the face or a Valsalva test than in the control group (healthy subjects of the same age who do not have hyperhidrosis), but more pronounced vasoconstriction to cool the hands. Such research says that excessive sympathetic activity passes through the T2-T3 ganglion, which leads to hyperhidrosis of the palms.
Electroencephalography and PET of the brain in patients with primary hyperhidrosis confirmed the occurrence of acute wave flares at the time of hyperperfusion and hyperventilation in the cortex of the frontal parts of the brain.
Since hyperhidrosis often begins its development in childhood and is often a hereditary disease, the physiological moments of the disease can be genetically predetermined.
Considering the causes of local hyperhidrosis, it is not difficult to recognize it. The patient, as a rule, complains of intense paraxismal sweating in certain areas of the body. For example, in the areas of the armpits, palms, feet, face and head.
Excessive sweating can be detected in one or all of the above areas, but the combination of hyperhidrosis on the palms and feet is more common than the local axillary hyperhidrosis. Local hyperhidrosis can be observed in both men and women, but studies show that in women it occurs twice as much.
Intensive local sweating with local hyperhidrosis can be detected during stressful situations. The probable pathophysiological aspects of the development of local hyperhidrosis are explained by the theory of autonomous double innervation of the glands of the palms, feet and axillae, and by the theory of excessive sensitivity of the mecric system to elevated concentrations in the blood of epinephrine and / or norepinephrine in emotional outbursts.
There may also be local hyperhidrosis after eating. Patients with this form of hyperhidrosis complain about excessive sweating of the face after eating. This local form of hyperhidrosis usually occurs after taking a specific food, often after coffee, tea, chocolate, hot drinks and spicy foods. Sweating appears after a few minutes after eating and is most pronounced in the areas of the upper lip and forehead. But in our time until now, the causes of the appearance of this type of local hyperhidrosis have not been elucidated.
The reasons for the emergence of generalized hyperhidrosis can be a great many.
With thyrotoxicosis e, as an endocrine disease, hyperhidrosis is the main symptom. Wet skin is usually the characteristic features of this disease.
When diabetes is also noted increased sweating of the skin. When hypoglycemia is also characteristic is the presence of hyperhidrosis.
Climacteric syndrome is characterized by hot flushes and intense sweating associated with cessation of menstruation, and they are in fact considered to be clear signs of this syndrome.
With pheochromocytoma, there are cases when the patient's arterial hypertension is accompanied by excessive sweating, which is a good diagnostic trait for the doctor. Such combinations of hyperhidrosis and increased blood pressure are considered the only manifestation of such a disease.
In case of carcinoid syndrome, hyperhidrosis may be supplemented by intensive vasomotor tides that are inherent in this syndrome.
Hyperhidrosis of the head, as well as generalized hyperhidrosis, can occur in 65% of patients with acromegaly . The increased sweating is explained by the direct effect on the peripheral tissues of growth hormone, large amounts of which appear after the increase in the activity of acidophilic cells in the pituitary gland.
Hyperhidrosis, accompanied by an increase in body temperature, can be considered characteristic of all acute infectious and chronic infectious diseases.
With tuberculosis , sweating is noted at night during sleep and is defined as a classic symptom of pulmonary tuberculosis.
Brucellosis in many signs of hyperhidrosis is similar to tuberculosis, but it is supplemented by fever.
With malaria, too, there is a high body temperature, heavy sweat and severe chills.
Hodgkin's disease also causes a generalized form of hyperhidrosis, especially at night.
Lymphomas that are not associated with Hodgkin's disease show excessive hyperhidrosis. Their group includes: malignant formations in the form of histiocytic, lymphocytic, mixed, undifferentiated, lymphoblastic lymphomas.
The compression of the spinal cord with tumor metastases can be manifested by increased sweating of the entire skin.
It is known that sweating has a regulation of an autonomous nature, but both local and generalized hyperhidrosis can vary with certain lesions of the central nervous system.
In Parkinson's disease, there may be hyperhidrosis of the head and hyperhidrosis of the face, which is a compensation reaction to anhidrosis caused by damage to the autonomic nervous system.
The defeat of the fibers of the nerve back roots during the course of neurosyphilis may provoke the appearance of local hyperhidrosis.
Hemorrhagic and ischemic strokes as a result of damage to the large arteries of the brain can have lesions of the hypothalamus and the disturbance of the adequate functioning of the thermoregulatory center.
With hyperhidrosis, children have a reason such as a diencephalic syndrome of newborns, which is characterized by excessive sweating.
Generalized hyperhidrosis can be a characteristic manifestation of emotional tension, pain and reactive state.
Excessive sweating can be related to possible side effects of a number of medications commonly used in the treatment of other diseases, including Insulin, Aspirin, antiemetics, analgesics of the Promedol group and Morphine.
Hyperhidrosis may be one of the more vivid symptoms of certain severe and life-threatening conditions. With the withdrawal of certain substances, there are characteristic vasomotor disorders, instability of body temperature, excitation of the cerebral cortex. Excitation and tremor, excessive sweating are considered characteristic symptoms of abstinence opiate reactions and acute alcohol poisoning.
Hyperhidrosis can often act as the main symptomatology in such urgent conditions as poisoning with substances of the organophosphorus group and fungi of the genus Amanita muscaria.
Hyperhidrosis is a violation of the sweat system. With this violation, the intensity of sweating is much higher than a certain rate of sweating. Often there is increased sweating on the palms, on the face, on the head, in the armpits and on the soles of the feet.
Hyperhidrosis of the head is defined as an increased sweating of the hairy area of the forehead and head. This type of hyperhidrosis is rare. A characteristic complaint with hyperhidrosis of the head is an excessive sweating of the head, which often rises at high ambient temperatures and physical exertion. Often, the sweating of the head can be increased during stress, and also at night. Also, head hyperhidrosis can be combined with excessive sweating of the face, hands and erythrophobia , which is usually characterized by the appearance on the face of pronounced red spots.
With local hyperhidrosis, for example, in the armpits, the patient notices wet spots on clothing, he has to repeatedly change clothes during the day. Often a patient with local hyperhidrosis avoids sports or social contact because of embarrassment. In exceptional cases sweaty areas of the skin are more sensitive to infection, which can also be accompanied by an unpleasant odor caused by fungal skin infections.
Quite often, hyperhidrosis is accompanied by symptoms such as anxiety, sleep disturbance, anxiety, emotional instability. That's why the facial hyperhidrosis can be accompanied by red face on the background of stress.
As a rule, three degrees of hyperhidrosis are distinguished. The first degree is characterized by increased sweating, especially not creating problems for the patient and for the people around him. The second degree of hyperhidrosis characterizes awkward situational moments when shaking hands, at public appearances, etc. The third degree is characterized by specific psychological problems of the patient, which are associated with wet stains on clothes, the smell of sweat, which can cause dislike and secret condemnation of people around him. This can create for the patient a big problem of social adaptation.
Hyperhidrosis of the armpits
Hyperhidrosis of the armpits is also called axillary hyperhidrosis. Abundant sweating in the axillary region usually leads to increased nervousness and patient complexes. Sweating in the area of the armpits is considered an absolutely adequate reaction of the body to thermal effects, physical activity and stressful situations. And only certain failures in the system of normal sweating can lead to hyperhidrosis of the armpits.
The reasons for the strong sweat secretion under the armpits can be different in origin. Idiopathic (local) hyperhidrosis is very difficult to determine. One of the irritants of sweat glands in this case can be hot weather. People who suffer from excessive sweating should not eat sharp foods and alcohol, which are the strongest provoking factor for sweating. Very common causes of increased sweating in the underarms in our time could be vegetative dystonia and emotional stress. Hormonal changes in the body in young people can also cause hyperhidrosis underarms.
There are many methods to combat hyperhidrosis underarms. All methods of treatment can be divided into surgical and conservative. For example, to conservative methods of treating hyperhidrosis armpits include botox, iontophoresis, Alumochloride hexahydrate.
With Botox, which is considered the best method of treatment these days, the transport of acetylcholine, which is responsible for the work of sweat glands, is blocked. Contraindications to it are pregnancy , lactation and complex allergic reactions ( anaphylactic shock ). But if certain rules are followed after applying botox, you can forget about excessive sweating for six months or a year.
With ionophoresis, the electric current method is used. It was discovered in the beginning of the 20th century and is successfully used for various dermatoses of the skin. After the treatment of dermatoses, this method marked the disappearance of sweating on the hands. Therefore, this method is used in the treatment of hyperhidrosis not only of the hands, but also of the armpits, feet.
Alumochloride hexahydrate is a kind of antiperspirant and is used for the treatment of underarm hyperhidrosis. This drug eliminates excessive sweating in the underarms in 65% of cases. It is available in the form of perfume products, which can be purchased at pharmacies. Also hyperhidrosis of armpits is treated by surgical methods.
ETS with local hyperhidrosis is considered a fairly simple operation, which involves inserting a special endoscope into the small incision in the thorax region to intersect the nerve endings. With curettage sweat glands are removed and nerve endings are removed, but this method of correction can leave scars and scars.
Liposuction in the underarm area is considered a very popular method in the treatment of underarm hyperhidrosis. It was noted that it helps to combat excessive sweating of the armpits and leaves a fairly long effect after this correction.
Therapy of hyperhidrosis in the underarm area by folk methods is carried out by compresses with medicinal herbs. Well proven: sage infusion, infusion with valerian and melissa. Also axillary cavities can be rubbed with lemon juice, wine or apple cider vinegar (in a ratio with water 1: 1).
Hyperhidrosis of the feet
Increased sweating of the feet or plantar hyperhidrosis can appear on the feet regardless of air temperature. The appearance of hyperhidrosis of the feet is explained by the excessive activity of the sweat glands on the feet and / and the sympathetic nervous system. Often, the hyperhidrosis of the feet can be combined with hyperhidrosis with palmar and axillary hyperhidrosis.
In patients with hyperhidrosis, patients often experience some anxiety when taking off or changing shoes in crowded rooms or on a visit, since this disease is combined with an unpleasant, sometimes fetid smell of feet.
Patients suffering from plantar hyperhidrosis need to pay great attention to foot hygiene and try to wear shoes, socks made from natural materials, since a constant moisture in the foot area can provoke excessive reproduction of microorganisms that cause skin irritation and unpleasant odor. There may even be infectious lesions on the feet. But if the lesions with hyperhidrosis stop are strong enough, then observance of elementary rules of personal hygiene is not enough.
As a therapy for hyperhidrosis, a stop antiperspirant, iontophoresis, Botox injections can be used.
When using an antiperspirant for feet, it is necessary to take into account that the skin on the feet is not as sensitive as on other skin areas of the body, so it may be necessary to use an antiperspirant for feet with an increased concentration of alumino chloride as an active substance (about 30%).
Therapy with iontophoresis can effectively remove the manifestations of hyperhidrosis of the feet, but they should be carried out according to a certain pattern on a regular basis. Botox or botulinum toxin injections are considered a minimally invasive procedure, which should be performed every six months.
In general, with excessive sweating, feet sometimes it is sufficient to change shoes. Cheap material or material, selected not for the weather, can trigger the development of hyperhidrosis of the feet.
Hyperhidrosis of the palms
Hyperhidrosis of the palms is considered the most common form of local hyperhidrosis, along with axillary hyperhidrosis. This disease is characterized by always wet and cold palms, with increased symptoms in stressful situations. In specific cases sweat from the palms can drip off in the literal sense of the word.
Sometimes palmar hyperhidrosis can be accompanied by a rash, itching and an unpleasant odor. Such a pathological disorder does not present any danger to the life of the patient, but it is very unpleasant and usually hard to transfer psychologically, especially for the female half of the population.
The most common cause of hyperhidrosis of the palms is an increased concentration of sweat glands in the human body. In some cases, the reason for the hyperhidrosis of the palms is an inadequate response of the body to various stimuli, for example, thermal stress, stressful situations, physical activity. Also, the cause of hyperhidrosis of the palms may be: an overdose of certain medicinal products and a hormonal failure.
To get rid of palmar hyperhidrosis for a start, you should consult specialists, despite the fact that the problem of this disease at first glance may seem simply aesthetic.
As with other forms of local hyperhidrosis, antiperspirants can be used. They are considered a simple and convenient method of therapy, but the least effective. It is worth remembering that the skin on the palms is more rough than in the underarm area, therefore, several times longer treatment should be performed.
The surgical method of treatment is considered the most radical method in the treatment of hyperhidrosis of any form, but as for the area of the palms, before using this method, one should try to eliminate the cause of it. The fact is that sweating of the palms can be a symptom of any systemic diseases. It is necessary to carefully examine the patient with hyperhidrosis of the palms, before prescribing therapy.
If, during the examination, it becomes clear that the cause of hyperhidrosis of the palms is a systemic or other chronic disease, then it is necessary to conduct appropriate treatment. If the cause of local hyperhidrosis is not so global, but only consists of nervous overexertion or local irritating factors, then it is possible to treat with local medications in the form of ointments and / or creams. With nervous causes of hyperhidrosis of the palms, treatment is prescribed in the form of sedatives and sedatives.
If to judge the methods of treatment of hyperhidrosis, then there are about two dozen methods of therapy. However, certain of them can only have historical significance. Sympathectomy endoscopic is considered a small operation, under which manipulations through a small hole in the skin. It completely and permanently relieves the patient of unpleasant symptoms in the hyperhidrosis of the hands and armpits.
Surgical interventions for hyperhidrosis are conventionally divided into two groups: remote and local. The first group identifies surgical intervention using a remote method in the problem area. These operations may include sympathectomy. In our time there are several methods of conducting such operations, below each we give a brief description.
Endoscopic sympathectomy is considered a unique type of intervention for hyperhidrosis and a number of other conditions that are associated with impaired work of the nervous sympathetic system. Through a definitely small incision on the skin, a thin tube with a microcamera is inserted into the thorax. The image from the chest cavity is displayed on the normal screen of the monitor. Through the same incision, other special tools are introduced to perform the manipulations. Within 10-15 minutes the surgeon achieves with the help of a visual review of the necessary problem zone and applies a metal clip to the ganglion of the paravertebral area, which crosses the sympathetic trunk of the nerve end. In this method of therapy, the main advantages of videothoracoscopic surgeries are used.
Sympathectomy endoscopic is performed, as a rule, with palmar hyperhidrosis. The least it can affect the operation of the axillae. Sympathectomy is not used in the treatment of hyperhidrosis of feet. It is also known that sympathectomy of the lumbar region can cause impotence.
Traditional or open sympathectomy is defined as the incision of the skin and tissue produced on the back surface of the chest. A standard thoracotomy is performed, in which the ribs part. The surgeon dissects surrounding tissues, detects the trunk of the paravertebral and binds the necessary nerve node. Access is traumatic, which forces subsequently to stay in the hospital for several days, and then restricts the physical activity of the patient for a month, forced surgeons to detect and apply other methods of surgical intervention. And the emerging scars after the intervention can also confuse the patient.
Sympathectomy percutaneous is carried out with the help of definitely thin needles, which are brought to the trunk paravertebrally. The introduction of certain chemicals and the destruction of nerve nodes with the help of electric current can lead to the same effect as with open sympathectomy.
Local surgical interventions have found application in the therapy of isolated hyperhidrosis of the armpits in the case when excessive sweating occurs exclusively in the axillary region.
With the help of a small tube, which is injected through a small incision on the skin, removal of the fiber of the armpit is performed with liposuction. The dissection of the sympathetic nerves passing through it leads to a disturbed work of the streams of nerve impulses to the sweat glands.
Curettage of the axillary zone differs from liposuction only in that instead of pumping out the fat, a so-called scraping of the problem zone is carried out, where the sweat glands are located. As a result, there is also a dissection of small nerves and destruction of the sweat glands.
The use of antiperspirants in local forms of hyperhidrosis also produces a result, but only temporary. It must be remembered that the problem areas for hyperhidrosis should be kept clean at all times.
In generalized hyperhidrosis, it is important to consult a specialist to determine the cause of hyperhidrosis and to treat the underlying disease. Under no circumstances should a general hyperhidrosis be neglected by this condition, since this can lead to unfortunate consequences, in the case of no treatment.