Hyperhidrosis (excessive, increased sweating) is a very unpleasant condition, which seems like a trivial problem to most people. This disease is not at all that rare - according to some statistics, about 3% of the population suffers from it. As our interlocutor, dermatologist Dr. Rajko Boričić says, that number is probably even higher, because there are many who do not attach much importance to this condition. Also, many do not report it, convinced that there is no cure.
"First of all, I would like to mention that there are two forms of hyperhidrosis - we have idiopathic or primary hyperhidrosis when there is no other disease or condition, and secondary hyperhidrosis, which occurs as part of infections, malignant diseases, neurological or endocrine diseases, spinal cord injuries, and systemic connective tissue diseases.
Primary hyperhidrosis is further divided into focal, when sweating affects certain parts of the body (palms, armpits or soles) and generalized, when sweating is expressed throughout the body. The most common, however, is focal hyperhidrosis: combined hyperhidrosis of the palms and soles, in about 15-20% sweating occurs under the armpits and palms, 5-10% only under the armpits. The rarest is increased facial sweating (so-called craniofacial sweating), which can be caused by emotional tension, heat or spicy food. Hyperhidrosis is also a very common disease that is inherited - in 25-50% of cases, there is a disorder in family members," says Dr. Boričić.
Why do we sweat?
"In order to properly understand excessive sweating, it is necessary to know why we sweat in the first place. The basic role of sweating is thermoregulation, i.e. maintaining body temperature through increased sweating when the outside temperature is elevated. This sweating can occur both during the day and during the night on the skin of the whole body. Another type of sweating is emotional, which is always daily and mostly limited to the face, armpits, palms and soles. The centers for these two types of sweating are separate and located in different regions of the brain. There are between 2 and 5 million sweat glands on the body, which are densest on the forehead, scalp, palms and soles. In people who do not have hyperhidrosis, at a normal body temperature and a moderate external temperature, a small amount of sweat is produced. If the external temperature rises, thermoregulation mechanisms are activated, which tend to maintain the body temperature at 37 C. The sweating that occurs then is all over the body, but very little on the palms and soles. But, if it is associated with an emotional factor and mental tension, sweating also occurs on the face, palms and soles. Increased sweating can, of course, also occur during physical activity," explains our interlocutor.
Treatment
Electrophoresis
This method was accepted in 1984 as an official therapeutic procedure in the treatment of hyperhidrosis. Many dermatologists use it as the first therapy primarily for increased sweating of the palms and soles. The therapeutic procedure is very simple: hands or feet are placed in shallow tubs of water, there are electrodes for the armpit, and then a direct galvanic current is released. There is no pain. Apart from a slight burning or tingling sensation, there are no other unwanted sensations. There is no risk of electric shock, because the current is very weak. The therapeutic procedure lasts about 30 minutes and is performed every other day. On average, between 10 and 12 treatments are needed. Once optimal dryness is achieved, maintenance therapy is necessary for some, from once a week to once a month. This regime is determined individually. When sweating is noticed again, it is necessary to repeat the therapeutic procedure.
Botox
This preparation has been used in modern medicine for more than 10 years in the treatment of various neurological diseases and conditions, with more than a million patients. Botulinum toxin is a natural, purified protein that has the ability to temporarily block the release of neurotransmitters in nerve endings, thus blocking the secretion of sweat glands. With such a "blockage", the botulinum toxin "turns off" sweating in the places where it was injected. Unfortunately, the effect is not permanent, over time the symptoms gradually return, mostly between 7 and 16 months. Then it is necessary to repeat the therapeutic procedure.
The procedure is performed with a thin needle, with which Botox is injected subcutaneously. The procedure can be painful, especially on the palms and soles. There are several methods by which this pain can be alleviated.
Medicines
Medicines from the group of anticholinergics, beta blockers and clonidine hydrochloride can theoretically reduce sweating, acting on all sweat glands. However, these drugs have serious side effects, which is why their long-term use is not recommended
Everyday life
"When we talk about hyperhidrosis, first of all, I recommend daily bathing with antibacterial soaps to reduce the number of bacteria on the skin. A mixture of bacteria, i.e. their metabolism, and sweat, creates an unpleasant smell. Wet feet can be very suitable for the development of fungal infections, so take care of foot hygiene. Use antiperspirants, twice a day, in the morning and in the evening. If you use them once a day, apply them in the evening. They can also be applied to the palms, soles and underarms. For specially prescribed prescriptions, follow the doctor's instructions. Clothes should be made of natural fibers: cotton, silk or wool, which will allow the skin to breathe. Wash your clothes often.
Get dress shields, pads that can be worn under the armpits to absorb excess sweat.
If your feet are wet, change your shoes often. If your shoes do not dry overnight, it would be best to replace them with dry steam. You can alternate between them. Change your socks often, and walk barefoot when you can.
Avoid spicy food, alcohol or hot drinks that can increase sweating.
Some are helped by breathing exercises, self-control, yoga or breathing techniques, any form of recreation that relieves stress," advises our dermatologist.
The problems start at puberty
"This problem manifests itself on a daily basis. The majority of patients describe problems that begin in childhood or puberty. Sweating is a visible problem and can cause quite a lot of psychological problems. Simply, there is a constant worry about how to hide the problem from the environment, there is frequent changing of clothes, wiping hands or face, wearing only dark clothes, and even missing school or work. Various emotional problems, even depression, social isolation and loss of self-confidence are not rare either. Hyperhidrosis can also lead to some skin diseases. The skin softens and is susceptible to bacterial and fungal infections, and a form of eczema - dyshidrosis - is not uncommon. Also, increased sweating, especially of the armpits, is accompanied by an unpleasant odor (bromchirosis). On the other hand, palmar hyperhidrosis (palm sweating) significantly affects daily activities. Moist or wet palms make it difficult to grasp objects, work at the computer, play an instrument or use electrical appliances. More than 95% of patients state that increased sweating significantly worsens or complicates everyday life and work. Glass and other smooth objects slip from the hands, the keyboard on the computer breaks due to excessive moisture, it is difficult to hold a pen, and the paper underneath is soaked with sweat. It is very difficult for members of the police or military to hold their weapons, even cases of corrosion due to profuse sweat have been reported. That's why these conditions often affect the choice of profession, patients avoid public appearances or direct contact with clients", says our doctor.Deodorants and antiperspirants
Deodorants - they cannot prevent sweating, but they prevent the odor caused by the action of bacteria. The effect lasts for several hours, and can be applied several times during the day. Antiperspirants - are applied locally, on the surface of the skin. They block the outlet channels of the sweat glands or reduce the blood supply to the sweat glands, so sweating is difficult. Metal salts are used, aluminum chloride hexahydrate being the most effective. In concentrations of 10-15%, they are applied to the armpit area, while higher concentrations, around 30%, are needed for the palms and soles. They can also be applied to the face. They are applied to completely dry skin, without water or sweat, preferably before going to bed, and they stay on the skin for 6-8 hours. If you shave your armpit, wait 24-48 hours, because this way irritation can develop more easily. The effect is immediate, lasts only a few days, and does not work in more severe conditions. Nevertheless, a large number of patients are satisfied with the effect of antiperspirants. Recent studies have shown that their application in the morning and evening, or only in the evening, is more effective than application only in the morning. If there is no irritation, it can be applied every evening. When a satisfactory effect is achieved, the treatments can be diluted. They can be used together with deodorants," says Dr. Boričić.
Bonus video:
