What is excessive sweating? What are the causes and treatments?

What is excessive sweating (Hyperhydrosis)?

Sweating is a physiological event that occurs to control the body’s temperature. Excessive sweating (hyperhidrosis), on the other hand, is an excessive amount of sweating regardless of environmental conditions and body temperature control. Patients with hyperhidrosis do not need to move to sweat. Even when they sit, sweat can drip from their hands. The disease may develop due to a primary drug or a medical condition. Regional excessive sweating is sweating that occurs especially in the armpits, palms, soles, and more rarely in the head and neck region.

Sweating while eating is seen in what is called Frey’s syndrome. Common hyperhidrosis; It may occur due to hormonal, neurological, infectious reasons or cardiovascular diseases, respiratory system diseases, drugs and poisoning.

Regional excessive sweating is more common than other sweating disorders. Although the exact cause is not known, improper functioning of the nervous system is seen as the main cause of the disease.


What are the symptoms of excessive sweating?

Primary hyperhidrosis is called excessive sweating for no specific reason. It occurs equally in both men and women. The average age of onset is usually around 25 years old. However, hand sweating and foot sweating may start earlier. In order to be diagnosed with primary regional hyperhidrosis, the patient should have the following symptoms besides regional and excessive sweating lasting at least 6 months:

  • Having at least one sweating attack per week
  • Symmetrical sweating
  • It impairs the quality of life
  • Appeared before the age of 25
  • Having a family history
  • No sweating during sleep

Excessive sweating can cause psychosocial problems as it disturbs people a lot. In addition, fungal infections are common in areas that sweat excessively.



What are the complications due to excessive sweating?

Bacterial and fungal infections, eczema and skin rashes, social and emotional problems in excessive sweating areas are the most common complications.


How is excessive sweating diagnosed?

It is essential to get a detailed history from the patients. Additional tests are not required in primary regional hyperhidrosis, which is not thought to be due to a specific cause. However, if there is general hyperhidrosis, the patient’s blood pressure and weight are checked, detailed neurological examination and blood tests are performed.


How to treat excessive sweating?

If excessive sweating is in the form of general body sweating, its cause is investigated and treatment is performed for the cause. There are surgical and non-surgical treatment options for primary regional sweating. In non-surgical treatment, sweating is reduced with locally applied or oral medications. Botox and iontophoresis are other treatment methods used. Iontophoresis treatment is particularly suitable for hand sweating cases. In this treatment, patients put their hands in a plastic container with tap water and electrodes. Initially, the treatment is applied for 10 minutes a day for 2-3 days. The supplied electrical energy is gradually increased.

Botox treatment is applied for both hand and foot sweating and armpit sweating. Starch iodine test can be performed to determine the sweating area on the application area before Botox application. There is a decrease in sweating for periods ranging from 4 days to 2 weeks after the treatment. The duration of effect is approximately 4-12 months.

In the case of sweating that does not pass under the armpit, surgical treatment for the armpit nerves can be applied or the sweat glands under the armpit can be surgically removed. Today, these surgical methods can also be performed endoscopically.

Modern devices that destroy the sweat glands in the area to be treated have also been developed. Despite successful results with these devices, side effects such as edema, redness and loss of sensation have also been reported.

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