Hyperhidrosis

Hyperhidrosis is the condition characterized by abnormally increased sweating/perspiration, in excess of that required for regulation of body temperature. It is associated with a significant quality of life burden from a psychological, emotional, and social perspective. As such, it has been referred to as the 'silent handicap'
Hyperhidrosis may also be divided into palmoplantar (symptomatic sweating of primarily the hands or feet),


Cause:

The cause of primary hyperhidrosis is unknown, although some surgeons claim it is caused by sympathetic over-activity. Nervousness or excitement can exacerbate the situation for many sufferers. Other factors can play a role; certain foods and drinks, nicotine, caffeine, and smells can trigger a response.

Humectants such as glycerin, lecithin, and propylene glycol, draw water into the outer layer of skin. Glycerin, lecithin, and propylene glycol are found in Vaseline. Hypothetically excessive use of vaseline over time may be one cause of palmar hyperhidrosis, however research needs to be conducted to provide evidence.

A common complaint of patients is they get nervous because they sweat, then sweat more because they are nervous.
Aluminium chloride is used in regular antiperspirants. However, hyperhydrosis sufferers need solutions or gels with a much higher concentration to effectively treat the symptoms of the condition. These antiperspirant solutions or hyperhydrosis gels are especially effective for treatment of axillary or underarm regions. Normally it takes around three to five days to see the results. The main secondary effect is irritation of the skin. For severe cases of plantar and palmar hyperhydrosis, there is some success using conservative measures such as higher strength aluminium chloride antiperspirants.[5] Treatment algorithms for hyperhidrosis recommend topical antiperspirants as the first line of therapy for hyperhidrosis. Both the International Hyperhidrosis Society (http://www.Sweathelp.Org) and the Canadian Hyperhidrosis Advisory Committee have published treatment guidelines for focal hyperhidrosis based on evidence based clinical support.

Injections of botulinum toxin type A, (Botox, Dysport) are used to block neural control of sweat glands.[5][6] The effects can last from 3?9 months depending on the site of injections.[7] This procedure used for underarm sweating has been approved by the U.S. Food and Drug Administration (FDA).[8]

Prescription medications called anticholinergics, taken by mouth (orally), may be used to treat either generalized or focal hyperhidrosis.Anticholinergics used for hyperhidrosis include propantheline, glycopyrronium bromide, oxybutynin, methantheline, and benztropine. Use of these drugs can be limited, however, by the common side effects of the anticholinergic class?dry mouth, urinary retention, constipation, and visual disturbances such as mydriasis and cycloplegia. Additionally, many of the medications used to treat excessive sweating are not FDA approved for that purpose and are, rather, being used "off label" For people who find their hyperhidrosis is made worse by anxiety-provoking situations (public speaking, stage performances, special events such as weddings, etc.) and want temporary, short-term treatment for the duration of the event, an oral medication/anticholinergic can be of assistance. (Reference: Böni R. Generalized hyperhidrosis and its systemic treatment.

Several anticholinergic drugs reduce hyperhidrosis. Oxybutynin (brand name Ditropan) is one that has shown promise,[5][10] although it has important side effects, which include drowsiness, visual symptoms and dryness in the mouth and other mucous membranes. A time release version of the drug is also available (Ditropan XL), with purportedly reduced effectiveness. Glycopyrrolate (Robinul) is another drug used on an off-label basis. The drug seems to be almost as effective as oxybutynin and has similar side-effects. Other anticholinergic agents that have tried to include propantheline bromide (Probanthine) and benztropine (Cogentin).


Non-surgical treatments:
Iontophoresis was originally described in the 1950s, although the exact mode of action remains elusive
of 2014,
the hyperhidrosis treatment device is available in North America, Asia Pacific, and Europe. Treatment with this device is given in a physician's office and results in the thermolysis (destruction by heat) of the sweat glands beneath the underarm skin.

Hyperhidrosis can have physiological consequences such as cold and clammy hands, dehydration, and skin infections secondary to maceration of the skin. Hyperhidrosis can also have devastating emotional effects on one?s individual life.