Hyperhidrosis is a condition in which excessive sweat production is unrelated to physical activity or temperature. People with this disorder feel that their clothes get wet quickly and their palms often sweat.
Apart from interfering with daily activities, hyperhidrosis can also reduce the sufferer's quality of life. This is caused by anxiety and shame.
In conditions of severe hyperhidrosis, it can even cause dehydration which can cause a person to become tired quickly, weak and can even cause a momentary loss of consciousness / fainting.
Sweating is a normal process to cool down an overheated body temperature. However, in patients with hyperhidrosis, sweat that comes out more than normal. This condition occurs even when the body does not need cooling.
Hyperhidrosis is more common in women. Generally, this condition begins to appear in childhood or adolescence. Although not dangerous, hyperhidrosis can cause feelings of shame, stress, depression, or anxiety.
Causes of Hyperhidrosis
The process of sweating occurs when the nervous system detects the level of body temperature. When the body temperature rises, the body's nervous system will trigger the sweat glands to secrete sweat. The goal is for the body temperature to decrease.
While hyperhidrosis occurs due to certain medical conditions, or because the body's nervous system is overactive.
Based on the cause, hyperhidrosis is divided into two, namely:
Primary hyperhidrosis
In primary hyperhidrosis, the nervous system is overactive in stimulating the sweat glands. As a result, the sweat glands secrete sweat even though it is not triggered by physical activity or an increase in body temperature.
The exact cause of primary hyperhidrosis is not known. However, there are allegations that this condition is passed down in families.
Secondary hyperhidrosis
Secondary hyperhidrosis occurs due to other medical conditions, such as diabetes, obesity, hyperthyroidism, gout, menopause, and some types of cancer.
Apart from medical conditions, secondary hyperhidrosis can also occur due to side effects of certain drugs, such as antidepressants, propranolol, or pilocarpine. The condition of quitting drug or alcohol dependence can also cause excessive sweating.
Symptoms of Hyperhidrosis
Hyperhidrosis is characterized by profuse sweating without a trigger. A person can be suspected of suffering from hyperhidrosis if:
- The grains of sweat can be seen clearly even though the weather is not hot or when you don't have much activity
- His clothes are often wet with sweat
- Experiencing disturbances during activities, for example difficulty opening a door or holding a pen, because your palms are wet with sweat
- The skin appears thin, cracked, and flaky, with a paler or reddish color
- Often experience skin infections on parts of the body that sweat too much
- Tired or weak quickly, because of losing a lot of fluids / dehydration
Symptoms of hyperhidrosis depend on the type. Here is the explanation:
Primary hyperhidrosis
Primary hyperhidrosis usually affects one or more parts of the body, especially the armpits, hands, feet or forehead. Excessive sweating doesn't appear during sleep, but it can occur soon after waking up. Generally, primary hyperhidrosis occurs from childhood or adolescence.
Secondary hyperhidrosis
Secondary hyperhidrosis usually causes the whole body to sweat excessively, even while sleeping. Secondary hyperhidrosis usually appears only after adulthood.
When to see a doctor
In some cases, excessive sweating can be a sign of a serious medical condition. Immediately go to the doctor or the nearest emergency room if excessive sweating is accompanied by nausea, chest pain, and dizziness or a feeling of fainting.
Examination to the doctor also needs to be done if you experience the following conditions:
- More sweat than usual
- Sweat comes out at night without a trigger
- Excessive sweating interferes with daily activities
- Excessive sweating causes emotional distress or disruption to social life
- Sweat comes out a lot and is accompanied by drastic weight loss
Diagnosis of Hyperhidrosis
To diagnose hyperhidrosis, the doctor will ask questions about the symptoms experienced, the age when the complaint first appeared, as well as the patient's and family's medical history. After that, the doctor will carry out a thorough physical examination.
To determine the cause of hyperhidrosis, the doctor will carry out supporting examinations, such as:
- Blood and urine tests
The doctor will take a sample of the patient's blood or urine for examination in the laboratory. This test is used to determine whether there are medical conditions that can cause hyperhidrosis, such as hyperthyroidism or low blood sugar (hypoglycemia).
- Sweat test
This test is done to find out which parts of the body experience hyperhidrosis and how severe the severity is.
Hyperhidrosis Treatment
Treatment for hyperhidrosis depends on the cause. If it is caused by a medical condition, the doctor will first treat that cause before treating hyperhidrosis. However, if the cause of hyperhidrosis is unknown, doctors will treat excessive sweating right away.
Initially, the doctor will advise the patient to use a deodorant containing antiperspirant containing aluminum chloride by applying it at night and washing it off in the morning. This deodorant is usually sold freely.
Apart from using deodorant, doctors will also advise patients to improve their lifestyle in the following ways:
- Bathe every day to prevent bacteria from growing on the skin
- Drying the body after bathing, especially in the armpits and between the fingers
- Wear leather shoes and cotton socks that absorb sweat
- Change socks regularly or when they start to feel damp
- Don't wear closed shoes too often
- Choose clothes that are cool on the skin for daily activities and clothes that easily absorb sweat for exercising
- Practice relaxation techniques, such as yoga or meditation, to manage stress that can trigger hyperhidrosis
- Limit consumption of foods and drinks that can trigger sweating, for example caffeinated drinks, spicy foods, curries and alcoholic beverages
If lifestyle improvements cannot control sweating, there are several methods that doctors generally use, namely:
- Administration of drugs
To relieve hyperhidrosis, the doctor will prescribe the following medicines:
- Medication creams that contain glycopyrrolate, to inhibit the nerves that trigger sweating
- Oral medication to improve the performance of the nerves that regulate the sweat glands
- Oral medicine that contains beta-blockers in low doses to relieve hyperhidrosis due to anxiety disorders
- Sweat inhibition device (iontophoresis)
Iontophoresis is performed if hyperhidrosis occurs on the palms or soles. This therapy is done by immersing the patient's hands or feet in water. After that, electricity will be channeled through the water to block the sweat glands.
This therapy is effective in many patients, but the effects are short-lived and must be repeated many times.
Initially, the patient may need 2–3 therapy sessions a week for 2–5 weeks. After that, the patient can reduce the therapy schedule to once a week or once a month when his complaints have improved.
- Botulinum toxin (botox) injections
Botox injections can temporarily block the nerves that cause excessive sweating. Botox injections are given several times in areas of the body that sweat, starting with local anesthetic administration.
The effects of botox injections can last up to 12 months and must be repeated. However, please note that this therapy can cause temporary muscle weakness in the injected body part.
- Microwave therapy
This therapy uses microwave energy to destroy sweat glands. This therapy is carried out for 20–30 minutes every 3 months, until the patient recovers. However, this therapy can cause side effects in the form of discomfort and changes in sensation on the skin.
- Sympathectomy surgery
Surgery for hyperhidrosis is done when other treatment methods are ineffective. This operation, called a sympathectomy, can be done by surgical or laparoscopic surgery (endoscopic thoracic sympathectomy). This operation is performed by cutting a small part of the nerves that regulate sweat production.
Hyperhidrosis complications
Hyperhidrosis can cause infection if the skin condition is often damp or too wet. In addition, hyperhidrosis can also make sufferers embarrassed because their clothes or armpits look wet. This condition can interfere with sufferers when working or studying.
Prevention of Hyperhidrosis
Hyperhidrosis due to hereditary factors cannot be prevented. Primary hyperhidrosis patients can prevent body odor with lifestyle improvements as described above.
In secondary hyperhidrosis, prevention is done depending on the cause. For example, hyperhidrosis due to side effects of drugs can be prevented by changing the drug. Meanwhile, hyperhidrosis due to consumption of caffeinated drinks can be prevented by stopping consuming caffeinated drinks.
Please note, secondary hyperhidrosis caused by certain diseases, such as heart disease or cancer, cannot be prevented.
Article written by dr. Achmad Faisal, Sp.BTKV, Subsp. T(K) (Specialist in Thoracic, Cardiac and Vascular Surgery, Sub Specialist in Thoracic Surgery at EMC Alam Sutera Hospital). For further information, contact: 0896 8506 2890 (Yohan).