Hyperhidrosis - description of the disease, causes and treatment methods

Types of hyperhidrosis

Hyperhidrosis is divided into primary and secondary, generalized and local.

• Generalized (generalized) hyperhidrosis. Manifested by increased sweating of the entire surface of the body.
• Local hyperhidrosis. It can appear on any part of the body, but most often in the armpits, palms and soles, face i Batyrshina S.V. Hyperhidrosis: method of correction / S.V. Batyrshina, L.A. Khaertdinova // Practical medicine. -2014. — No. 8 (84). — P. 16-23. .
• Primary (essential) hyperhidrosis. Appears for unknown reasons or spontaneously. In patients with primary hyperhidrosis, both an increase in the number of sweat glands and an increase in their reactivity to ordinary stimuli were noted. Typically, this variant of hyperhidrosis manifests itself from childhood, sharply intensifying during puberty. About 40% of patients note the presence of hyperhidrosis in one of the parents i Batyrshina S.V. Hyperhidrosis: method of correction / S.V. Batyrshina, L.A. Khaertdinova // Practical medicine. -2014. — No. 8 (84). — P. 16-23. .
• Secondary hyperhidrosis. Develops in various diseases and conditions (pathological and normal). Usually of a generalized nature.

What is hyperhidrosis

A person has 2 types of sweat glands, which differ in their functions and regulatory mechanisms:

• Apocrine glands - most of them are located in the armpits and around the external genitalia, regulated by the sympathetic nervous system, adrenergic fibers, where the main substance is adrenaline. They begin to function in adolescence, produce a secretion with pheromones - an individual smell; under stress, the function increases, but they do not participate in thermoregulation.
• Eccrine glands - the largest number - are located in the armpits, on the feet and palms, and secrete the liquid part of sweat. The main regulator of the function is acetylcholine. The glands are involved in thermoregulation and sweating during stress.

The work of the vegetative unequal system, which controls the sweat glands, is not controlled by consciousness. Therefore, it is impossible to cause increased sweating on your own; it increases in response to an increase in body temperature during illness, in hot weather or after physical activity. Sweating increases with excitement, emotional stress, which leads to the release of adrenaline.

But the condition of hyperhidrosis is different from normal sweat production. The glands work actively when a person is calm and does not overheat. This is often associated with various pathologies. There is diffuse hyperhidrosis, in which sweating increases throughout the body. The disease is often associated with pathology of the nervous system. Local, or focal hyperhidrosis, affects only one area of ​​the body. This form is more common than others.

Sweating may be seasonal and occur only in the hot season, but for most people with pathology it does not depend on the season.

Symptoms and consequences

The disease has symptoms of varying severity. There are several levels of severity. At level 1, sweating does not interfere with human activity; it is invisible. At level 2, hyperhidrosis may interfere with daily life, but the disease is tolerable. At level 3, the problem causes significant inconvenience. At level 4, excessive sweating interferes with a person's ability to carry out daily activities.

In severe cases, the following symptoms are observed:

• swelling;
• pain;
• redness;
• constant cooling of the body due to evaporation of fluid;
• psychosomatics – problems in society, anxiety, rapid heartbeat.

Symptoms are aggravated by stressful situations, strong emotionality, warm seasons, body heat, as well as the consumption of chocolate products, coffee and certain spices.

Many people experience seasonal increased sweating in the spring and summer. Constant manifestations are rare - sweating occurs regardless of the weather and is not associated with activity or stress. Relapses may occur when, after hyperhidrosis, the work of the sweat glands returns to normal, and then increased sweating returns. This is usually due to hormone surges and disruptions in the functioning of the autonomic nervous system.

In most cases, the cause of the disease is not known; the pathology can be caused by high activity of the reflexes responsible for sweating. Hyperhidrosis of the armpits and palms is typical for people under 25 years of age and appears for no reason. Genetics matters; in more than 40% of cases there is a history of the disease.

Causes of excessive sweating

Patients most often turn to dermatologists with the primary form of pathology, for which it is impossible to establish the cause. The first symptoms of hyperhidrosis appear during puberty. In girls and boys, this is associated with increased activity of the hormones testosterone and cortisol and immaturity of the nervous system. Daily sweat production becomes strong, activity increases in all types of sweat glands. This is why body odor increases in teenagers.

It is believed that primary hyperhidrosis in 30-50% of patients is associated with hereditary factors. But the first symptoms may appear at the age of 20-30 years. They are provoked by chronic stress, hormonal changes and other reasons. The secondary form of excessive sweating of the armpits is associated with the following conditions:

• excitability and high activity of the autonomic nervous system;
• endocrine pathologies, most often the state of hyperthyroidism, insulin resistance in diabetes mellitus;
• diseases of the cardiovascular system, accompanied by cardiac arrhythmias and rapid heartbeat;
• some types of malignant and benign tumors;
• metabolic disorders and excess body weight;
• overdose or side effects of drugs affecting the autonomic nervous system.

It is not always possible to determine the cause of excessive sweating. But it helps to effectively combat sweating.

How to properly treat hyperhidrosis?

How to deal with the problem and how to cure it forever - this worries people who are faced with the disease. Can hyperhidrosis be cured? It is possible, but it will take a lot of effort.

It is important to consider the reasons for successfully getting rid of the problem. Sometimes hyperhidrosis is inherited. Currently, various methods are used to treat sweating and the unpleasant odor that accompanies it.

The first recommendation is to regularly wash problem areas. In case of excessive sweating of the feet, in most cases, washing them with cool water twice a day is sufficient. How to get rid of excessive sweating under the arms, chest and back? Shower more often. This is especially true in hot weather.

If hygiene methods are not effective, you need to use special antiperspirants. If special means do not help, you need to know which doctor to see. It is necessary to find out the reasons and get tested.

If sweating was normal before, and then excessive sweating develops, hyperhidrosis may be suspected. If the causes of the problem cannot be determined, you can resort to iontophoresis, surgery, or inject Botox.

When to see a doctor

If a person begins to sweat during exercise, hot weather, or extreme excitement, there is no reason to worry. Health problems are indicated by sweating, which occurs against a background of complete calm or is accompanied by additional symptoms.

A slightly elevated body temperature, which is accompanied by night or evening sweats, may be a sign of a chronic infection. Sometimes this is how pulmonary tuberculosis, immune disorders, and the initial stages of cancer manifest themselves.

A dangerous symptom is the appearance of weakness, dizziness, loss of consciousness against the background of increased sweating. This may be a sign of low glucose levels - hypoglycemia. The condition is life-threatening and therefore requires emergency medical attention. Hyperhidrosis is cured only after glucose levels are normalized.

Older women who experience menstrual irregularities and the first symptoms of approaching menopause require special treatment. Without special means, the condition may gradually worsen, and menopause will be difficult.

Increased sweating is one of the signs of thyrotoxicosis. This disease is accompanied by an increase in thyroid function and the release of increased doses of hormones into the blood. At the same time, the heartbeat increases, heart rhythm disturbances appear, and the person quickly loses body weight, despite maintaining the nature of the diet.

At the doctor

Many people ask which doctor treats hyperhidrosis. First you need to see a therapist, you may also need to consult the following specialists:

• dermatologist - to exclude dermatosis and inflammation of the sweat glands;
• neurologist - to check for autonomic disorders;
• endocrinologist - to assess the functioning of the thyroid gland, check hormone levels and exclude diabetes;
• cardiologist - to check for the absence of angina pectoris;
• orthopedist – often sweating feet is associated with flat feet.

Only a qualified specialist can determine the diseases that cause excessive sweating. The attending physician prescribes various studies.

Heavy sweating can be a sign of a number of other pathologies, which only a doctor can determine. If no diseases are detected, then they fight the problem using standard methods.

Hyperhidrosis test

The extent of hyperhidrosis and its boundaries are determined using the Minor test. You need to apply a 2% iodide solution to the armpit area. Next, let the liquid dry and sprinkle the skin with starch. In the presence of excessive sweating, the skin becomes purple, sometimes black. The area of ​​manifestation is circled and marks are made to evenly distribute the antiperspirant over the skin.

Sweaty armpits in women

In the female body, the release of large amounts of sweat depends on hormonal levels. When it changes, the interaction of various parts of the autonomic nervous system changes. This process is most pronounced during menopause.

With a decrease in ovarian function in women, their stimulation by pituitary hormones - follicle-stimulating and luteinizing hormones - increases. But due to physiological characteristics, the release of thyroid-stimulating hormone, which increases blood flow in the thyroid gland, simultaneously increases. Most often this process starts in the evening or at night. It manifests itself in the form of hot flashes - the appearance of a feeling of heat in the upper body and head. The woman begins to sweat heavily. The duration of such an attack is several minutes.

You are more likely to experience heavy sweating if you are overweight. Thermoregulation disorders appear with arterial hypertension. These diseases also often progress after age 50. Hyperhidrosis in this case is secondary. It is not life-threatening, but causes discomfort.

Use of products: antiperspirants and deodorants

Antiperspirants are not medicines, but products that prevent increased sweating after treatment. For hyperhidrosis, it is better to use products that are sold in pharmacies, or resort to traditional medicine recipes. It is recommended to combine products, adhering to the rules of use.

Deodorants for hyperhidrosis are applied before bedtime so that the effect begins in the morning. This is the optimal time for application, since the glandular ducts do not function at night. The application area must be dried, you can use a hairdryer.

The composition often includes aluminum chloride hexahydrate. Such antiperspirants are medicinal and are used in the evening, before bed, once every five days. With continued use, you can achieve normalization of sweating and switch to your usual products.

What traditional medicine offers:

• alum – minerals with antibacterial effects;
• Jojoba oils, as well as tea tree and coconut oils, are effective against sweating;
• kaolin powder.

To get rid of the accompanying unpleasant odor, use baking soda.

Botulinum toxin for hyperhidrosis

Botox is a widely known means of preserving youth. Another way to use it is to reduce excessive sweating.

Botulinum toxin injections are used to treat local hyperhidrosis by injecting the substance into the problem area. The action of the drug blocks impulses and eliminates the effect of hyperhidrosis. In most cases, the effect of the procedure lasts 6-8 or more months i Rakhmatullina E.F. Botulinum toxin type A in the treatment of autonomic disorders / E.F. Rakhmatullina // Practical medicine. — 2013. — No. 1 (66). — P. 50-54. .

Features of the effects and benefits of Botox injections

Medications for the treatment of excessive sweating of the armpits include botulinum toxin type A, which is a strong poison of organic origin. In small doses it is safe for the body - it is used to block nerve and muscle impulses.

When Botox is injected under the skin, impulses from sweating fibers are not transmitted to the glands - hyperhidrosis stops. At the same time, heat and water exchange of the skin is not disturbed.

Treatment with this method is effective in the second and third stages of the disease, when severe sweating is observed due to nervous tension, discomfort in communication, or a person has constant sweating and wet clothes under the arms. During the first stage, it is recommended to use aluminum chloride antiperspirants that block the sweat glands for a period of 3 to 4 days.

Among the advantages:

• long-lasting effect, lasting up to 10-12 months;
• safety of injections provided the correct injection technique is used;
• short recovery period.

Contraindications

Absolute contraindications for the use of botulinum toxin are neuromuscular disorders, pregnancy, lactation, local inflammatory process, hypersensitivity to the components of the drug. Relative contraindications are a history of neurological diseases, use of anticoagulants and antiplatelet agents, chronic diseases in the acute stage, hemophilia.

Treatment technique with botulinum toxin

The procedure does not require special preparation and is carried out after a preliminary iodine-starch test. The area of ​​the blue spot and its intensity are assessed. To eliminate pain, a local anesthetic is applied to the skin. The composition is administered intradermally at intervals of 1.5-2 cm to a depth of 2 to 3 mm. Together with Minor's test, the procedure takes from 40 to 60 minutes.

Post-procedure care

After the session, slight swelling, redness and nodules are observed in the armpit area, which disappear after 3-4 days. Botulinum toxin begins to act on the 4th day, the final result will be visible after 2 weeks and lasts for 10-12 months, it depends on the characteristics of the body. Then the treatment must be repeated. Each time the amount of the drug decreases, and the duration of exposure increases.

Recommendations for care after the procedure:

• for three days, massage, which reduces the effectiveness of the product, and the use of antiperspirants are contraindicated;
• For seven days it is not recommended to visit the bathhouse, swimming pool, actively engage in sports or drink alcohol.

Which drug is better?

For injection treatment of sweating, drugs containing botulinum toxin type A are used, which blocks nerve impulses traveling to the sweat glands. The difference lies in the result obtained, the price, the consumption of the product and the duration of the effect. We invite you to familiarize yourself with the characteristics of the drugs.

Injecting botulinum toxin type A under the skin is a safe, simple and effective treatment for excessive sweating.