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Hyperhidrosis Symptoms

Hyperhidrosisis a chronic medical condition characterized by excessive sweating. While its real cause continue to challenge medical researchers, its symptoms often manifest either during childhood or adolescence. Surprisingly, about 40% of hyperhidrosis patients share the same problem with their families. As it appears, the role of genes in this respect is far too significant for medical professionals not to explore heredity and its contribution to understanding the etiology of hyperhidrosis.

Given that a majority of hyperhidrosis patients may have been suffering from it since their early years, a few lucky ones may experience spontaneous relief from its symptoms by the time they reach adulthood. While for most of them, symptoms of hyperhidrosis is a permanent cause of social embarrassment and physical discomfort.

Excessive sweating can either affect the whole body (generalized sweating) or it can be limited to specific body areas where the active eccrine sweat glands are found (localized sweating). Some of the sweat prone areas of the body are the palms, soles, armpit, groin and chest. It can cause the affected skin to appear pink or blue-white, macerated, cracked, or scaly – more so if it involves the palms (palmar hyperhidrosis) and soles (plantar hyperhidrosis).

Sweating is a natural and involuntary body response controlled by the sympathetic nervous system to cool the body. Various stimuli such as heightened emotions (anger, fear, stress, or anxiety) and increased physical activity, make one susceptible to and experience hyperhidrosis symptoms. Likewise, exposure to certain chemicals like nicotine and caffeine (found in foods, drinks, cigarettes, etc.) triggers the production of sweat. However, hyperhidrosis symptoms occur almost spontaneously that even without these stimuli, or perhaps even with the slightest experience of any of these factors, patients sweat profusely.

Hyperactivity of either the sympathetic nerves or eccrine sweat glands is generally accepted as the physiological explanation for excessive sweat production. The reason why they become over-activated is still unknown.

Degree of sweating in hyperhidrosis cases varies from person to person. Most patients can tolerate mild to moderate symptoms.  On the other hand, severe cases are very much a cause of embarrassment and distress especially when their condition does not only bring physical discomfort, but also when it already becomes socially disabling. It is especially alarming when their condition is already taking a heavy toll on their normal daily activities. Patients, for instance, may find it extremely difficult to perform an otherwise very simple job-related task such as typing on the computer keyboard, or holding papers and documents. Some, whose palms are often damp or dripping wet, even hesitate to shake hands. It is not at all surprising if, in the long run, they begin to avoid people rather than suffer from social embarrassment.

Considering the tremendous impact of hyperhidrosis and its symptoms to the lives of a significant number of the affected population, only appropriate medical treatments and interventions should be given to those finding temporary or long-term relief from their condition.

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Compensatory Hyperhidrosis

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Compensatory hyperhidrosis usually occur after a surgical operation for axillary and palmar hyperhidrosis (sympathectomy). It’s the most common and notable side effect of sympathectomy. Other side-effects include gustatory sweating (sweating when eating), and neuralgic pain, but these are relatively rare.

Excessive sweating occurs in untreated body areas, usually in the upper or lower back and trunk, to compensate for reduced sweating in the treated areas (armpit and hands). The brain is responsible for shifting sweat production to a different body location to get rid of the perceived excess body heat. It’s actually a reflex response of the brain when it senses that it’s not cooling the body enough. The brain sends signals to the body to sweat more through the existing and undamaged sweat channels.

The symptoms of compensatory hyperhidrosis, such as profuse sweating and feeling of hotness (or sometimes coldness), may happen at irregular intervals or be constant throughout the day. Excessive sweating may occur in the lower and upper back, lower chest, abdomen, buttocks, groin and backs of the thighs. Patients who experience compensatory hyperhidrosis sweat profusely with the slightest thermal increase and physical activity.

Patients who have undergone sympathectomy for hyperhidrosis may develop compensatory hyperhidrosis soon after the operation, or later for some. On the average, sweating symptoms will remain stable six months after, but may continue to occur long after the operation.

It’s impossible to accurately predict who will and won’t develop severe compensatory hyperhidrosis after surgery. Likewise, it’s impossible to know in advance how intense the symptoms will manifest in certain patients. What’s certain is that almost all patients who undergo any form of sympathectomy experience some degree of compensatory hyperhidrosis. Its severity, however, will depend upon the levels of the interrupted sympathetic chain.

Research shows that a significant reduction in compensatory hyperhidrosis symptoms can be done by dividing the sympathetic chain at a single level (T2 sympathectomy). For older patients that have increased body mass index (BMI), it may be recommended that they undergo a temporary sympathetic block prior to permanent sympathectomy. This should help determine if compensatory hyperhidrosis would be a significant side effect for them after the operation.

Degree of tolerance for compensatory hyperhidrosis as a side effect of sympathectomy varies. Some patients may regret the surgical procedure because of the severity of the symptoms of compensatory hyperhidrosis, but this is relatively rare. Still, a majority of patients who have undergone this procedure can very well tolerate mild to moderate compensatory hyperhidrosis symptoms, which, for them, is an insignificant price to pay compared to a lifetime of trouble and discomfort from profuse underarm or hand sweating.

Since sympathectomy is a surgical procedure that’s irreversible, it’s still important that the patient be made aware of its side effects. Although most patients report that it’s an acceptable trade-off for getting rid of axillary and palmar hyperhidrosis, compensatory hyperhidrosis is something real and could be permanent, with no known cure. An informed choice is still the best privilege any patient could possibly have.

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Hyperhidrosis Medicine

Hyperhidrosisis a condition in which a person experiences excessive sweating in their hands (palmar hyperhidrosis), underarms (axillary), face and/or feet (plantar). Everyone perspires more when they get nervous or excited or when they exercise, but people with this condition perspire excessively, often for no apparent reason. The sympathetic nervous system, which controls involuntary responses such as sweating, blushing, and salivation, simply fails to regulate sweating in these body areas. Consequently, people with hyperhidrosis often experience sweating so severe that it becomes a source of embarrassment, making them reluctant to shake or touch hands.

It also can interfere with everyday activities such as writing, driving, taking tests, making presentations or even holding or grasping objects. The severity of the condition varies from person to person, but in most cases the sweating proves problematic both socially and professionally. The prevalence of hyperhidrosis is not well-documented, but it is estimated to affect up to one percent of the U.S. population.
The most common non-surgical treatments for this condition include:
Topical anti-perspirants, such as aluminum chloride. Drysol, a topical lotion applied two to four times a day, is usually the first medication tried. It is often very effective for those patients with the mildest symptoms, but it can cause chapping and cracking of the skin.

Oral medicines: Anticholinergic medicines (such as Robinul) are used to block certain receivers on nerve receptors at involuntary nerve sites. In people with hyperhidrosis, this leads to decreased sweating. Some psychotropic drugs (drugs that affect mental function), like amitriptyline, have also been prescribed for hyperhidrosis.
Iontophoresis (Drionics): This involves applying low-intensity electrical current to the hands or feet while they are immersed in an electrolyte solution. When used daily, it can decrease the problem or even solve it temporarily. However, the procedure is time consuming and can be mildly to moderately painful.

Botox: This substance, a derivative of the deadly botulism toxin, is injected into the affected area. The success rate is only fair for axillary hyperhidrosis and even less so for palmar symptoms. Although it can sometimes work, its effectiveness wears off after 3 to 4 months. Therefore, the person has to undergo periodic and potentially painful injections.

While these treatments can help many people with hyperhidrosis, they do not work for everyone and their effectiveness can even decrease over time. Moreover, they often don’t provide a permanent solution to the problem. Consequently, many people with hyperhidrosis are now considering the minimally invasive surgical treatment known as thoracoscopic sympathectomy, sometimes called endoscopic transthoracic sympathectomy (ETS).

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