Hyperhidrosis (excessive sweating/perspiration)

Hyperhidrosis is another name for excessive sweating. About 1% of the population has hyperhidrosis. Hyperhidrosis occurs in the palms of the hands, in the armpits, on the hairy head and face, on the trunk, in the groin or on the soles of the feet.

How does hyperhidrosis develop?

The cause of hyperhidrosis is often unknown, but in 30-50% it runs in the family and is therefore hereditary. Hyperhidrosis usually occurs during puberty and you will continue to have the complaints for decades. There are two forms of hyperhidrosis:

Primary hyperhidrosis

Primary hyperhidrosis is excessive sweating of certain areas such as the hands or armpits. Often no cause can be found for this.

Secondary hyperhidrosis

Secondary hyperhidrosis is when excessive sweating is a symptom of an underlying disease. In this case, it is wise to go to the doctor to find the cause of the excessive sweating.

Symptoms

Hyperhidrosis can be recognized by a lot of sweating without any effort and the hands, armpits, feet or face are constantly moist. Moisture spots are often visible on clothing near the armpits. Sweaty feet often spread an unpleasant odor and are susceptible to fungal infections. Sweaty hands can be difficult when shaking hands and holding objects. Sweaty hands in particular sometimes cause emotional and psychosocial problems. It can reduce self-confidence and sometimes even lead to depression.

Diagnosis

To demonstrate localized hyperhidrosis, the iodine-starch test is sometimes done. The skin is first thoroughly dried and then rubbed with 20% iodine in alcohol. Starch powder is sprinkled over the dried alcohol on the skin. Where there are droplets of sweat, the starch will turn black.
However, this test is usually not necessary. The diagnosis can easily be established based on the patient’s story.

Treatments

If you experience a lot of sweating, you can make an appointment with your doctor. They will probably prescribe an ointment or give a referral to the dermatologist. Below are the possible treatments for hyperhidrosis.

Aluminum chloride

This is the least invasive treatment and is often the first prescribed by the GP. Aluminum chloride is often given in an ointment or lotion. This should be applied to the affected area in the evening. This is washed off again in the morning. During the day it should reduce sweat production. Aluminum chloride treatment can cause skin irritation and does not always work well, especially in extreme cases of hyperhidrosis. The effect may also decrease after use for a longer period of time.
If aluminum chloride does not appear to help, your doctor will probably refer you to a dermatologist. They will probably come up with these solutions.

Iontophoresis

Iontophoresis is a method in which the hands and feet are immersed in water through which a weak electrical charge is passed. Iontophoresis can produce good results. The treatment takes 15 to 20 minutes and should be done two to three times a week. After a few times, the treatment can be reduced to, for example, once a week or once every two weeks. The treatment can probably be tested by a physiotherapist and eventually you will have to purchase a device yourself. Skin irritation can also occur with this treatment, and it does not always work well in extreme cases.

Botulinum injections

A fairly new treatment is botox injections. This blocks the nerves that cause excessive sweating. The effect of this treatment is often very good, but the blockade only has a temporary effect of about three to six months. After this, the treatment will have to be repeated. The botulinum toxin injections are very painful, especially in the hands. The hand muscles in the hands can also become paralyzed for several weeks to months after treatment.

Anticholinergics

These are medicines that suppress the activity of the sweat glands in the nerves. Anticholinergics are administered in the form of tablets. However, there are side effects such as insomnia, dry mouth and poor bowel movements.

Operations

This is a very drastic treatment that is often only carried out when none of the other treatments seem to be working. During the operation, some nerve junctions or nerve pathways are blocked or cut. The results are very good. However, there is a risk of complications during the operation, such as a collapsed lung. In addition, perspiration may increase in other places after treatment.

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