Hyperhidrosis: Causes and treatments

Abstract

Sweating helps to regulate body temperature by cooling via the evaporation of sweat produced by sweat glands. Hyperhidrosis is a condition characterized by constant and increased production of sweat by sweat glands, and may be local (primary) or generalized (secondary). Primary hyperhidrosis is a constant and excessive sweating disorder, of unknown cause, that occurs mainly in the axilla, palms, soles of feet and craniofacial region, and more than one area may be involved. The secondary form is caused by a latent condition, such as an infection, endocrine or metabolic disorder, neoplasic disease, neurological condition, psychiatric disorder, spinal cord injury and respiratory or cardiovascular problems. Hyperhidrosis is a clinical manifestation that significantly interferes in an individual's life, causing emotional and social problems, a lower quality of life, physical discomfort and increased risk of skin infections. In general treatment is symptomatic, and varies according to the intensity of the disease. In less severe cases it is customary to use creams and antiperspirant deodorants based on aluminium chloride. In intermediate cases the treatment of choice is oxybutynin. Severe cases require invasive modes of therapy, and are more likely in the adult population. The most widely used form of treatment is thoracic sympathectomy, but most patients experience recurrence of the manifestation in another region of the body (compensatory hyperhidrosis or reflex) after surgery, in the absence of full resolution. The application of botulinum toxin is an alternative approach, although sweating is only temporarily reduced. Acupuncture is a form of treatment that has been used with success, because this condition, according to Traditional Chinese Medicine, is caused by a disorder in the metabolism of water, which is responsible for sweat. As acupuncture is based on treating the cause and not just the effect of pathologies, patients who undergo this treatment report a very satisfactory and more efficient outcome compared to those previously cited.