What Causes Hyperhidrosis?
Although neurologic, endocrine, infectious, and other systemic diseases can sometimes cause hyperhidrosis, most cases occur in people who are otherwise healthy. Heat and emotions may trigger hyperhidrosis in some, but many who suffer from hyperhidrosis sweat nearly all their waking hours, regardless of their mood or the weather.
Everyone sweats when it’s hot outside, but people who have hyperhidrosis experience excessive sweating to the point that moisture may literally drip from their hands. Hyperhidrosis causes them to sweat profusely even without cause.
Normally, your sweat glands produce perspiration that’s carried to the skin’s surface when the air temperature rises, you develop a fever, you’re exercising, or you’re feeling anxious, nervous, or under stress. When those factors are no longer an issue, the nerves that signal to sweat are put on hold.
For the 1% to 2% of the population who have hyperhidrosis, however, the sweat glands don’t shut off. They sweat even when the circumstances don’t call for it: when they’re in air conditioning, or while they’re sitting and watching television. Some people even tell their doctors that they sweat in a swimming pool.
The causes of hyperhidrosis depend on the type of sweating occurring. Most times, excessive sweating is harmless. In some cases, doctors don’t know why people sweat too much. In other cases, the causes of hyperhidrosis may be a medical condition that you don’t want to miss.
What is the Treatment for Hyperhidrosis?
Through a systematic evaluation of causes and triggers of hyperhidrosis, followed by a judicious, stepwise approach to treatment, many people with this annoying disorder can sometimes achieve good results and improved quality of life.
The approach to treating excessive sweating generally proceeds as follows:
Over-the-counter antiperspirants: containing a low dose of metal salt (usually aluminum) are usually tried first because they are readily available. Antiperspirants containing aluminum chloride (for example Certain Dri) may be more effective when other antiperspirants have failed.
Prescription-strength antiperspirants: which contain aluminum chloride hexahydrate.
Iontophoresis: a device which passes ionized tap water through the skin using direct electricity.
Oral medications: Anticholinergics reduce sweating.
Botox (botulinum toxin): has been approved in the U.S. by the FDA for treating excessive axillary (underarm) sweating.
miraDry: This technique uses microwave energy to permanently kill sweat glands.
Lasers: Lasers can target and kill the underarm sweat glands.
Surgery. A procedure called thoracic sympathectomy may be considered as a last resort.
Aluminum Chloride Hexahydrate and Excessive Sweating
When regular antiperspirants fail to treat excessive sweating, most doctors start by recommending aluminum chloride hexahydrate (Drysol), a prescription-strength version of aluminum chloride. It is applied just before bedtime 2 to 3 nights in a row, then roughly once a week thereafter to maintain improvement. Use as directed by your doctor.This treatment works reasonably well for many patients whose problem is excessive underarm sweating, but it is not satisfactory for most of those with palm and sole sweating.
The main side effect of Drysol is irritation, which can sometimes, but not always, be overcome by making sure the skin is dry before application and letting the medicine dry completely afterwards. Also, reducing the frequency of use or applying anti-inflammatory drugs, such as lotions containing a corticosteroid may help.
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