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What is hyperhidrosis
Hyperhidrosis is excessive sweating, in which the sweat glands produce an abnormal amount of secretion. Hyperhidrosis represents increased sweating of certain body areas, resulting from augmented secretion of the sweat glands. Excessive sweating is usually associated with hyperactivity of these glands due to nervous overstimulation linked to emotional stress or tension, the action of pharmacological agents, or exposure to temperature changes. Although the hypothalamus normally regulates body temperature, in hyperhidrosis the sweat glands of the palms, soles, axillae, and craniofacial region are particularly sensitive to stimuli. Excessive sweating affects 1–3% of the population, with nearly half of cases being hereditary.
Types of hyperhidrosis
Two types of hyperhidrosis are distinguished: primary and secondary.
Primary (idiopathic). It manifests in specific body regions: palms, soles, and axillae. It occurs in approximately 1–2% of individuals during childhood or adolescence. Determining the cause of this condition is difficult; thus, researchers consider it an individual characteristic. In primary hyperhidrosis, sweating occurs during the day, while at night it remains within normal limits.
Secondary. This represents excessive sweating caused by another condition or pathology. Sweating may be generalized or localized to certain areas. Most often, it develops in the context of the following health issues:
Diabetes mellitus. Elevated blood glucose damages nerve fibers, leading to autonomic neuropathy, which impairs temperature receptor sensitivity in the skin.
Obesity. Metabolic disturbances occur, followed by impaired sweat gland function.
Hyperthyroidism. Excessive thyroid hormone synthesis enhances metabolic processes and sweat gland activity.
Onset of menopause. “Hot flashes” are a typical manifestation of climacteric changes and mark the beginning of hormonal restructuring in the female body.
Tuberculosis. Characterized by fever up to 39 °C or higher, with night sweats being a very common manifestation.
Oncological diseases. Malignancies induce changes in the lymphatic system, resulting in increased sweating, sometimes accompanied by pain.
Nervous system disorders. Dysfunction of the sympathetic and parasympathetic nervous systems may lead to hyperhidrosis.
Symptoms and diagnosis
Hyperhidrosis creates favorable conditions for fungal and purulent bacterial infections, leading to skin maceration and altered acidity.
This condition may be accompanied by the following symptoms:
excessive sweating,
strong odor,
sweat capable of staining,
possible pain in sweating areas,
redness and swelling.
The diagnosis of “hyperhidrosis” is established by a dermatologist based on patient complaints, examination, and laboratory testing. First, it is necessary to identify the underlying condition provoking excessive sweating.
Special diagnostic tests include:
Minor’s test. Used to determine the area and intensity of sweating. The examined skin is dried, treated with an aqueous iodine solution, and dusted with starch. Areas of sweat localization become dark blue, with their borders marked.
Gravimetric method. A piece of filter paper is weighed before and after contact with the test area.
Chromatographic method. Based on determination of the spectrum of unsaturated fatty acids in sweat gland secretion. A sample is taken from the area of active sweating and analyzed in the laboratory. This method helps determine the type of hyperhidrosis and the treatment strategy.
Additional diagnostic methods include:
blood tests (complete blood count, glucose, thyroid hormones),
urinalysis,
chest X-ray and sputum analysis (to exclude tuberculosis),
Wassermann reaction (syphilis test),
head CT scan.
Treatment methods
For the primary form, general strengthening therapy is prescribed.
For the secondary form, a highly effective treatment is the injection of botulinum toxin type A into the affected areas. This is a laboratory-purified neurotoxin. Prior to the procedure, a consultation with a cosmetologist, physical examination, and medical history are required. The affected area is cleaned, marked, and injected, followed by cooling and application of a post-injection cream. Administration of botulinum toxin type A is considered the most modern and effective treatment for secondary hyperhidrosis.
Additionally, the use of disinfecting wipes and special antiperspirants to dry problem areas is recommended as preventive and supportive measures.
Advantages of hyperhidrosis treatment with injections
Botulinum toxin is highly effective in treating excessive sweating, as it temporarily blocks the activity of sweat glands. Among its major advantages is the absence of systemic side effects. Injections are administered with very fine subcutaneous needles, making the procedure nearly painless. A topical anesthetic cream may be applied to reduce discomfort. Each session lasts less than an hour, so treatment can be carried out without interrupting daily activities.
Usually, within one week, sweating significantly decreases, and by about 15 days it stops completely. The effect of botulinum toxin therapy lasts from six months to one year. Botulinum toxin is gradually excreted in urine and leaves no toxic residues in the liver.
Botulinum toxin injections for hyperhidrosis should be repeated annually.
Hyperhidrosis is excessive sweating, in which the sweat glands produce an abnormal amount of secretion. Hyperhidrosis represents increased sweating of certain body areas, resulting from augmented secretion of the sweat glands. Excessive sweating is usually associated with hyperactivity of these glands due to nervous overstimulation linked to emotional stress or tension, the action of pharmacological agents, or exposure to temperature changes. Although the hypothalamus normally regulates body temperature, in hyperhidrosis the sweat glands of the palms, soles, axillae, and craniofacial region are particularly sensitive to stimuli. Excessive sweating affects 1–3% of the population, with nearly half of cases being hereditary.
Types of hyperhidrosis
Two types of hyperhidrosis are distinguished: primary and secondary.
Primary (idiopathic). It manifests in specific body regions: palms, soles, and axillae. It occurs in approximately 1–2% of individuals during childhood or adolescence. Determining the cause of this condition is difficult; thus, researchers consider it an individual characteristic. In primary hyperhidrosis, sweating occurs during the day, while at night it remains within normal limits.
Secondary. This represents excessive sweating caused by another condition or pathology. Sweating may be generalized or localized to certain areas. Most often, it develops in the context of the following health issues:
Diabetes mellitus. Elevated blood glucose damages nerve fibers, leading to autonomic neuropathy, which impairs temperature receptor sensitivity in the skin.
Obesity. Metabolic disturbances occur, followed by impaired sweat gland function.
Hyperthyroidism. Excessive thyroid hormone synthesis enhances metabolic processes and sweat gland activity.
Onset of menopause. “Hot flashes” are a typical manifestation of climacteric changes and mark the beginning of hormonal restructuring in the female body.
Tuberculosis. Characterized by fever up to 39 °C or higher, with night sweats being a very common manifestation.
Oncological diseases. Malignancies induce changes in the lymphatic system, resulting in increased sweating, sometimes accompanied by pain.
Nervous system disorders. Dysfunction of the sympathetic and parasympathetic nervous systems may lead to hyperhidrosis.
Symptoms and diagnosis
Hyperhidrosis creates favorable conditions for fungal and purulent bacterial infections, leading to skin maceration and altered acidity.
This condition may be accompanied by the following symptoms:
excessive sweating,
strong odor,
sweat capable of staining,
possible pain in sweating areas,
redness and swelling.
The diagnosis of “hyperhidrosis” is established by a dermatologist based on patient complaints, examination, and laboratory testing. First, it is necessary to identify the underlying condition provoking excessive sweating.
Special diagnostic tests include:
Minor’s test. Used to determine the area and intensity of sweating. The examined skin is dried, treated with an aqueous iodine solution, and dusted with starch. Areas of sweat localization become dark blue, with their borders marked.
Gravimetric method. A piece of filter paper is weighed before and after contact with the test area.
Chromatographic method. Based on determination of the spectrum of unsaturated fatty acids in sweat gland secretion. A sample is taken from the area of active sweating and analyzed in the laboratory. This method helps determine the type of hyperhidrosis and the treatment strategy.
Additional diagnostic methods include:
blood tests (complete blood count, glucose, thyroid hormones),
urinalysis,
chest X-ray and sputum analysis (to exclude tuberculosis),
Wassermann reaction (syphilis test),
head CT scan.
Treatment methods
For the primary form, general strengthening therapy is prescribed.
For the secondary form, a highly effective treatment is the injection of botulinum toxin type A into the affected areas. This is a laboratory-purified neurotoxin. Prior to the procedure, a consultation with a cosmetologist, physical examination, and medical history are required. The affected area is cleaned, marked, and injected, followed by cooling and application of a post-injection cream. Administration of botulinum toxin type A is considered the most modern and effective treatment for secondary hyperhidrosis.
Additionally, the use of disinfecting wipes and special antiperspirants to dry problem areas is recommended as preventive and supportive measures.
Advantages of hyperhidrosis treatment with injections
Botulinum toxin is highly effective in treating excessive sweating, as it temporarily blocks the activity of sweat glands. Among its major advantages is the absence of systemic side effects. Injections are administered with very fine subcutaneous needles, making the procedure nearly painless. A topical anesthetic cream may be applied to reduce discomfort. Each session lasts less than an hour, so treatment can be carried out without interrupting daily activities.
Usually, within one week, sweating significantly decreases, and by about 15 days it stops completely. The effect of botulinum toxin therapy lasts from six months to one year. Botulinum toxin is gradually excreted in urine and leaves no toxic residues in the liver.
Botulinum toxin injections for hyperhidrosis should be repeated annually.
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