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Hyperhidrosis

From Greek: hidros - sweat
Commonly: excessive sweating
German: Hyperhidrose

1 Definition

The term hyperhidrosis describes a unphysiologically strong secretion of sweat.

The contrary of hyperhidrosis is anhydrosis.

2 The physiology of sweating

In order to keep up vital body functions (eg. circulation, respiration, digestion) you need to permanently produce energy from nutrients. This produces heat. This combustion heat is given off partly by thermal radiation, but mainly by sweating. So, sweating is vital in the framework of thermoregulation.

Sweat is produced in the perspiratory glands. There are two kinds of glands:

  • eccrine perspiratory glands, around 2 to 3 million, distributed over the body. These glands exists from birth on.
  • apocrine perspiratory glands; these glands develop just in puberty and are located at the base of a hair, predominantly in the axilla and genital area, but also in the face.

Fresh sweat is odorless. The characteristic perspiration odor is caused by skin bacteria that can multiply well in warm and humid areas, especially in the axilla. Different species of skin bacteria and the secretion of hormonal degradation products cause the perspiration of women and men to have different odors. Its importance as pheromone is controversial.

The produced quantity of sweat does not only depend on outside temperature and physical activity, but also on emotional factors. Fear, pain and sexual arousal increase the apocrine perspiration. The controlling hormone here is mainly adrenaline. Since adrenaline also has a vasoconstrictive effect, the skin circulation is decreased.

3 Classification

Hyperhidrosis can be classified according to various systems:

3.1 ...according to localization

  • Local or focal hyperhidrosis: Increased perspiration only in certain regions of the body (eg. axilla, hands, feet)
  • Generalized hyperhidrosis: Increased perspiration over the whole body.
  • Hemihyperhidrosis: increased perspiration that affects only one half of the body or of the face.

3.2 ...according to cause

  • Primary hyperhidrosis: Increased perspiration without tangible cause.
  • Secondary hyperhidrosis: Increased perspiration as concomitant symptom of an underlying disorder

A special variant of hyperhidrosis with particularly strong odor secretion is bromhidrosis.

4 Etiology

In primary hyperhidrosis, the exact causes cannot be found, however, it often is triggered by the same factors as physiological perspiration. But the threshold stimulation needed is much lower. Possible triggers are:

Secondary hyperhidrosis occurs as concomitant symptom in numerous internal and neurological disorders, such as:

5 Symptoms

In the evaluation of hyperhidrosis, you have to consider that the transition from normal to increased perspiration are fluid. The individual extend and the psychological strain can differ greatly. Hyperhidrosis can manifest discretely as an uncomfortable wet sensation, or by noticeable moist sweating with spots on the clothes.

6 Therapy

Secondary hyperhidrosis is treated by treating the underlying disease.

With primary hyperhidrosis, you have the following options:

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