Excessive Sweating

Excessive Sweating :Known medically as Hyperhidrosis :About 1% and some say 2% of people all over the world complain of excessive sweating , and because this is a high percentage , we will talk about this problem , its presentation , causes and treatment.


Presentation : The typical presentation is an excessive sweating that commonly affects : hands "palmer" , feet "planter" and armpits "axillary" and less commonly face , forehead and other areas. It could occur without any identified reason (such as heat , hyperactivity , anxiety or emotional stress).
Sweating usually subsides during sleeping and comes back again after waking up .

Sweating is embarrassing, it stains clothes, and it complicates business and social interactions. Severe cases can have serious practical consequences as well, making it hard for people who suffer from it to hold a pen, grip a steering wheel, or shake hands.

Causes :
Many diseases can cause excessive sweating , such as hyperthyroidism , but patients in this case have other complaints for example : heat intolerance , weight loss , diarrhea ... etc.
TB and Malignancies cause night sweating not day sweating. Emotional stress can trigger sweating but it subsides once the cause of the stress goes.


In general most cases of occur in people who are otherwise healthy , and it tends to affect more than one member of the same family which means that hereditary factors have a role.


Mechanism :As we know we have in our bodies the autonomous nervous system. This system on which we have no control affects blood pressure, heart rate, anxiety level and many other functions.. it's divided into 2 parts : the sympathatic "that trigger sweating" and the parasympathetic.
In hyperhidrosis patient has over activation of the Sypmathatic nervous system.


Treatment :1) Local treatment with Aluminium chloride containing antiperspirants such as ANHYDROL solution : it's very effective mainly in the axillary area . You have to use it for 4 times in the first week "once per day" to notice the results , then use it 2 times in the second week and 1 time for every week later.
Aluminium chloride causes sever skin irritation so to avoid this side effect you have to ensure that your armpits are totally dry before using it, then apply a very thin layer of the agent over the targeted area "armpit" and keep your arms raised or put your hands behind your head and lie on the bed until it dries completely "it takes 5 - 10 minutes" .
It's advised to use it just before going to bed because the parasympathetic system takes the lead over the sympathetic system during sleeping and there will be no sweating and no skin irritation , then washing it after waking up by taking a hot bath.

2) Injections of botulinum toxin type A, under the brand names Botox or Dysport, are used to disable the sweat glands.The effects may persist from four to nine months depending on the site of injection. This procedure has been approved by the U.S. Food and Drug Administration (FDA) to treat underarm sweating. It's also most effective in the axillary area.

3) Surgical procedures

Sweat gland removal or destruction is one surgical option available for axillary hyperhidrosis. There are multiple methods for sweat gland removal or destruction such as sweat gland suction, retrodermal currettage, and axillary liposuction, Vaser, or Laser Sweat Ablation. Sweat gland suction is a technique adapted from liposuction, in which approximately 30% of the sweat glands are removed, with a proportionate reduction in sweat.

There are other choices of treatment but less effective.