Hyperhidrosis
is the condition characterized by abnormally increased
perspiration, in excess of that required for regulation
of body temperature.
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Hyperhidrosis can either
be generalized or localized to specific parts
of the body. Hands, feet, axillae, and the
groin area are among the most active regions
of perspiration due to the relatively high
concentration of sweat glands. |
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Primary hyperhidrosis
must be distinguished from secondary hyperhidrosis,
which can start at any point in life. The
latter form may be due to a disorder of the
thyroid or pituitary gland, diabetes mellitus,
tumors, gout, menopause or certain drugs.
Primary hyperhidrosis is estimated at around
1% of the population, afflicting women more. |
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The most common treatment
is aluminum chloride (hexahydrate) solution.
The most common brands are Drysol®, Maxim®,
Odaban®, and Driclor®. A 15% aluminum
chloride solution or higher usually takes
about a week of nightly use to stop the sweating,
with one or two nightly applications per week
to maintain the results. |
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Iontophoresis is often
effective in patients with hand or foot hyperhidrosis
who do not respond to aluminum chloride. The
hand or foot is placed in a device that has
two pails of water, each with a conductor.
The hand or foot acts like a conductor between
the positively- and negatively-charged pails.
As the low current passes through the area,
the minerals in the water clog the sweat glands,
limiting the amount of sweat released. Common
brands of tap water iontophoresis devices
are the Drionic®, Idrostar and MD-1A (RA
Fischer). There can be some mild pain, which
is usually limited to small wounds on the
skin. Over time the body adjusts to the procedure. |
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Oral medication: There
are several drugs available with varying degrees
of success. A class of anticholinergic drugs
are available that have shown to reduce hyperhidrosis.
Ditropan® (generic name: oxybutynin),
Robinul® (generic name: glycopyrrolate),
propantheline bromide (Probanthine®) and
benztropine (Cogentin®). Antidepressant
drugs, such as Zoloft®, may also help
to alleviate symptoms. |
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Botulinum toxin type
A (trademarked as Botox®): Injections
of the botulinum toxin are used to disable
the sweat glands. The effects can last from
4-9 months depending on the site of injections.
The procedure has been approved by the U.S.
Food and Drug Administration (FDA), and now
some insurance companies pay partially for
the treatments. |
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Percutaneous Sympathectomy:
a minimally invasive procedure in which the
sympathectomy nerve is blocked by an injection
of phenol. |
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Surgery (Endoscopic
Thoracic Sympathectomy or ETS): Select sympathetic
nerves or nerve ganglia in the chest are either
cut, burned or clamped to stop their transmission
of impulses. The procedure often causes anhidrosis
from the mid-chest upwards, a disturbing condition.
Another drawback is compensatory hyperhidrosis
(excessive sweating in a new area). |
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