Don't Sweat It

Do you constantly sweat?

Are sweaty palms and excessive perspiration part of your everyday life?

Does the problem get worse on special occasions ? Like a first date, job interview or night out with friends?

Are routine tasks like shaking hands, holding hands and dancing tormenting?

Although not life threatening, excessive sweating or Hyperhidrosis is far from trivial.It ia a common skin condition that affects 3% of the population.Hyperhidrosis takes a toll on one's quality of life and the ability to carry out simple chores.People with this condition may have to change their clothing a few times a day.

The cloud that is Hyperhidrosis does have a silver lining.It can be treated.

Sweating is the body's way of regulating its temperature.The body has between two and four million eccrine and apocrine sweat glands.Apocrine sweat glands play a role in scent and body odour. The eccrine glands' main function is thermoregulation; a process that cools the body.

Eccrine sweat glands are concentrated on the palms, soles, axillae(underarms) and scalp.Eccrine sweat glands can overact to stimulation by the production of a chemical messanger known as acrtylcholine, and produce more sweat than necessaary.

The two main types of hyperhidrosis are Primary Focal Hyperhidrosis and Secondary Generalized Hyperhidrosis.

Primary Focal Hyperhidrosis often begins in childhood and adolescence and affects the feet, hands, underarms, head and face.This type of hyperhidrosis may be hereditary.

Secondary Generalized Hyperhidrosis may be caused by a medical condition or as a side effect of medication.Medical conditions include infection, an overactive thyroid gland, menopause, obesity, diabetes, gout, heart failure and stroke.Medications including certain antidepressants and antihypertensives(blood pressure medication) can also cause this type of sweating which involves large areas of the body.

How is Hyperhidrosis treated?

The first line of treatment is antiperspirants.They are the least invasive,inexpensive and easy to use.Sweat dissolves the antiperspirant particles and pulls them into the sweat pores.Plugs are then formed just below the surface of the skin in the sweat duct.When the sweat duct is plugged, a feedback mechanism stops the flow of sweat.

In cases where antiperspirants do not produce the desired results, more robust treatment options are available.These include:

• IONTOPHORESIS - This is especially useful for hyperhidrosis of the palms and soles.The patient immerses their hands or feet in a shallow pan filled with water and low-voltage current is sent into the water.This temporarily shuts off the sweat glands.It takes about 8-10 treatments on alternate days to decrease sweat production.
• BOTULINUM TOXIN TYPE A- Botulinum Toxin Type A may be injected into the palms, soles or underarms. This is a protein with the ability to temporarily block the seceretion of acetylcholine that activates the sweat glands.Botulinum toxin "turns off" sweating at the area where it has been injected.This treatment is effective and may last for up to 8 months.Repeated injection is necessary to maintain the effect.
• ORAL MEDICATION - The most commonly used medications belong to the anticholinergic group, which work by blocking the transmission of acetylcholine to the receptors on the glands.Bacause similiar receptors are located in multiple areas of the body, there may be a range of side effects from these medications such as: dry mouth, constipation, impaired taste, blurred vision, urinary retention, and heart palpitations.
• SURGERY-mainly for underarm hyperhidrosis, the sweat glands are removed by various methods like surgical excision, liposuction and curettage. Symphatectomy is another surgical procedure performed under general anaesthesia.The nerve pathway associated with the overactive sweat glands is destroyed.A common side effect of this procedure is "compensatory sweating" in different parts of the body like back, chest, face, legs and buttocks.

A relatively new therapy that has emerged is the MiraDry® device.It uses microwave energy to destroy the eccrine sweat glands in the axillae.Other emerging therapies that may prove beneficial in the future include laser, ultrasound and devices that utilize radiofrequency.

In summary, hyperhidrosis is a physically, emotionally and socially disabling condition that has a profound negative effect on the sufferer's quality of life.A lack of awareness about the condition and treatment options along with the associated shame means that the problem is often underreported and hence undertreated.Treatment of patients with hyperhidrosis resultd in a marked improvement of the patients'quality of life and confidence.There is no need to suffer in silence anymore!