Excessive Sweating (Hyperhidrosis)
What Is Hyperhidrosis?
Hyperhidrosis, or excessive sweating, is a common
disorder which produces a lot of unhappiness. An
estimated 2-3% of Americans suffer from excessive
sweating of the underarms (axillary hyperhidrosis) or of
the palms and soles of the feet (palmoplantar
hyperhidrosis). Underarm problems tend to start in late
adolescence, while palm and sole sweating often begins
earlier, around the age 13 (on the average). Untreated,
these problems may continue throughout life.
Sweating is embarrassing, it stains clothes, ruins
romance, and 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 car steering wheel, or
shake hands.
What Causes Hyperhidrosis?
Although neurologic, endocrine, infectious, and other
systemic diseases can sometimes cause hyperhidrosis,
most cases occur in people who are otherwise healthy.
Heat and emotions may trigger hyperhidrosis in some,
but many who suffer from hyperhidrosis sweat nearly
all their waking hours, regardless of their mood or the
weather.
What is the Treatment for Hyperhidrosis?
Through a systematic evaluation of causes and triggers
of hyperhidrosis, followed by a judicious, stepwise
approach to treatment, many people with this annoying
disorder can sometimes achieve good results and
improved quality of life.
The approach to treating excessive sweating generally
proceeds as follows:
Over-the-counter antiperspirants containing a low dose
of metal salt (usually aluminum) are usually tried first
because they are readily available. Antiperspirants
containing aluminum chloride (for example Certain Dri)
may be more effective when other antiperspirants have
failed.
Prescription strength antiperspirants, which
contain aluminum chloride hexahydrate.
Iontophoresis, a device which passes ionized tap
water through the skin using direct electricity.
Oral medications, Anticholinergics reduce
sweating.
Botox (botulinum toxin)-A, has been approved in
the U.S. by the FDA for treating excessive axillary
(underarm) sweating.
Surgery. A procedure called thoracic
sympathectomy may be considered as a last
resort.
Aluminum Chloride Hexahydrate and Excessive
Sweating
When regular antiperspirants fail to treat excessive
sweating, most doctors start by recommending
aluminum chloride hexahydrate (Drysol), a
prescription-strength version of aluminum
chloride. It is applied just before bedtime 2 to 3
nights in a row, then roughly once a week
thereafter to maintain improvement. Use as
directed by your doctor.This treatment works
reasonably well for many patients whose problem
is excessive underarm sweating, but it is not
satisfactory for most of those with palm and sole
sweating.
The main side effect of Drysol is irritation, which can
sometimes, but not always, be overcome by making sure
the skin is dry before application and letting the
medicine dry completely afterwards. Also, reducing the
frequency of use or applying anti-inflammatory drugs,
such as lotions containing a corticosteroid may help.
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