Primary and secondary hyperhidrosis
Primary hyperhidrosis is an independent condition without a disease-cause. It affects symmetrical areas: palms, soles, armpits, less often the face and scalp. It begins more often in childhood or adolescence, intensifies with excitement and almost always stops in sleep. It is often observed in several family members. Secondary hyperhidrosis develops at any age, covers the entire body, worries at night and is associated with another cause - hormonal, infectious, neurological or drug. It is night sweats that serve as the main signal that you need to look for a disease.
- Primary - local, symmetrical, occurs during sleep
- Onset in adolescence, familial cases
- Secondary - throughout the body, including at night
- Secondary can appear at any age
- Division determines examination tactics
Possible causes of secondary sweating
The list of causes is wide, and most of them are identified during routine examination. Often this is an increased function of the thyroid gland, menopause, low blood sugar in people with diabetes, obesity. Profuse sweating occurs with infections, including tuberculosis, with diseases of the blood and lymphatic system, with anxiety disorders and sleep disorders. Drug sweating is distinguished separately: it is caused by some antidepressants, antipyretics, hormonal and antitumor drugs. A rare but important cause is a tumor of the adrenal gland, causing bouts of sweating with high blood pressure.
- Increased thyroid function
- Menopause and hormonal changes
- Hypoglycemia in diabetes mellitus
- Infections, including tuberculosis
- Diseases of the blood and lymphatic system
- Anxiety and sleep disorders
- Side effects of drugs
How does this affect life?
Primary hyperhidrosis rarely threatens health, but its impact on everyday life is underestimated. Wet palms make it difficult to work with papers, equipment, tools, or shake hands; stains on clothes force you to change your wardrobe and avoid light-colored fabrics. Constant skin moisture creates conditions for fungal and bacterial infections, especially on the feet, leading to diaper rash and unpleasant odor. A vicious circle is formed: a person is worried about sweating, and worry increases sweating. Therefore, the psychological side is also important in treatment.
- Difficulties in work and study
- Limitations in communication
- Fungal infections of feet and nails
- Diaper rash and skin irritation
- Unpleasant smell
- Anxiety that increases sweating
Survey
The doctor clarifies which areas sweat, whether there is symmetry, whether sweat occurs at night, at what age it bothers you, what medications the person takes and whether relatives have a similar problem. With a typical local picture from childhood, extensive examination is not required. If the sweat is widespread or nocturnal, tests are prescribed: thyroid-stimulating hormone, glucose, general blood test, inflammation indicators, and, if indicated, an examination for tuberculosis, X-ray or chest tomography. In case of attacks with high blood pressure, an adrenal tumor is excluded.
- Detailed questioning and inspection
- TSH and thyroid hormones
- Blood glucose
- Complete blood count and inflammation indicators
- Testing for tuberculosis for night sweats
- X-ray or CT scan of the chest if indicated
- Consultation with a neurologist and endocrinologist
Treatment
They start with simple measures: breathable clothing made from natural fabrics, daily hygiene, antiperspirants with aluminum salts, which are applied to dry skin at night. For sweating of the palms and feet, iontophoresis is effective - a course of procedures with a weak current. Botulinum toxin injections temporarily block signal transmission to the sweat glands and significantly reduce sweating in the armpits and palms; the effect lasts for several months. If the result is insufficient, the doctor may prescribe medications orally. Surgical methods are considered last because of the risk of compensatory sweating.
- Antiperspirants with aluminum salts at night
- Clothes and shoes made of breathable materials
- Iontophoresis for palms and feet
- Botulinum toxin injections
- Oral medications as prescribed by a doctor
- Working with anxiety, relaxation techniques
- Surgical treatment - only if everything else is ineffective