Hyperhidrosis | Doctors & information on excessive sweating

Leading Medicine Guide Editors
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Leading Medicine Guide Editors
Sweating is vital for humans. Among other things, it regulates body temperature. Excessive heat is dissipated from the inside of the body to the outside. Sweating is therefore basically normal. However, anyone who sweats a lot for no reason could be suffering from hyperhidrosis. This term is used to describe excessive sweating, which can have various causes. The treatment methods are also different, and even surgery may be necessary in extreme cases.
ICD codes for this diseases: R61

Article overview

Hyperhidrosis (ICD code: R61) is the term used to describe excessive sweating caused by a malfunction in sweat secretion. Anyone who does a lot of sport or otherwise exerts themselves physically will sweat more - a completely normal process. However, if this increased sweating occurs for no apparent reason, it is known as hyperhidrosis. Popular areas are, for example, the armpits, hands or feet. However, hyperhidrosis can also be noticeable on the face. This is unpleasant for those affected, as either clearly visible beads of sweat can form on the face or large patches of sweat can form on clothing.

Hyperhidrose: Starkes Schwitzen
© werayuth / Fotolia

Distinguishing the disease

As with many other diseases, a distinction is made between different forms:

Primary hyperhidrosis

The primary form is congenital, although the exact reasons for this have not yet been determined. In individual cases, however, it is possible that the increased sweating is caused by certain stimuli to the taste buds. This phenomenon occurs when you eat something very spicy. This is referred to as "gustatory stimuli".

Secondary hyperhidrosis

The secondary variant is usually the result of other factors that can cause excessive sweat production. These can be the side effects of certain medications, hormonal disorders or illnesses.

Diagnosis of hyperhidrosis

Not every increase in perspiration is pathological and results in hyperhidrosis. For this reason, the doctor will carry out a number of examinations to determine whether this is actually the case. For example, there is the so-called iodine strength test. This test can be used to narrow down the particularly severely affected areas, as the applied compound of iodine solution and starch powder turns brown if there is increased sweat production there.

In order to be able to speak of hyperhidrosis, doctors use certain guideline values. For example, it depends on how much sweat is produced in a certain period of time. The gravimetry test is used to find this out. A piece of paper is applied to the affected area of skin and removed again after a certain period of time. By comparing the weight of the paper before and after the measurement, the value can be determined.

Aufbau der Haut
© bilderzwerg / Fotolia

Causes of hyperhidrosis

The causes of primary hyperhidrosis cannot be precisely identified. Doctors assume that there is a certain predisposition. However, other reasons can also play a role in secondary hyperhidrosis. For example, the menopause can be a cause in women, as the hormone balance changes significantly. Circulatory disorders or chronic infections are also among the possible causes of hyperhidrosis. In extreme cases, malignant diseases such as lymphomas or malignancies can also be involved in the development of hyperhidrosis. Another reason: being overweight.

Treatment of hyperhidrosis

There are various ways and means of dealing with hyperhidrosis. If hyperhidrosis occurs more frequently in the armpit area, for example, you can try products such as antiperspirants. These are available as a spray or roller or are sold in cream form. Initially, they are applied daily. With long-term use, the frequency can later be reduced to once or twice a week. This is known as topical therapy.

There are also other variants. Treatment with a neurotoxin is used to reduce perspiration. The toxin is injected directly into the skin under the armpits. However, the results can vary greatly from patient to patient. This treatment falls under systemic denervation. Systemic therapy in turn relies on the use of psychotropic drugs. However, there are no reliable studies on this yet.

Behandlung bei Hyperhidrose
Dimid / Fotolia

Surgical methods can also be used to treat hyperhidrosis. The removal of areas of skin and sweat glands is no longer standard, as this can result in scarring and wound healing disorders. Other surgical methods include suction of the sweat glands (subcutaneous sweat gland suction curettage) and endoscopic transthoracic sympathectomy (ETS). However, due to possible complications such as compensatory sweating of other areas, this method is considered the final option if the other treatment methods are unsuccessful.

In addition, secondary hyperhidrosis requires treatment of underlying diseases. Anyone who sweats excessively due to being overweight can be helped by losing weight.

Possible forms of treatment:

  • Topical therapy
  • medication
  • surgery
  • For secondary hyperhidrosis: treatment of the underlying disease, reduction of excess weight

Prognosis for hyperhidrosis

The prognosis for this condition cannot be predicted across the board. It depends on the type of hyperhidrosis and its treatment. In rare cases, complications can occur, for example after surgery.
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