Sweating can be pathological

Treatment options for pathological sweating

06/26/2013

Sweating is usually a natural function of the body to regulate body temperature. However, around 13 million people in the industrialized countries suffer from pathological sweating. The so-called hyperhidrosis can affect the entire body or only parts such as the hands, the soles of the feet and the armpits. However, with the right therapy measures, the sweat attacks can be handled well.

Sweating morbidly strains the psyche
Sweating is a natural process in the human body where excess heat is released and the temperature is regulated. In addition, sweat has a signal effect on the sense of smell. Since the sexual sweat also contains sexual perfumes, so-called pheromones, the secretion also plays an important role in sexual arousal and reproduction.

In pathological sweating the body forms - even in the resting state - significantly more sweat. The German Dermatological Society defines the formation of 100 milligrams of sweat within five minutes in an armpit as hyperhidrosis. However, there are different degrees of severity. Some sufferers only suffer from abnormally increased sweat production in certain areas of the body, such as the hands, soles and armpits. In other people, the entire body is affected. In addition to the physical symptoms, the patients also perceive the psychological stress as severely limiting their quality of life. Shaking hands, for example, can already be a problem with Sharm. Also for the wet spots on the T-shirt ashamed many sufferers.

According to a study by the Gesellschaft für Konsumforschung (GfK), about 13 million people in the industrialized countries suffer from pathological sweating, which usually begins at puberty or young adulthood. If left untreated, the disease usually lasts a lifetime.

Doctors distinguish between primary and secondary hyperhidrosis. While in primary hyperhidrosis the cause is still unknown, secondary hyperhidrosis is seen as a concomitant of another underlying disease, such as diabetes mellitus, congestive heart failure and thyroid hyperfunction. Although secondary hyperhidrosis is less common, it should be excluded during a medical examination.

Diagnosis of morbid sweating
Whether it is actually due to morbid sweating or the sweat production is still in the normal healthy range, a doctor can determine with various diagnostic procedures. On the one hand, quantitative methods can be used in which the occurring amount of sweat per unit of time is determined. Qualitative procedures are used to determine the areas of the body where there is increased perspiration. In addition, an iodine-starch test (Minor test) can be performed, which can also provide information on pathological sweating, by first an iodine solution and then starch is applied to the affected areas. If spots turn brown, it is excessive sweat production. Also, a gravimetric test that places a special paper on the affected area of ​​the skin may be helpful in the diagnosis. By means of differential measurement, the amount of sweat can then be determined and evaluated.
If there is primary hyperhidrosis, ie no causative underlying disease, therapy tailored to the patient should be used. This usually starts with the gentlest method.

Therapies for pathological sweating
As part of the GfK survey, 62 percent of respondents answered the question: „Did you know that sweating hidrosis can be pathological? "With one „Yes“. However, many people are unaware that there are various treatments available to control the pathological sweating.

In the therapy, a distinction is made according to the affected body regions. While in a generalized, whole-body primary hyperhidrosis usually only a so-called systemic treatment with antihidrotic or psychotropic drugs usually provides in tablet form relief, come in heavy sweating on the hands, soles or under the armpit other less stressful therapies in question. So the first remedy would be a treatment with antiperspirants from the pharmacy. Often aluminum chloride is included in the preparations, which are painted before going to bed on the affected parts of the body. After one week, the application can be reduced to once or twice a week until it is finally stopped. The goal is to permanently reduce sweat production.

The so-called iontophoresis can be used in pathological sweating of the hands and soles. Pulsating direct current in a water bath should reduce sweat production. If these methods have not led to the desired success, a so-called chemical denervation can be carried out, in which Botulinumtoxin (Botox) is injected into the affected skin and should inhibit sweating.

In addition, in severe cases - as a last resort - sweat glands can be surgically removed. Patients should always be examined and advised by a doctor. Often, even minor measures, such as the use of antiperspirants, significantly relieve patient discomfort and distress. (Ag)

Image: Maria Lanznaster