Introduction:
Hyperhidrosis is a condition characterized by abnormally increased sweating, in excess of that required for regulation of body temperature. Although primarily a physical burden, hyperhidrosis can deteriorate quality of life from a psychological, emotional, and social perspective. Common places to sweat can include underarms, face, neck, back, and groin. It has been called by some 'the silent handicap'.
Both the words diaphoresis and hidrosis can mean either perspiration (in which sense they are synonymous with sweating) or excessive perspiration, in which case they refer to a specific, narrowly defined, clinical disorder.
Pathogenesis:
The cause of primary hyperhidrosis is unknown, although some physicians[who?] claim it is caused by over-activity of the sympathetic nervous system. Anxiety or excitement can exacerbate the condition for many sufferers. A common complaint of patients is they get nervous because they sweat, then sweat more because they are nervous. Other factors can play a role, including certain foods and drinks, nicotine, caffeine, and smells.
Similarly, secondary (generalized) hyperhidrosis has many causes including certain types of cancer, disturbances of the endocrine system, infections, and medications.
Epidemiology:
It is estimated that the incidence of focal hyperhidrosis may be as high as 2.8% of the population of the United States. It affects men and women equally, and most commonly occurs among people aged 25–64 years, though some may have been affected since early childhood. About 30–50% of people have another family member afflicted, implying a genetic predisposition.
Treatment:
There are several systemic, topical, surgical and electrical treatments available for hyperhidrosis. Topical agents for hyperhidrosis therapy include formaldehyde lotion, topical anticholinergics etc. These agents reduce perspiration by denaturing keratin, in turn occluding the pores of the sweat glands. They have a short-lasting effect.
Prognosis:
Hyperhidrosis can have physiological consequences such as cold and clammy hands, dehydration, and skin infections secondary to maceration of the skin. Hyperhidrosis can also have devastating emotional effects on one’s individual life.
Those with hyperhidrosis may have greater stress levels and more frequent depression.
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