This document discusses hyperhydrosis, or excessive sweating. It defines hyperhydrosis and classifies it as either primary or secondary. Primary hyperhydrosis is associated with overactive sweat glands and often starts in childhood, while secondary is caused by other disorders. Causes mentioned include infections, obesity, and neurological issues. Diagnosis involves examining the patient's history and conducting sweat tests. Treatment options reviewed include topical antiperspirants, oral medications, iontophoresis, botulinum toxin injections, and surgery. The conclusion states that while embarrassing, hyperhydrosis is treatable and need not interfere significantly with one's quality of life.

1. HYPERHYDROSIS: CAUSES AND EFFECTS
MAY, 2012

2. TABLE OF CONTENT
 INTRODUCTION
 MECHANISM OF SWEATING
 DEFINITION
 CLASSIFICATION
 GENETICS
 CAUSES OF HYPERHYDROSIS
 SOCIAL EFFECT
 DIAGNOSIS
 TREATMENT
 CONCLUSION
 REFERENCES

3. INTRODUCTION
Sweating is a normal bodily function, but for
some people, it can be an embarrassing or
traumatic experience. They find themselves
changing clothes several times a day; they sweat
even when the weather is cool and when they are
not doing any strenuous work.
A number of these people do not realize they are
suffering from a disorder called hyperhydrosis,
or the condition can be treated.

4. The human body has about 2-5 million sweat
glands. The two main ones are; eccrine and
apocrine.
Eccrine Sweat Glands
Approximately 3 million
eccrine sweat glands
Secrete a clear, odorless fluid
Aid in regulating body
temperature
Areas of concentration:
Facial, plantar, and axillae
Apocrine Sweat Glands
Inactive until puberty
Produce thick fluid
Secretions come in contact
with bacteria on the skin
and produce characteristic
“body odor”
Found in axillary and
genital areas

5. MECHANISM OF SWEATING
Hypothalamus serve as the
thermoregulatory centre. It
controls both blood flow and
sweat output to the skin’s surface.
It is triggered by exercise,
temperature change, hormones
and stress.
Once trigger send message to the
spinal cord via neurotransmitters
(acetylcholine an catecholamine).
These neurotransmitters travel
down to ganglion to nerves
innervating the skin’s surface
Photo used with permission: The Whiteley
Clinic,2007

6. DEFINITION
Hyperhydrosis is a state of
excessive sweating of the
axilla, palms, soles, or face
that interferes with daily
activities. It is a condition
characterized by abnormally
increased perspiration in
excess of that required for
thermal regulation.
University of Miami Cosmetic Center, 2007

7. CLASSIFICATION
 Hyperhydrosis is classified into primary and
secondary types.
• Primary type: is associated with hyperactivity of the
sympathetic nervous system and can affect one or
several areas of the body (Strutton et al(2004),
Hornberger et. al (2004)), starts during childhood or
adolescence.
• Secondary type: is caused by other factors mainly
disorders.

8. GENETICS
 Hyperhydrosis appear to be inherited in a
dorminant fashion. It was thought to be autosomal
recessive genetic potential.
 A new UCLA (University of California-Los
Angeles) study published in the journal of vascular
surgery shows strong evidence that sweaty palms
syndrome is genetic (Champeau,2002).
It is caused by dorminant gene, indicating that
family members of those who have the disorder
may suffer from it more than has been previously
reported.

9. It has been found by the Department of Human
Genetics of UCLA that as much as 5% of the
population maybe at risk for some form of
hyperhydrosis, commonly known as sweaty ‘palms
syndrome’. Also according to research carried out
by UCLA, it was found that 65% of the patients
reported family recurrence of the disorder.

10. CAUSES
 Excessive sweating affects a great number and
there are various factors, this include;
 heart attack:
 Infections: eg T.B those living with it.
 Malignancy: eg Lymphoma
 Obesity
 Neurologic and endocrine disorder (eg
hyperthyroidism, diabetes)
 Others; (anxiety, hypoglycemia, menopause,
stress) (Clinic, 2011)

11. SOCIAL EFFECT
 This pose a lot of problem on individuals with
this disorder, such as;
 Low esteem and self confidence
 Embarrassment
 Rule out a career such as being a chef
 Workplace limitations such as low output, time
management, mental and interpersonal tasks.
 Social isolation
 Daily activities impacted

14. DIAGNOSIS
 Diagnosis involve two types i.e.
 Patient’s examination (include
history)(Hornberger et. al, 2004).
 Clinical test could include; i. Minor starch iodine
test: this delineates the area of sweating by use of
iodine solution in 3.5% of alcohol.
 ii Thermoregulatory sweat Test (TST): This
delineate the distribution response to a controlled
heat and humidity stimulus (Fealey, 1997).

15. Photo used with permission:
Eisenach, Atkinson, & Fealey, 2005

16. Treatment Option Review
HYPERHYDROSIS
AXILLARY PALMOPLANTAR
TOPICAL TREATMENT
BOTOX IONTOPHORESIS
IONTOPHORESIS
LOCAL EXCISION
BOTOX
ETS

17. TREATMENT
 Treatment depends on the outcome of the
diagnosis and the area affected.
 Topical treatment: use of Antiperspirants eg.
Aluminum chloride hexahydrate, block sweat pore
and reduce sweat, and also eliminate odour
 Systemic treatment: use of Anticholinergics, has
sympathetic inhibitory action.
 Iontophoresis: block sweat duct by directing a
mild electrical current through the skin
(Hornberger et. al, 2003).

18. Treatment cont’n
 Botox: use of Botulin toxin injection, inhibit nerve
impulse (Heckman, 2001, Naumann and Lowe,
2001, lowe et. al, 2003).
 Surgery: can be done for severe cases. It is of two
types; (i) Local Excision (ii) Endoscopic Thoracic
Sympathectomy.
 Endoscopic thoracic sympathectomy (ETS) is the
most effective of all. It also have some side effects.

19. CONCLUSION
Hyperhydrosis is an embarrassing disorder
that even today is misconceived as rare and
untreatable. It is aggravated during emotional
stress and the pathophysiological mechanism
appears to be hyperfunctioning of the gland.
Hyperhydrosis does not have to be a
problem of epic proportion. By acknowledging
the condition and by getting help from the right
sources, you can minimize its impact on the
quality of your life.

20. REFERENCES
 Fealey R.D (1997): Thermoregulatory sweat test. In: low PA,
ed. Clinical Autonomic Disorders. 2nd ed. Philadelphia,
pa: Lippincott-Raven; 245-257
 Hamm, H., Naumann, M., & Kowalski, J. (2006). Primary focal
hyperhydrosis: Disease characteristics and functional
impairment. Dermatology, 212. 343-353.
 Heckmann M, Ceballos-Baumann A.O, Plewig G (2001): Hyperhydrosis
study Group, Botulinum toxin A for axillary hyperhydrosis;
344:111- 117.
 Hornberger J, Grimes K, Naumann M, et al. (2004 Aug):Multi- Specialty
Working Group on the Recognition, Diagnosis, and Treatment of
Primary Focal Hyperhydrosis. Recognition, diagnosis, and
treatment of primary focal hyperhydrosis. JAmAcad Derm.
51(2):274-286,

21. •Mayo Clinic (2011): What causes excessive sweating, Article reviewed by
M.J Ingram,
•Rachel Champeau (2002); Evidence that 'sweaty palms' syndrome’
is genetic , UCLA issues of the journal of vascular surgery
• Reisfeld R, Berliner K (2008): Evidence based review of the
nonsurgical management of hyperhydrosis, thorac surg
clin 18(2); 157-166
• Strutton DR, Kowalski JW, Glaser DA, Stang PE.(2004 Aug.): US prevalence
of hyperhydrosis and impact on individuals with axillary
hyperhydrosis: results from a national survey. J Am Acad
Derm. 51(2):241-8,