Hyperhidrosis (Axillary)

What is Hyperhidrosis?

Hyperhidrosis is excessive sweating. Sweating is one of the most important ways in which the body loses heat, however, people with hyperhidrosis produce sweat in amounts far greater than needed to control their temperature. It is thought that about 0.5% of the population (or about one person in 200) has some form of hyperhidrosis. Despite 0.5% of population having hyperhidorsis, there are no nationally agreed guidelines.

There are two main types of hyperhidrosis. The more common type is focal hyperhidrosis which can affect the armpits, hands, feet or face. Generalised hyperhidrosis is less common, affecting the whole body and usually caused by another illness such as infection, diabetes or hyperthyroidism. When the illness is treated, the excessive sweating usually stops. Cause of focal hyperhidrosis

Sweating is controlled by emotions through the limbic system and the thermo-regulatory centre in the Hypothalamus. These affect the post-ganglionic sympathetic outflow of the para-spinal sympathetic chain. While the definitve cause of this condition is yet to be elucidated, most evidence points to a hyperactive autonomic system.

How is Hyperhidrosis treated?

Cool clothing
Avoiding certain foods which may trigger sweating
Reducing stress, tension or anxiety
Increased attention to personal hygiene

Treatments:

1. Aluminium chloride is the active ingredient of some roll-on or aerosol anti-perspirants. It is used in stronger solutions to treat hyperhidrosis. The effects last only for 48 hours.

2. Iontophoresis is the passage of a weak electric current through a water bath. The area affected by sweating is immersed in the water and electrically charged particles clock the activity of sweat glands. When effective, this lasts for three-four days but can become longer with repeated use.

3. There is a variety of drug treatment available. Some of these affect the body's entire nervous system and side effects such as a dry mouth, drowsiness and constipation can be troublesome. Where sweating is made worse by stress or anxiety, other drugs (beta blockers) may be used with less troublesome side effects.

4. Injections of botulinum toxin (type A) into the skin has been shown to be a very effective treatment for axillary (armpit) hyperhidrosis. Effects start within the first week after treatment and last for an average of seven months before further injections are required. Side effects are rarely troublesome.

5. Surgery can provide a permanent solution but the side effects can be serious. Surgery is usually considered when other methods of treatment have not worked.

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