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Causes and Symptoms of Excessive Sweating (Hyperhidrosis)
Author: Rafael Reisfeld

Hyperhidrosis Symptoms
While doctors don't know why excessive sweating starts, the most likely cause is a genetic one. Medical Scientists have successfully linked it to over-activity in the sympathetic nervous system. In cases of palmar hyperhidrosis (hand sweating) the responsible sympathetic ganglia that receive the wrong signal for that abnormal activity are located within the upper part of the chest cavity. In cases of plantar hyperhidrosis (foot sweating) the responsible sympathetic ganglia that receive the wrong signal are located within a section of the lumbar sympathetic chain. This is a somewhat simplified way of explaining the complex anatomical – neurological basis for excessive local hyperhidrosis (Hands, Feet & Armpit).

Further explanation of the problem can be divided into two categories:

  • Generalized hyperhidrosis - Over the entire body.
  • Focal (Localized) hyperhidrosis - Focused in one area.

Generalized hyperhidrosis
In cases with generalized hyperhidrosis excessive sweating can appear in most parts of the body. It can happen on the face, trunk and extremities. In those cases most of the patients do have some other systemic problems such as obesity, febrile illnesses or some sort of neoplastic disease (cancers) or some endocrinological disorders (thyroid glands, etc). A search for a specific reason to excessive sweating in general can be long. A cause cannot be found in every case and then the diagnosis of idiopathic hyperhidrosis can be applied to those cases. Idiopathic meaning "unknown." Cases of generalized hyperhidrosis usually appear in the adult population where cases of focal hyperhidrosis (hands, feet, armpits) usually start at a younger age. It is not uncommon to hear mothers call about their infants who suffer from excessive sweating. Obviously this is more bothersome to the parents than the child at that time. It is usually later in life, when the child has more social and functional needs such as school, that hyperhidrosis can become a serious and bothersome issue.

Another common situation that is asked about very often is the presentation of upper body sweating in elderly patients especially elderly women. This could present a unique situation where aging, hormonal changes, weight and lack of activity can contribute to this particular type of sweating. Even though it is a common question asked by those women a specific cause cannot be identified and as a result an effective treatment is not always easy to find.

Focal Hyperhidrosis
In focal hyperhidrosis there are specific sites with excessive sweating. The most common areas of the body are the hands, armpit and feet. In these cases of focal hyperhidrosis the most likely explanation is a genetic trait. We know that in most studies a genetic connection was shown in about 50% to 60% of the cases. Even though the genetic connection is very well established genetic manipulation for the purpose of treatment is still a very long ways off. Dr. Reisfeld believes one day this will be the key element in the treatment of focal hyperhidrosis.

This sympathetic chain controls the glands, known as the apocrine and eccrine glands, responsible for perspiration throughout the entire body. The eccrine sweat glands are mainly concentrated in the palms of the hands and soles of the feet. In most cases, the hands and feet are affected. To a lesser degree, the face and armpit (axillae) regions are affected. Another manifestation of the hyperactive sympathetic activity is facial blushing.

It used to be a common thought that excessive hand sweating is caused by over activity of the thyroid gland but over the years it was proven not to be the case. Another thought was that patients who suffered from anxiety problems would have excessive hand sweating. This was also proven to be wrong as patients can have severe palmar hyperhidrosis (hand sweating) even in the most relaxing moments of their life. Having said that it is still true that anxiety and or socially unpleasant situations can add to this just as they would affect a person without hyperhidrosis because of the secretion of sympathetic like materials/hormones (mediators) from different organs in the body.

Sometimes people sweat heavily because of other illnesses such as hyperthyroidism, psychiatric disorders, menopause and obesity. These causes must first be ruled out before Primary Hyperhidrosis can be diagnosed. Dr. Reisfeld speaks with potential candidates for the procedure over the phone or in person to review their condition and advise them of their best options.

Excessive Sweating Symptoms:
Sweat can occur in many different areas on the body. Most commonly, focal hyperhidrosis occurs on the palms of the hands. In such cases, this condition is known as Palmar Hyperhidrosis. But hyperhidrosis is not just limited to the hands, it can also occur on the face, the soles of the feet (plantar), and in the armpits (axillae).

Regardless of where it occurs, excessive sweating presents an incredible problem to those living with the condition. When the act of shaking hands presents a problem, business and day-to-day life can become very uncomfortable. Many patients report that they are even embarrassed to hold the hands of those they love and those they are closest to. Some patients report that the sweat prevents them from being as sociable as they would like to be, as they are forced to hide in the shadow of hyperhidrosis. Other problems occur such as smeared ink when writing or an inability to use electronic devices such as keyboards and computers. Driving with excessive hand sweating can become hazardous. Hyperhidrosis can extremely affect people socially and functionally in their everyday lives. Thankfully, there is a permanent surgical solution for the condition.

Hyperhidrosis is not a temporary condition. Many people who suffer from it have suffered for many years, usually since childhood. Also, whether living in a hot or cold climate, patients who experience hyperhidrosis experience constant sweating. Very infrequently one can hear stories of patients who claim that their excessive hand sweating disappeared with time. Indeed this can happen on rare occasions. Usually the second generation of those who are affected have less of a chance to experience cessation of their excessive sweating.

Other topics of interest:

Do you have any sweat related questions that were not answered here? Would you like to speak with Dr. Reisfeld to answer those questions? To learn more about what we can do for you, contact The Center for Hyperhidrosis by contacting our office.

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