Sweat is secreted by the sweat glands. The function of the sweat glands is largely influenced by hormonal factors and sweat secretion is controlled by the Autonomic Nervous System (ANS). Sweat secretion occurs in situations of high environmental conditions in order to maintain normal body temperature. Furthermore, sweating occurs in cases of high fever, when the body is trying to fight inflammation. The secretion of sweat is used to excrete various substances from the body, such as water, minerals, fatty acids, etc.
Hyperhidrosis refers to excessive production of sweat, above the normal amount required for thermoregulation of the body. Hyperhidrosis usually first appears during childhood or during adolescence. Although the phenomenon of excessive sweating can occur on any part of the body, it is most commonly found on the palms, soles and armpits.
According to the Dermatologist - Venereologist Dr. Amalia Tsiatoura, it is very important to distinguish between primary and secondary hyperhidrosis. Hyperhidrosis can be idiopathic, i.e. it does not have an exact cause, or it can be due to other diseases, such as metabolic disorders, fever or some therapeutic treatment, in which case it is called secondary hyperhidrosis. In primary hyperhidrosis, while the function of the sweat glands is normal, sweat excretion can be up to 20 times more than in a person without hyperhidrosis. As mentioned above, excessive sweat secretion is not due to morphological abnormalities of the sweat glands, but is associated with a dysfunction of the autonomic nervous system controlling the function of the sweat glands.
Hyperhidrosis has also gained the title of 'silent disability' because of the significant impact it has on the social life of the individual.
At Cosmetic Derma Medicine we apply the most appropriate methods of Hyperhidrosis Treatment, achieving excellent results against the abnormal sweat secretion responsible for the feeling of embarrassment and low self-esteem felt by most patients suffering from the disease.
Hyperhidrosis is divided into the following types:
Primary Hyperhidrosis:
It is due to hyperactivity of the sympathetic nervous system and may be associated with genetic predisposition and heredity. It has been shown that almost 40% of people with hyperhidrosis have a family history of hyperhidrosis. It usually starts in childhood - adolescence and can be aggravated in stressful situations.
Additional features of the disease are the symmetrical and bilateral location of sweating, the frequency of occurrence of more than once a week and its regression during sleep.
Primary hyperhidrosis is usually focal, i.e. it occurs in specific areas of the body. The onset of symptoms of primary hyperhidrosis is usually symmetrical. This means that it may not appear on one palm, or on one sole, but it appears bilaterally, i.e. it will affect both palms. Primary hyperhidrosis has an incidence of 2-3% in the population and occurs in both men and women. Characteristics of primary hyperhidrosis are:
- Symmetric and bilateral location
- At least one episode per week
- At least one occurrence per month and at least one month of sleep
- Positive family history
Secondary hyperhidrosis:
The disease is not hereditary, usually occurs after the 25th year of the individual's age, and is indicative of an underlying systemic disease due to endocrine, metabolic or other disorders (thyrotoxicosis, diabetes mellitus, hypoglycaemia, menopause, neoplasms and paraneoplastic manifestations such as Hodgkin's disease, myeloproliferative diseases, infections, cardiovascular events, antidepressants). Often, secondary hyperhidrosis is due to high consumption of alcohol, nicotine and caffeine. Often there is universal Hyperhidrosis all over the body even during the night. Characteristics of secondary hyperhidrosis:
- Absence of family history
- Presence of hyperhidrosis during night
- Generalised hyperhidrosis over the whole body
Also, depending on its location, hyperhidrosis can be classified as:
Focal Hyperhidrosis:
It is mainly Primary and is usually located on the palms, armpits, feet, face, back and chest. The incidence rate in the palms and soles is 60%, while in the axillae the rate is lower and reaches 40%. Focal facial hyperhidrosis is less common with an incidence rate of less than 10%.
The quantification of focal hyperhidrosis is more than 50 mg of sweat per minute from the axillary region and more than 30 mg per minute from the palms.
Generalized Hyperhidrosis:
Secondary Hyperhidrosis is usually generalized and occurs throughout the body. The causes of generalized hyperhidrosis are varied and include:
- Diabetes
- Arthritis
- Hyperthyroidism
- Alcoholism
- Obesity
- Cardiopulmonary problems
- Porphyria
- Infectious diseases such as tuberculosis, HIV
- Carcinoid syndrome
- Neoplastic haematological diseases
- Pheochromocytoma
The diagnosis of hyperhidrosis is very important for its further treatment as the Dermatologist - Venereologist Dr. Amalia Tsiatoura emphasizes. It is usually done clinically and by taking the patient's medical history. Important help is provided by the starch - iodine test. This is a test performed in both limb and axillary hyperhidrosis in which a 5% iodine solution is placed in the area to be examined and then starch in powder form. The areas of intense sweating are stained black and the problem area is thus accurately mapped.
The starch-iodine test is a test that helps us to diagnose the disease and to assess the severity of hyperhidrosis of the hands, feet and armpits. It is an important diagnostic test and helps us to plan the treatment plan for each case.
Hyperhidrosis causes several significant problems for those who suffer from it. It causes serious social and psychological problems. Excessive sweat secretion in the armpit makes people feel embarrassed and limits them as to the clothing they can wear. At the same time, patients with palmar hyperhidrosis or hand hyperhidrosis feel quite self-conscious when shaking hands and often have difficulty holding objects or performing simple tasks with their hands, such as using a computer. Hyperhidrosis of feet or legs can lead not only to odour but also to an increased likelihood of developing fungal infections in the lower limbs. In general, in addition to the practical problems caused, hyperhidrosis of the extremities (palms and feet) has a serious psychological impact on the patient and has a significant effect on the social, professional and personal life of these people, who often become isolated and depressed as a result of this problem. In addition to the impact on the social life and self-confidence of the individual, hyperhidrosis of the limbs and armpits causes dehydration and creates an increased risk of skin infections. In particular, patients with hyperhidrosis are much more likely to develop serious dermatological diseases, such as psoriasis (especially inverted axillary psoriasis for which primary axillary hyperhidrosis is a triggering factor), dysautonomia eczema, fungal infections and atopic dermatitis.
In addition to hand, foot and axillary hyperhidrosis, focal primary hyperhidrosis may also occur less frequently on the face, most commonly on the upper lip and forehead, causing embarrassment to the sufferers.
A more serious form of hyperhidrosis is the Secondary Hyperhidrosis, because in this case there is a risk that a more serious disease, such as an infection, hormonal imbalance or malignancy, may be underlying it. The symptoms of secondary hyperhidrosis are characterized by generalized excessive sweating throughout the body and may be accompanied by symptoms of the underlying disease that causes it. Especially patients who sweat excessively during the night should be examined by a specialist as this secondary hyperhidrosis may indicate more serious problems.
Hyperhidrosis Treatment is preceded by mapping the area with the starch-iodine test (Minor test). This is a qualitative assessment of Hyperhidrosis in which a 5% iodine solution is first applied to the problem area followed by the application of starch in powder form. After 5 minutes, the areas of excessive sweating show a dark violet to black colour and are visually assessed. Quantification of hyperhidrosis is performed by using and weighing a special absorbent paper (mg of sweat/5 minutes/area).
Laser Smartlipo (ND-Yag laser) is the most modern method for the treatment of axillary hyperhidrosis. After the starch-iodine diagnostic test and the local anesthesia administration, the laser's optical fiber is inserted under the epidermis. There, the specific wavelength of the Smartlipo Laser is selectively absorbed by the subcutaneous tissue of the armpit, inactivating the sweat glands of the armpit without affecting the surrounding tissues.
The procedure is simple, painless and guarantees permanent treatment of axillary hyperhidrosis, with efficacy rates of up to 85%. Hyperhidrosis Treatment must be performed by a Dermatologist and may require 1 to 2 sessions, lasting 40 minutes, to complete. It is the ideal treatment for those who want a permanent sweat reduction effect.
