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1. What is hyperhidrosis
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| Hyperhidrosis is excessive sweating. Sweating is
one of the most important ways in which the body loses heat.
People with hyperhidrosis produce sweat in amounts far greater
than needed to control their temperature.
There are 2 main types of hyperhidrosis.
The most common type is focal hyperhidrosis. The excessive
sweating occurs in 30-40% of people in the armpits alone. In the
remainder the sweating occurs in the hands, face and feet. BOTOX
is recommended for the treatment of focal axillary hyperhidrosis.
If the hands are affected then thoracoscopic
sympathectomy should be considered.
Generalised hyperhidrosis affects the whole body. It is much
less common and is usually associated with obesity,
hyperthyroidism, infection or diabetes.
A less common form is gustatory hyperhidrosis when sweating
on the face is triggered by hot or spicy food.
People with hyperhidrosis produce a large volume of sweat.
This means the hands, feet, chest or armpits may be constantly
damp. This can cause embarrassment at work or socially, and it
may make normal everyday activities more difficult to carry out.
It is not true that hyperhidrosis causes body odour. The smell
that some people think is due to sweating is actually caused by
bacteria on the skin if the sweat remains on the skin for a long
time. Daily washing and clean clothes prevent the smell.
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2. How common is hyperhidrosis?
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| About 1 person in every 200 (0.5%) has some form
of hyperhidrosis. It usually starts during the teenage years or
early 20s. |
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3. What causes hyperhidrosis?
We do not know why some people and not others are affected.
About one third to half of people with hyperhidrosis have a
relative with the problem. There may be a genetic cause.
Many things can trigger normal sweating and the same do cause
hyperhidrosis. Examples are exercise, stress or anxiety,
alcohol, coffee, smoking, hot or spicy food and strong emotions.
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4. What can I do about hyperhidrosis?
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| Simple measures you can take are:
Cool clothing. Choose clothes made from natural fibres as
they absorb sweat. Consider having a change of clothing
available during the day.
Keep your work environment cool and well aired.
Avoid the foods and drinks that trigger sweating.
If stress causes your hyperhidrosis then think how you can
reduce those situations.
Body odour can be prevented by good personal hygiene (like
frequent showers).
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5. What treatments are available for hyperhidrosis?
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There are several treatments for hyperhidrosis:
Aluminium Chloride is the active ingredient of some anti-perspirants.
In strong solutions, it works well on sweating armpits. It lasts for
only 48 Hours but it is usually applied daily.
Iontophoresis is a technique that passes a weak electrical current
through a water bath. The area affected by sweating is immersed in the
water and electrically charged particles block the activity of sweat
glands. The effects last for 3-4 days and are best used on hands and
feet.
Relaxation, hypnosis, counselling or acupuncture can be helpful but
expensive. They are not generally available as an NHS treatment.
Drugs.
Antimuscarininc drugs reduce the activity of the nerves that supply
the sweat glands. The problem is they affect all the nerves in the body
and can cause many side effects like a dry mouth, drowsiness and
constipation.
Beta-blocker drugs can be used if the sweating is associated with
stress and anxiety.
BOTOX is a treatment given by injection into the skin.
Surgery
An operation can give a permanent solution but there are side-effects
and surgery should be reserved for a time when all other methods have
been unsuccessful.
Thoracoscopic sympathectomy can cure most
people with sweaty hands but only 80% with sweaty armpits.
Curettage involves removal of the sweat glands but the wounds can be
troublesome.
The area of sweating can be cut out but can cause large scars
6. What is BOTOX and how does it work?
Botox is a treatment given by injection into the skin. It is
recommended for the treatment of hyperhidrosis. For many years,
it has been used to treat muscle spasms affecting the eyes, face
and neck as well as children with cerebral palsy.
BOTOX is a very pure preparation of a protein botulinum
toxin, Type A, that has been obtained from the bacterium
Clostridium botulinum. When small doses are injected into the
skin, BOTOX blocks the actions of the nerves that supply sweat
glands (eccrine glands) and prevents them from making sweat.
BOTOX permanently blocks the nerve endings but ove 6 to 12
weeks, new nerves grow to replace them. This means the treatment
lasts for several months but eventually it wears off.
BOTOX does not affect the nerves that are sensitive to touch
or pain, but if it comes into contact with the nerves that
supply muscles it will stop them working too.
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