Hyperhidrosis, the medical term used to describe excessive sweating, can cause embarrassing problems that impact the quality of life and interfere with normal daily activities.
The excessive sweating can occur either only in some specific areas of the body, most often in the armpits, in the hands, in the feet or in the forehead (focal hyperhidrosis) or it can involve the entire body (generalized hyperhidrosis). It is estimated that almost 3% of the general population experience hyperhidrosis. Both sexes are equally affected. The condition most often occurs in people aged between 25-60 years. Focal hyperhidrosis is a disorder that occurs in otherwise healthy people, while generalized hyperhidrosis is usually associated with an underlying systemic disease.
Although the causes of this condition are not entirely understood, the disorder is assumed to be associated with dysfunction of the autonomic (both sympathetic and parasympathetic) nervous system, or the system that is responsible for sweat secretion from sweat glands. In addition, inherited factors are also assumed to be largely responsible for the condition as 50% of patients report similar symptoms among their family members.
Therapy
Regular hygienic practices should be adopted and care should be taken to wear clothes and footwear made primarily of natural fibers. In focal hyperhidrosis, the symptoms are tried to be alleviated by temporary blocking of the eccrine sweat gland ducts using a 15-25% water-based aluminum chloride – hexahydrate solution, a 2-5% tannic acid solution, and a 5-20% water-based or ethanol-based formalin solution. The therapy, however, most often produces only partial results.
Botulinum toxin A
Botulinum toxin A is the only effective therapy option for excessive sweating. In the treatment of hyperhidrosis, the toxin is injected intradermally into the previously marked areas of excessive sweating. The toxin inhibits acetylcholine release, and thus the release of sweat from the sweat glands.
A significant improvement occurs in 95% of patients after a week, and the effects from Botox itself will last for 4-6 months. In 2004, the US Food and Drug Administration (FDA) approved Botox for the aforementioned use.
Contraindications to therapy procedure include generalized hyperhidrosis, myasthenia gravis, pregnancy, breast feeding, and the use of certain drugs.
