Sweating (hyperhidrosis) is an increased sweating, often with a sharp unpleasant odor, which is accompanied by subjective discomfort. Hyperhidrosis occurs with lesions of the peripheral and central parts of the nervous system that regulate sweating, hormonal failures, exogenous intoxication. To determine the cause of excessive sweating, special tests and a neurological examination are performed, and the hormonal profile is examined. To eliminate unpleasant symptoms, sedatives, methods of physiotherapy and psychotherapy are used.
Excessive sweating is a subjective complaint: patients notice that they sweat more than other people. A person finds wet sweat stains on clothes, not only in the armpits, but also on the chest or back. Sweating is combined with a cooling of the skin, an unpleasant pungent odor, which is well felt at a distance. Patients may note that a large amount of sweat appears only on certain parts of the body - for example, on the palms and feet, on the face. Increased sweating is provoked by stress, minor physical exertion, food intake.
The symptom also causes psychological disturbances: a person begins to experience a sense of shame, discomfort, avoid contact with others. Great inconvenience is caused by increased sweating of the palms, which interferes with professional activities, makes it difficult to get to know people, shaking hands. A short-term increase in sweating in response to physical labor or emotional upheaval is considered a variant of the norm, but persistent hyperhidrosis that disrupts quality of life is an indication for contacting a specialist.
The difficulty of identifying individual variants of excessive sweating is due to the great subjectivity in assessing symptoms. Depending on the frequency of occurrence, hyperhidrosis is classified into permanent, the severity of which does not depend on the season, seasonal, in which sweating increases during the hot months, and intermittent, characterized by periodic relapses. In clinical practice, it is important to classify a symptom by prevalence, according to which the following are distinguished:
Various pathogenetic mechanisms cause the division of pathologically increased sweat secretion into two forms: primary idiopathic, the causes of which have not been established, and secondary, caused by damage to various organ systems. Night sweats associated with chronic infectious processes or hormonal surges are classified into a separate species. Due to a special mechanism of development, doctors secrete stress sweating (the so-called "cold sweat"), provoked by an increased concentration of catecholamines (adrenaline) in the blood. Given the degree of social discomfort, there is:
Increased sweating is often accompanied by a sharp cooling and blanching of the skin. Such a reaction normally occurs during severe emotional upheavals, but more often the appearance of cold sweat is caused by pathological conditions:
Excessive sweating over the surface of the entire skin is a normal reaction in hot climates, after intense physical work. Persistent hyperhidrosis with no apparent cause is a sign of illness. To the appearance of increased general sweating lead to:
Severe sweating in the face and scalp, accompanied by hot flashes or, conversely, a sharp pallor and coldness, develops in the presence of painful disorders. Local sweating of the head is caused by:
Women are more susceptible to various pathological reactions of the autonomic nervous system and hormonal disruptions, so hyperhidrosis is more common in them. Increased night sweats in women can provoke such diseases and conditions:
Normally, sweating increases at high air temperatures in the bedroom, when using synthetic bed linen. The unreasonable release of a large amount of sweat, causing the pillow and sheets to get wet, indicates the possible presence of a pathological process. In men, night sweats are most often caused by conditions such as:
A decrease in the secretion of sweat glands (anhidrosis), occurring against the background of normal health, is observed in older people due to natural age-related skin changes. Sweat production is markedly reduced in the following conditions and diseases:
The primary diagnostic search for excessive sweating is carried out by a specialist therapist or general practitioner. The main task of the survey is to identify violations of the body, which provoked changes in the mode of operation of the sweat glands. For this purpose, special functional tests, laboratory tests and instrumental visualization methods are prescribed. The most valuable for diagnosis are:
When organizing a further examination, accompanying symptoms are taken into account: with signs of an infectious process, serological reactions are performed, with autoimmune diseases, the levels of rheumatoid factor and other specific markers are measured. Some patients are recommended to undergo a psychiatric evaluation. To diagnose doubtful cases of excessive sweating, they resort to the consultations of other specialists (dermatologist, infectious disease specialist, oncologist).
Antiperspirants reduce sweat and neutralize odor
To reduce the unpleasant smell of sweat and prevent irritation, it is necessary to take a hygienic shower at least 2 times a day, use underwear made from natural fabrics and loose clothing that does not rub the skin. In some cases, herbal sedatives are effective, which normalize the functioning of the nervous system and reduce psychological discomfort. With increased sweating, it is necessary to consult a specialist to find out the cause of hyperhidrosis and select the optimal treatment regimen.
Medical tactics for sweating are aimed both at stopping the underlying disease and at reducing subjective discomfort. Medicines are combined with physiotherapy methods - reflexology, electrophoresis with anticholinergic solutions. To eliminate psychological problems associated with increased sweat production, individual psychotherapy sessions are offered. The most commonly used drugs for the treatment of hyperhidrosis are:
In severe forms of excessive sweating, refractory to conservative therapy, resort to stem endoscopic thoracic sympathectomy. Due to the destruction of nerve fibers that stimulate the work of the sweat glands, a persistent decrease in sweating is achieved. With local axillary hyperhidrosis, curettage (curettage) of the inner surface of the skin and partial excision of the dermis in the armpit are effective. Sometimes an open adenotomy is used.