There are some people who continue to sweat, even though the air temperature is not too hot or he’s not finished running. You’ll never see it. In essence, sweat well above normal sweat an average person. How could? Let us refer to the scientific explanation about Excessive sweating and how to solve Excessive sweating problem.

Synonym
Another name for excessive sweating include:  hyperhidrosis, hyperidrosis, polyhidrosi.

The cause (etiology)
In general, the causes of hyperhidrosis can be no known cause (idiopathic), a condition secondary to other diseases of metabolic disturbances, fever, use of certain drugs,
Many references also mention the various causes of hyperhidrosis include: spicy foods, drinks (hot / caffeinated / alcoholic), overdose of drugs (morphine, aspirin), menopause, tuberculosis, malaria, heart attack, certain diseases (thyrotoxicosis, hyperthyroidism, hypoglycemia, leukemia, lymphoma, pheochromocytoma). Spinal cord injury (spinal injuries). Abnormal nervous system that control sweat also the cause of hyperhidrosis (Anurogo D, 2008).
Generalized hyperhidrosis may be a secondary condition of the following conditions:

  1. Neurological diseases (related to the nerve) or neoplastic (associated with neoplasm)
  2. Disorders or metabolic processes (for example: thyrotoxicosis, diabetes mellitus, hypoglycemia, gout, pheochromocytoma, menopause)
  3. Fever (febrile illnesses)
  4. Drug use: Some drugs can cause hyperhidrosis such as: propranolol, physostigmine, pilocarpine, tricyclic antidepressants, and serotonin reuptake inhibitors. Especially for efavirenz could spark excessive sweating at night (nocturnal excessive sweating).
  5. Consumption of alcohol in a long time (chronic Alcoholism)
  6. Hodgkin’s disease or tuberculosis (in nocturnal hyperhidrosis).

For Localized hyperhidrosis, can be caused by various conditions below:

  1. Taste or gustatory stimuli (associated with Frey syndrome, encephalitis, syringomyelia, diabetic neuropathies, herpes zoster parotitis, and Parotid abscess)
  2. Eccrine nevus
  3. Eccrine angiomatous hamartoma
  4. Blue rubber-bleb nevus
  5. Glomus Tumor
  6. Poems syndrome, namely:
  • Peripheral neuropathy,
  • Organomegaly (enlarged organs),
  • Endocrinopathy (hormonal disease),
  • Monoclonal plasma-proliferative disorder,
  • Skin changes (skin changes)
  • Burning foot sensation (burning feet syndrome)
  • Pachydermoperiostosis
  • Pretibial myxedema

Localized state of unilateral or segmental hyperhidrosis is a rare condition and its cause is unknown. This condition is usually on the forearm or forehead.

Pathophysiology (Disease Travel Process)

According to Schwartz RA, et.al., (2009), there are three forms of hyperhidrosis:
1. Triggered by an emotional condition (emotionally induced)
2. Local (Localized)
3. General (generalized)

Generalized hyperhidrosis may be caused by autonomic disregulation, or a secondary condition of a metabolic disorder, febrile illness, or malignancy.

Form of local hyperhidrosis (Localized hyperhidrosis) is the result or consequence of an abnormal disruption followed by regeneration of sympathetic nerves or local abnormalities in the number or the spread of ekrin glands (exocrine glands), or may also be associated with other abnormalities (usually associated with blood vessels / vascular).

In essence, hyperhidrosis is a disorder of sweat glands associated with overaktivitas ekrin sympathetic. This is not a generalized disorder involving vascular endothelium.

Clinical Manifestations
Excessive sweating on the (palms), arms, underarms, pubic area, (soles) feet; can be triggered by stress, emotion, exercise. Often dressing.

Examination Support
Some investigation that can be done to diagnose hyperhidrosis and removing various differential diagnosis is as follows:
1. Thyroid function tests, to indicate the possibility of hyperthyroidism or thyrotoxicosis.
2. Blood glucose level, to express the likelihood of diabetes mellitus or hypoglycemia.
3. Examination of urine catecholamines, to state the possibility of pheochromocytoma.
4. Uric acid levels, to indicate the possibility of gout.
5. Test purified protein derivative (PPD) as a screening for tuberculosis.
6. Chest X-rays (chest radiography), to rule out the possibility of tuberculosis or neoplastic causes.

Treatment
In principle there are five alternative treatment of hyperhidrosis cases, among others:

1. Topical agents
2. Systemic Agents
3. Iontophoresis
4. Injections of Botox (Botulinum toxin injections)
5. Surgery

Topically Agent
According to Sato K, et.al. (1989), topical agents include topical anticholinergics, boric acid, 2-5% tannic acid solutions, resorcinol, potassium permanganate, formaldehyde (which may cause sensitization), glutaraldehyde, and methenamine.

Drysol (aluminum chloride hexahydrate 20% in absolute anhydrous ethyl alcohol) is commonly used as first-line topical agent, used at night on dry skin.

To minimize irritation, the remaining patients the drug should be washed when you wake up, then the area was neutralized with the topical application of baking soda.

Systemic Agents
According Klaber M, Catterall M. (2000), systemic agents include anticholinergic, sedatives and tranquilizers, indomethacin, and calcium channel blocker (calcium channel blockers).

Anticholinergics such as propantheline bromide, glycopyrrolate, oxybutynin, and benztropine effective due to the secretion of sweat preglandular neurotransmitter is acetylcholine (although it stimulates the sympathetic nervous system is working (to innervate) ekrin sweat glands.

Use of anticholinergic may not be very interesting because side effects such as reflex pupillary dilatation (mydriasis), blurred vision (Blurry vision), mouth and eyes felt dry, difficult urination, and constipation.

Other systemic agents such as sedatives and tranquilizers, indomethacin, and calcium channel blockers, useful for the treatment of palmoplantar hyperhidrosis, hyperhidrosis in the area of the palms and soles of the feet.

Iontophoresis
For the case of palmoplantar hyperhidrosis, the daily dose for each of your palms or soles of the feet for 30 minutes was 15-20 mA with tap water iontophoresis. According to Abell E, Morgan K (1974), with Anticholinergic therapy is more effective than iontophoresis with tap water iontophoresis.

Botox injections
According to Fujita M, et.al. (2001), Botulinum toxin injection effective for anticolinergic effects on the neuromuscular junction and at the postganglionic sympathetic cholinergic nerves in the sweat glands.

Surgery
Surgery can be done to overcome hyperhidrosis include: sympathectomy, excision of the areas experiencing hiperhdrosis, 1064-nm laser using Nd-YAG, and subcutaneous liposuction.

Sympathectomy is the last option in the treatment of hyperhidrosis because it involves the destruction of action (surgical destruction) ganglia responsible for the occurrence of hyperhidrosis (Hsu CP, et.al., 2001).

Second thoracic ganglia (T2) and third (T3) for palmar hyperhidrosis is responsible. Fourth thoracic ganglia (T4) to control axillary hyperhidrosis. While the first thoracic ganglia (T1) controls facial hyperhidrosis.

Two surgical approaches are performed: open and endoscopic approach. Endoscopic approach is preferred because the process of repair of complications, surgical scars, and the time of surgery. Thus it is clear that endoscopic thoracic sympathectomy is an effective therapy for hyperhidrosis.

Diagnosis of Appeals
Various diseases that need to be considered as a differential diagnosis hyperhidrosis include:
1. Burning feet syndrome
2. Blue Rubber Bleb Nevus Syndrome
3. Fever (febrile illnesses)
4. Diabetes mellitus
5. Eccrine angiomatous hamartoma
6. Eccrine nevus
7. Gout
8. Hypoglycemia
9. Hodgkin’s disease
10. Menopause
11. Pachydermoperiostosis
12. Use of alcohol in a long time (chronic Alcoholism)
13. Drug use (eg: propranolol, physostigmine, pilocarpine, tricyclic antidepressants, venlafaxine)
14. Neoplastic disease
15. Neurological disease
16. Pheochromocytoma
17. Poems Syndrome
18. Pretibial Myxedema
19. Riley-Day syndrome (familial dysautonomia)
20. Tuberculosis (TB)
21. Thyrotoxicosis
22. Glomus Tumor

Complication
Some severe cases of hyperhidrosis that can reduce the quality of life for patients, such as causing deep psychological pain (great emotional distress), embarrassed by interacting with the community (social embarrassment), and work-related disability.

His sweaty palms of hands and feet (palmoplantar sweating) may cause irritation of the skin is exposed, which in turn trigger a rubbing motion.

Hyperhidrosis in the armpits of an unpleasant smell, causing embarrassment.

Prevention
Clean the skin every night and morning. Avoid garments of Lycra and nylon materials. Better to use the emollient (Conditioning, skin softener) and moisturizer (skin moisturizer) instead of soap. Wear colors that do not show perspiration, for example: black, white (Anurogo D, 2008).

Prognosis
Difficult to effectively treat hyperhidrosis. However, with the various modalities of therapy are available now, patients have many choices so that a better prognosis.[Healthy Living Solution]

Incoming search terms for the article:

Related Post: