Summary about Disease
Focal hyperhidrosis is a condition characterized by excessive sweating that is localized to specific areas of the body, most commonly the palms, soles, armpits, and face. It is not related to underlying medical conditions or generalized sweating due to heat or exercise. Instead, it's believed to be caused by overactivity of the sympathetic nervous system, which controls sweat glands. This overactivity triggers the sweat glands in the affected areas to produce sweat beyond what is needed for thermoregulation.
Symptoms
The primary symptom is excessive sweating in specific areas:
Palms (palmar hyperhidrosis)
Soles (plantar hyperhidrosis)
Armpits (axillary hyperhidrosis)
Face (facial hyperhidrosis) Sweating is often unpredictable and can occur at any time, regardless of temperature or activity level. The sweating can be so profuse that it drips from the hands or feet, soaks through clothing, or causes noticeable wetness on the face. Other symptoms may include:
Skin irritation or maceration (softening and breakdown of the skin due to prolonged exposure to moisture).
Body odor
Social anxiety or embarrassment due to the visible sweating.
Secondary skin infections
Causes
The exact cause of primary focal hyperhidrosis is unknown. It is believed to be related to an overactivity of the sympathetic nervous system. This part of the nervous system controls sweat gland function. In individuals with focal hyperhidrosis, the signals from the brain to the sweat glands in specific areas are amplified, leading to excessive sweat production. Genetic factors may also play a role, as it tends to run in families.
Medicine Used
Several medications are used to manage focal hyperhidrosis:
Topical antiperspirants: Aluminum chloride is a common ingredient that blocks sweat ducts. Stronger formulations (e.g., Drysol) may be prescribed.
Topical anticholinergics: These block the action of acetylcholine, a neurotransmitter that stimulates sweat glands (e.g., Qbrexza).
Oral anticholinergics: These medications (e.g., glycopyrrolate, oxybutynin) are systemic medications that reduce sweating throughout the body by blocking acetylcholine. Side effects can be significant (dry mouth, blurred vision, constipation).
Botulinum toxin (Botox) injections: Injected into the affected areas, Botox blocks the release of acetylcholine, temporarily paralyzing the sweat glands.
Is Communicable
No, focal hyperhidrosis is not communicable. It is not caused by an infection or contagious agent.
Precautions
While there's no guaranteed way to prevent focal hyperhidrosis, these precautions can help manage symptoms and minimize its impact:
Use antiperspirants regularly: Apply antiperspirants at night before bed when sweat glands are less active.
Wear breathable clothing: Choose natural fabrics like cotton that allow sweat to evaporate.
Change socks frequently: If you have plantar hyperhidrosis, change your socks multiple times a day.
Use absorbent powders: Apply powders to absorb moisture in shoes and socks.
Manage stress: Stress and anxiety can trigger sweating. Practice relaxation techniques.
Avoid triggers: Identify and avoid specific foods or situations that worsen your sweating.
How long does an outbreak last?
Focal hyperhidrosis is a chronic condition, not an outbreak. It's a persistent state of excessive sweating. The intensity of sweating can fluctuate depending on factors like stress, temperature, and activity levels, but the condition itself doesn't "break out" and then resolve. Without treatment, the excessive sweating will persist. With treatment (e.g., Botox), the effects are temporary, lasting several months.
How is it diagnosed?
Diagnosis typically involves a medical history and physical examination. The doctor will ask about your sweating patterns, triggers, and impact on your life. A physical exam will help rule out other potential causes of excessive sweating (secondary hyperhidrosis).
Starch-iodine test: Iodine solution is applied to the affected area, followed by starch powder. Areas of excessive sweating will turn dark blue.
Paper test: A special paper is placed on the affected area to measure the amount of sweat produced.
Timeline of Symptoms
Focal hyperhidrosis often begins in childhood or adolescence, although it can start at any age.
Onset: Typically starts during puberty for palmar and plantar hyperhidrosis. Axillary hyperhidrosis may start later, in the late teens or early twenties.
Progression: Symptoms are usually persistent. They can worsen with stress or anxiety.
Fluctuations: The intensity of sweating can vary from day to day or even within the same day.
Long-term: Without treatment, the condition is likely to continue indefinitely.
Important Considerations
Impact on quality of life: Focal hyperhidrosis can have a significant impact on social, emotional, and occupational well-being.
Differential diagnosis: It's important to rule out secondary hyperhidrosis, which is caused by underlying medical conditions.
Treatment options: Various treatments are available, and the best option depends on the severity of symptoms and the affected area.
Side effects of treatments: Be aware of the potential side effects of medications and procedures used to treat hyperhidrosis.
Consult a healthcare professional: A dermatologist or other qualified healthcare provider can provide a diagnosis and recommend the best course of treatment.