Hyperhidrosis

Hyperhidrosis is a condition characterised by excessive sweating beyond the amount required to regulate body temperature. It results from dysfunction of the autonomic nervous system, which controls the eccrine sweat glands.

Depending on its cause, it is classified as primary or secondary, and according to its extent as focal or generalised. Primary hyperhidrosis is usually focal, most often affecting the armpits, palms, soles or face. Secondary hyperhidrosis is usually generalised and affects the whole body.

Secondary generalised hyperhidrosis requires thorough investigation, as it may be associated with endocrine and metabolic disorders, including thyroid disorders, diabetes mellitus and hypoglycaemia, as well as cardiovascular or neurological conditions, malignancies, infections, medicines and other causes. Its treatment consists of addressing the underlying condition.

Primary focal hyperhidrosis usually has a symmetrical, bilateral distribution, begins before the age of 25 and is often associated with a positive family history. Reported triggers include stress, high ambient temperatures and the consumption of substances such as caffeine, nicotine and alcohol.

Hyperhidrosis has serious social, occupational, financial and psychological effects and significantly affects quality of life. It therefore requires thorough investigation and individualised treatment by a dermatologist.

Treatment of primary focal hyperhidrosis includes specialist antiperspirants, oral anticholinergic medicines or local injections of botulinum toxin (BOTOX, DYSPORT). Using Minor’s starch–iodine test, Dr Anastasia Emvalomati precisely identifies the extent and distribution of focal hyperhidrosis and maps the affected areas. Small intradermal injections of botulinum toxin then interrupt the nerve supply to the sweat glands and, consequently, excessive sweating. Botulinum toxin treatment (BOTOX, DYSPORT) provides excellent results in the management of hyperhidrosis.