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Excessive sweating is called hyperhidrosis. It can occur locally or even on the whole body.
 
Even though exact data is missing, it is assumed that more than 1% of the western population is suffering from this disease. Within the scope of thermoregulation, sweating is a physiological function essential for life. Thus a generalized anhidrosis (strongly reduced or completely missing perspiration) can lead to hyperthermia or heat stroke. Excessive perspiration on the other side needs to be considered as a dysfunction, as the necessary degree for heat regulation is extravagated. Excessive sweating causes psychic or organic symptoms, which considerably affect the social and professional life of persons concerned.
 
In a society that does not tolerate body odor, persons suffering from hyperhidrosis are feeling socially stigmatized. Almost always psychic problems are a consequence of this disease. Sometimes hyperhidrosis even causes social isolation of persons concerned.   
 
Hyperhidrosis can arouse thermo regulatory, emotionally or gustatory and can occur locally (focally) or generalized. It can arise as a symptom (secondary hyperhidrosis) or without visible cause (primary hyperhidrosis) and evoke secondary complications like mycosis, bacterial skin infections or eczemas.
 

Classification and causes

 

1. Hyperhidrosis as a symptom of a disease (secondary hyperhidrosis)


Secondary hyperhidrosis is characterized by excessive perspiration as an attendant symptom of a primary disease. In this case the whole body is generally affected (generalized hyperhidrosis).
 
Some of the disease patterns are:
  • Thyroid hyperfunction or similar hormonal diseases
  • Severe psychiatric suffering
  • Obesity
  • Hot flashes in the climacteric

2. Hyperhidrosis for no apparent reason (primary hyperhidrosis)


This form of hyperhidrosis appears much more frequent than secondary hyperhidrosis. Generally it sets off at the age of puberty and lasts a whole lifetime. Nervousness and excitement are often triggers, without any mental disorder being existent. For the case patients have psychiatric problems and also suffer from hyperhidrosis, the symptoms can further aggravate the psychological instability.


Appearances of primary hyperhidrosis:


Axillary hyperhidrosis (underarm sweating)


This form of hyperhidrosis, often combined with sweating of hands, can be very unpleasant and is noticeable through large pit stains and even through ring-shaped salt deposits on the clothes.


Palmar hyperhidrosis (perspiration of hands)


Excessive perspiration of the hands is by far the most unpleasant form of hyperhidrosis and is most commonly accompanied by negative consequences. Hands are responsible for important functions in daily life, both socially and vocationally. They are therefore more exposed than any other parts of the body. Many people with this complaint are limited in their choice of occupation, have difficulties handling moisture-sensitive materials and are afraid of shaking hands. Some patients even avoid personal contact with others completely. The amount of perspiration varies from patient to patient and is submitted to change in its intensity for each individual. It can range from unpleasant moistness to a considerable flow. Most patients’ hands do not only get wet, but also get cold, with white-bluish discoloration in extreme cases.


Plantar hyperhidrosis (perspiration of feet)


Perspiration on feet occurs frequently, however, for most concerned persons, this phenomenon only appears moderately if well-ventilated footwear is used. Only cases where sweating is considerable without footwear, or when shoes are soaked within a short time by the amount of sweat, should be called hyperhidrosis.


Other localizations


An isolated hyperhidrosis of the torso or the thighs appears less frequently than the above listed forms of hyperhidrosis. Some patients complain about excessive facial transpiration, particularly on the forehead, which leads to the fact that they feel embarrassed.
  • Many patients suffer from a combination of several of the forms of appearance described above.
  • Perspiration can occur suddenly or steadily.
  • Perspiration can arise through high outside temperature or emotional factors (excitement, stress), or can arise without a determinable cause.
  • Generally, the situation gets worse in summer and improves in winter time.