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Hyperhydrosis

Details:

Hyperhydrosis is a condition in which the sweat glands are over productive resulting in excessive perspiration. This condition is most common in adolescents and young adults. What causes hyperhydrosis? Each of us has a set point for our metabolism. This set point is somewhat like the thermostat in our homes. Some folks have a higher set point than others. For some patients, hyperhydrosis may be due to anxiety, stress, hyperthyroidism, hypoadrenalism or excessive fluid intake. For others, it's just their natural metabolic set point.

The opposite of hyperhydrosis is called anhydrosis, or lack of perspiration. Anhydrosis is common in patients with advanced diabetic peripheral neuropathy. Diabetic peripheral neuropathy is common is cases of poorly controlled diabetes.  As diabetic peripheral neuropathy progresses, the autonomic nervous system becomes dysfunctional. The autonomic nervous system is that system that controls the 'behind the curtain' activity in our bodies such as perspiration, salivation and bowel motility. Anhydrosis results in dry, brittle skin that heals poorly.

Treatment of hyperhydrosis

When treating hyperhydrosis, it's important to realize that this condition cannot be cured with oral or topical medications. Treating hyperhydrosis requires ongoing, daily care. Some of the methods used to treat hyperhydrosis are really quite simple and focus on creating an environment in the shoe that is cool, dry and accessible to UV light. As an example, try these four simple tricks to keep the foot dry:

1. Rotate your shoes, wearing each pair every other day to allow them to dry thoroughly.
2. Avoid synthetic materials like rubber or vinyl and wear leather or cloth that can absorb moisture.
3. Frequent changes of socks to wick away moisture.
4. Use talc or baby powder daily to wick away moisture.

Topical drying agents, such as Onox, are useful to help control hyperhydrosis. Aluminum chloride is the most commonly used topical drying agent. Aluminum chloride is found in many under arm anti-perspirants and in several prescription strength medications used to treat hyperhydrosis. Formalin is used in other prescription strength medications to control perspiration. Antihistamine and anticholinergic medications are used in severe cases. These medications include Benadryl, Banthine or Pro-Banthine.

Shoe odor, called bromhydrosis, can be reduced with the use of a drying agent like Onox. Bromhydrosis is due to bacterial overgrowth in the shoe that is promoted by hyperhydrosis. Control of bacterial growth in the shoe can be helped with the use of a shoe disinfectant. And remember that it's imperative to keep the shoe as dry as possible.

Severe cases of hyperhydrosis can also be treated with injections or surgery. Recently, injections of Botox, or attenuated botulism, have been used very successfully by dermatologists and podiatrists to control hyperhydrosis. Botox is used to paralyze the smooth muscle that regulates the sweat gland. Endoscopic excision of the dorsal root ganglion is a method used by neurosurgeons to create surgical anhydrosis by surgically removing that component of the nervous system responsible for autonomic functions.

And finally, it's interesting to note that those patients who have an interest in alternative healthcare may be reluctant to treat hyperhydrosis. Their philosophy is that perspiration is a natural way that the body is ridding itself of toxic material. Inhibiting perspiration by any means will result in the accumulation of free radicals and other metabolic waste.


Nomenclature:

Anhydrosis - loss of perspiration.

Bromhydrosis - shoe odor.

Dyshydrosis - dysfunction of the sweat glands resulting in abnormal function.

Hyperhydrosis - excessive sweating.


Anatomy:

There is no information available for this topic.


Biomechanics:

There is no information available for this topic.


Symptoms:

Hyperhydrosis results in soft, macerated skin on the bottom of the foot.  In severe cases, callus on the bottom of the foot takes on a soft cheese like consistency due to exposure to persistent moisture.  Interdigital infections are common due to the over proliferation of bacteria in the shoe.

Bromhydrosis is normally associated with hyperhydrosis.  Bromhydrosis is particularly noticeable when shoes are worn without socks.

Differential Diagnosis:

There is no information available for this topic.


Products Recommended for Hyperhydrosis:

See Also:

References:

This article was written by Jeffrey A. Oster, DPM and last updated 2/26/10. No additional information is available for this topic.


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