Whole body sweating causes. Excessive sweating. Hyperhidrosis: causes, treatment and prevention

A large number of people are worried about why I sweat a lot and what to do if you want to get rid of this unpleasant symptom. It should be noted that such a problem is a widespread phenomenon, it worries many people in our society. Severe sweating in most cases is a temporary phenomenon, but it can bother a person and constantly, if the reasons for its occurrence are not determined. We will try to figure out why some people sweat and how to quickly get rid of this condition in the presented article.

There are a lot of reasons why a person sweats, but it is necessary to focus on the fact that with the normal functioning of the sweat glands and the absence of pathological processes associated with their work, the secretion of sweat should be carried out in a normal mode.

The reasons that a person began to sweat a lot can be:

Physical exertion (heavy sweating may appear even when walking).
The influence of stressful situations.
Climate change accompanied by an increase in temperature environment.
Synthetic materials from which clothes are made, because they are poorly permeable to oxygen.
Wearing clothes that are too warm.

If this is the reason for excessive sweating, then the hyperhidrosis is usually short-lived and disappears after the elimination of the contributing factors. However, the situation can go in another way, when a person sweats a lot and after these actions, this pathological symptom does not disappear. In this case, you need to suspect the presence in the human body of some pathological process, which disrupts the normal activity of the sweat glands.

The causes of excessive sweating in women, men and children and what to do if a person sweats often, we will now consider in more detail.

Causes of hyper-consistency in children

Parents are very often interested in why their children sweat (the question why I sweat a lot can also appear in children) and what it means. In infants, intensive sweat production is considered normal, and they perspire during feeding, sleeping and periods of activity. Quite often, in young children, the occipital part of the head sweats, this is due to the fact that the child is in a supine position for too much time, which causes overheating of this particular part of the head. To eliminate this, it is necessary from time to time to turn the child's head to the sides.

Newborn babies and under one year old have a large number of folds on the body (especially if they are also plump), so the body overheats, and these areas sweat. To eliminate this symptom, it is recommended to use a cream, vegetable oil or baby powder.

Preschoolers and schoolchildren of primary grades often sweat a lot due to physical activity, the body thus tries to avoid overheating. Therefore, this must be taken into account and not put on a lot of clothes on the child if he will play outdoor games, jump or run, because at the same time he will really sweat.

Heavy sweating can also occur during nighttime sleep. This is explained by the fact that the child's body reacts to the stress of a nervous nature that he experienced during the day.

A lot of sweat is produced most often on areas of the body such as:

back;
upper limbs;
head.

Hyperhidrosis appears quite often and in adolescence, this is explained by the puberty of the child and the fact that the body is rebuilding its work. In this case, sweating is local, that is, it manifests itself only in some parts of the body, most often it is:

armpits;
upper limbs;
Feet.

In order to somehow reduce the intensity of sweating in a person, it is necessary to wash as often as possible areas of the body that are distinguished by the release of excess sweat with the use of soap. The best option it is considered carrying out baths prepared on the basis of decoctions from medicinal herbs... Many people who have applied such recommendations in practice say that "I have so much relieved my condition."

Causes of excessive sweating in men

Most often, men sweat on the palms of the hands, armpits, back, legs and groin. It should be noted that at the same time, sweat has a very Strong smell... There are cases when hyperhidrosis worries representatives of the strong half of humanity at night while sleeping. They often ask questions, "why am I sweating a lot, and what exactly does the body react to?"

Excessive sweat production in men occurs as a result of:

excessively intense physical activity;
abuse of spicy, salty and hot dishes;
drinking excessive amounts of alcoholic beverages;
overloads of a nervous nature.

If excessive sweating appears and it is not associated with the listed factors, then it is necessary to exclude the presence in the body of such pathological conditions and processes as:

inflammation of the prostate gland;
diseases of the genitourinary system;
oncological diseases;
cold;
diseases of infectious and fungal genesis;
violation of the functioning of the organs of the cardiovascular system;
respiratory diseases;
disruption of the functioning of the organs of the gastrointestinal tract.

Factors that lead to excessive sweat production in women

First of all, it is necessary to focus on the fact that the causes of sweating in women are the same as in men, however, it is additionally necessary to highlight several more reasons that can lead to the appearance of this unpleasant symptom, namely:

The period of puberty (observed at the age of 10 to 18 years), is characterized by the restructuring of the organs of the girl's genital area into adults, ready to perform the function of procreation. Excessive sweating in this situation is observed during sleep.
Period. Women are worried about excessive sweating in the lower extremities, armpits, palmar surfaces of the hands, head and intimate organs. At the same time, anxiety should not appear; to alleviate the condition, it is recommended to take a shower as often as possible.
Menopause. Excessive sweating occurs in the armpits, face, feet and palms. To alleviate the condition, it is recommended to take medications that are prescribed during this period, as well as folk recipes.
Disruption of metabolic processes. This pathological condition is accompanied not only by excessive sweat production, but also by an increase or decrease in body weight.

Measures to combat hyperhidrosis

When diagnosing excessive sweating, use different methods fight against pathological condition, namely:

Surgical treatments. Considered an option in cases of excessive sweating due to heredity or chronic disease. Part of the sweat glands are removed or the nerve impulses that are responsible for their functioning are affected.
Narrowing of the lumen of the tubules responsible for the secretion of sweat.
Medical treatment. The purpose of its implementation is to eliminate the disease that caused the formation of hyperhidrosis.
Treatment with recipes from folk sources. It helps eliminate unpleasant sweat odor and excess moisture from problem areas of the body.

Eliminate head sweating

In the vast majority of cases, the head of men and women sweats at night. It is not recommended to eliminate this unpleasant symptom by taking measures that reduce blood flow or lead to atrophy of nerve receptors, because these actions will leave Negative influence on the condition of the hair.

If a person sweats in this way, then the way out of this not entirely simple situation will be the use of masks or rinsing with substances such as:

basma;
clay;
sea salt;
strong tea brewing.

The procedures should be carried out before going to bed, this is due to the fact that it is during sleep that the maximum absorption of medicinal substances will occur.

A positive effect is observed when sweating people use a decoction of chamomile and celandine for rinsing. For cooking, you need 3 tbsp. l. pour 500 ml of boiling water over the herbs and leave for one hour.

Treatment of hyperhidrosis with recipes from folk sources

It should be noted that the problem of excessive sweating is not so difficult to solve. If you sweat a lot, then the type of recipe must be selected depending on the localization of the area with excessive sweat production. A wonderful effect, if the whole body sweats, is observed during general therapeutic baths, their duration should not be less than 30 minutes. In addition to eliminating excessive sweating, a sweating person will observe the cleansing of the skin and the restoration of its elasticity. Such baths need to be prepared from a decoction of oak bark or from sage infusion.

If a person sweats a lot, then it is recommended to wipe him (at least twice a day) with chilled tea or milk. In this case, it is forbidden to wipe off, it is necessary that the liquid dries on its own.

The best remedy for foot hyperhidrosis is potato starch, or its combination with talcum powder. An even better effect is observed if salicylic acid is added to this mixture. Another tool that is used to eliminate this pathological symptom, is oak bark powder. The selected ingredient should be poured into socks, changing every day.

If a person is worried about excessive sweating in the face, then it is recommended to wash with a solution prepared as follows: add 1 tsp to 250 ml of boiled water. salt.

If frequent sweating has led to the appearance of diaper rash in a person, then marshmallow tincture will help well, you need to lubricate the affected areas of the skin or make lotions. To do this, moisten the gauze in the infusion and apply it to the desired area of the body for 30 minutes, after which it is recommended to apply a powder to the treated area.

Now you have information about why a person can sweat a lot. Summing up, it should be noted that sweating is not a dangerous condition (which in some situations cannot be said about the reasons for its appearance), it can be successfully eliminated if not folk recipes, then with the help of medication. However, you should consult your doctor before starting treatment.

Excessive sweating is a familiar problem. It can seriously ruin the quality of life in any area: in personal relationships, in communication with other people, at work. A person who sweats excessively sometimes arouses the pity of others. But more often than not, they treat him with disgust. Such a person is forced to move less, she avoids shaking hands. Hugging is generally taboo for her. As a result, a person loses contact with the world. To reduce the severity of their problem, people resort to various cosmetic products or folk remedies... At the same time, they do not at all think that such a condition can be dictated by ailments. It is important to understand what diseases a person sweats a lot? After all, you can get rid of the symptoms only by eliminating the pathology that provoked it.

Main reasons

The problem of an unpleasant phenomenon before today continues to be studied by doctors. And, unfortunately, if a person is what this means, doctors cannot always explain.

However, experts have identified several main causes of hyperhidrosis, or increased sweating:

Pathology is caused by diseases that occur in a latent or open form.
Taking some medications.
An individual feature of the organism, which is most often inherited.

But often the problem is hidden in ailments. Therefore, it is very important to understand which diseases a person sweats a lot.

Doctors say that hyperhidrosis can be provoked by:

endocrine disorders;
infectious pathologies;
neurological diseases;
tumors;
genetic failure;
kidney ailments;
cardiovascular diseases;
acute poisoning;
withdrawal symptoms.

Let's consider them in more detail.

Endocrine diseases

Any violations in this system almost always provoke hyperhidrosis. For example, why does a person sweat a lot with diabetes? This is due to increased metabolism, vasodilation and increased blood flow.

The most common systems are:

Hyperthyroidism. Pathology is characterized by increased functioning of the thyroid gland. except excessive sweating, other symptoms of the disease are often present. There is a tumor on the neck of a person with hyperthyroidism. Its size reaches a hen's egg, and sometimes even more. A characteristic symptom of the disease is "rolling out" eyes. Excessive sweating is provoked by thyroid hormones, which lead to strong heat production. As a result, the body “turns on” protection from overheating.
Diabetes. A formidable pathology characterized by increased content in the blood glucose. Sweating in diabetes manifests itself in a rather peculiar way. The upper (face, palms, armpits) suffers from hyperhidrosis. And the lower one, on the contrary, is excessively dry. Additional symptoms suggestive of diabetes are: being overweight, frequent urination at night, sensation constant thirst, high irritability.
Obesity. Obese people have disrupted work endocrine glands... In addition, hyperhidrosis is based on inactivity and an addiction to unhealthy eating. Spicy food, an abundance of spices can activate work
Pheochromocytoma. The disease is based on a tumor of the adrenal glands. With the disease, hyperglycemia, weight loss and increased sweating are observed. Symptoms are accompanied by high pressure and palpitations.

Women suffer from increased hyperhidrosis during menopause. This phenomenon is dictated by a disturbed hormonal background.

Infectious pathologies

Hyperhidrosis is very typical of these ailments. It is easily explained why a person sweats a lot with infectious pathologies. The reasons are hidden in the mechanism of heat transfer, with which the body reacts to an increased temperature.

Infectious ailments that increase sweat production include:

Influenza, ARVI. Severe sweating is characteristic of a person at the initial stage of the disease. This reaction is dictated precisely by high temperature.
Bronchitis. The pathology is accompanied by severe hypothermia. Accordingly, the body tries to defend itself and normalize heat transfer.
Tuberculosis. Such an ailment is the answer to the question of what kind of illness a person sweats a lot at night. After all, hyperhidrosis during sleep is a classic symptomatology of pulmonary tuberculosis. At the same time, the mechanism for the development of such a trait has not yet been fully established.
Brucellosis. The pathology is transmitted to humans from animals through contaminated milk. Prolonged fever is a symptom of the disease. The disease affects the musculoskeletal, nervous, reproductive system... Leads to an increase in lymph nodes, spleen, liver.
Malaria. As you know, the mosquito is the carrier of the disease. With pathology, humans are observed: recurrent fever, profuse sweat and attacks of chills.
Septicemia. Such a diagnosis is made to a person who has bacteria in the blood. Most often these are streptococci, staphylococci. The disease is characterized by severe chills, fever, excessive sweating and sharp jumps temperatures to very high values.
Syphilis. The disease can affect the nerve fibers that are responsible for the production of sweat. Therefore, with syphilis, hyperhidrosis is often observed.

Neurological diseases

Some lesions of the central nervous system can cause a person to sweat a lot.

The causes of hyperhidrosis are sometimes hidden in diseases:

Parkinsonism. With pathology, the vegetative system is damaged. As a result, the patient often experiences increased facial sweating.
Dorsal tabes. The disease is characterized by destruction of the posterior columns and roots spinal cord... The patient has lost peripheral reflexes, vibration sensitivity. Typical symptoms is heavy sweating.
Stroke. At the heart of the disease is damage to the arteries of the brain. Violations can affect the center of thermoregulation. In this case, the patient has a strong and persistent hyperhidrosis.

Oncological pathologies

Fever and excessive sweating are symptoms that almost always accompany these pathologies, especially at the stage of the onset of metastases.

Consider diseases in which hyperhidrosis is the most common symptom:

Hodgkin's disease. In medicine, it is called lymphogranulomatosis. The disease is based on tumor lesion of the lymph nodes. The initial symptomatology of the disease is increased sweating at night.
Non-Hodgkin's lymphomas. This is a tumor lymphoid tissue... Such formations lead to stimulation of the thermoregulatory center in the brain. As a result, the patient experiences increased sweating, especially at night.
Compression by metastases of the spinal cord. In this case, the vegetative system suffers, which causes an increase in sweating.

Kidney pathology

You need to know what diseases a person sweats a lot.

Doctors give the following list of kidney pathologies:

urolithiasis disease;
pyelonephritis;
glomerulonephritis;
uremia;
eclampsia.

Cardiovascular ailments

Acute hyperhidrosis almost always accompanies acute stages... What diseases does a person sweat a lot? As a rule, such symptoms are observed with the following ailments:

myocardial infarction;
hypertonic disease;
thrombophlebitis;
rheumatism;
ischemia of the heart.

Withdrawal symptoms

This phenomenon is characteristic of people who are addicted to various kinds of chemicals. It is especially pronounced given state from drug addicts or alcoholics. As soon as the chemical stimulant ceases to enter the body, a person develops severe hyperhidrosis. In this case, the state is maintained for the entire period while "withdrawal" occurs.

Withdrawal symptoms can also be observed with the refusal of medication. A person reacts with increased sweating to the withdrawal of insulin or an analgesic.

Acute poisoning

This is another serious reason hyperhidrosis. If a person sweats a lot, it is necessary to analyze what food he ate or with what chemicals he interacted.

Often, such symptoms are caused by poisoning, provoked by:

mushrooms (fly agaric);
organophosphate poisons that are used to fight insects or rodents.

As a rule, a person has not only increased sweating, but also characteristic lacrimation, salivation. Constriction of the pupils is observed.

Psycho-emotional sphere

Very often, troubles at work, failures in personal life can lead to similar symptoms. In other words, any severe stress can cause hyperhidrosis.

Nervous tension sharp pain or fright often lead to an unpleasant symptom. No wonder, talking about the strongest emotional stress, the person emphasizes: "Threw in a cold sweat."

It is noticed that as soon as the problem is resolved, "holding" the person long time under stress, increased hyperhidrosis disappears.

What to do?

It is very important to understand that the presence of hyperhidrosis is serious reason be examined in the hospital. Only after a thorough diagnosis can the doctor tell which disease a person sweats a lot.

It is very important to correctly and extensively answer the following questions of the doctor:

When did the excessive sweating start?
The frequency of seizures.
What circumstances provoke hyperhidrosis?

Do not forget that many of the pathologies can occur in a latent form. Therefore, a person can feel good for a long time. And only recurring attacks of sweating signal that not everything is safe in the body.

Heavy sweating of the whole body (hyperhidrosis) can be caused by various medical conditions. , or odd-smelling sweat are often signs of health problems. Even as serious as cancer, tuberculosis or hyperthyroidism.

Excessive sweating of the whole body is a common symptom for many diseases. But this is only one of the symptoms of the disease, below are additional ones that may more accurately indicate a specific ailment.

Diseases that are accompanied sweating

Feverintramural diseases- those that are accompanied by a very high body temperature and are caused by the ingestion of so-called pyrogens (most often viruses). An increase in sweat production is the body's response to heat - this is how it tries to cool down. The higher the temperature, the more we sweat. Most sweat is released when the body temperature drops.
Obesity... For overweight people, every movement requires effort. The body overheats and sweats easily.
Overactive thyroid(hyperthyroidism). Sweating increases during the day. In addition, the disease is accompanied by loss of appetite and weight, weakness, irritability, palpitations, trembling hands, and sometimes bulging eyes.
Tumors lymphatic system ... Leukemia and lymphomania begin with weakness and loss of appetite. The skin becomes pale and the lymph nodes swell. Heavy sweating of the whole body appears at night.
Tuberculosis... Night sweats, persistent cough, weight loss, weakness, slight fever or fluctuations.
... When your blood sugar drops sharply (hypoglycemia), you sweat heavily. The patient turns pale, the heartbeat accelerates, the muscles tremble. Dizziness, weakness and hunger appear.
Pancreas cancer... The same symptoms appear as in hypoglycemia: sweating, weakness, bouts of hunger, tremors in the muscles, nervousness.
Central nervous system disorders... Unbalanced sweating - one side of the body sweats more. Alopecia, hair loss in some part of the body, may occur.
Parkinson's disease... Slow motion and heavy sweating with a noticeable odor. Progressive stiffness and tremors of the muscles - involuntary tension and tremors. A face with signs of seborrhea (acne, oily skin, redness) and covered in sweat.
Acromegaly- a slowly developing disease of an adult caused by a dysfunction of the pituitary gland. Thickening of the toes, lengthening of the legs, lower jaw, superciliary arches and heavy sweating.
Heart attack... Burning pain behind the breastbone, sweating, restlessness, shortness of breath, and sometimes nausea.

What disease does the smell of sweat indicate?

Diseases that are accompanied by severe sweating often disrupt chemical processes in organism. As a result, the smell of sweat also changes, which makes it possible to diagnose the disease itself.

Sweating (perspiration, hyperactivity and hyperfunction of the sweat glands, increased sweating) - in medicine, this is all called the term hyperhidrosis.

Sweating is natural physiological process, participates in thermoregulation of the body. Sweating may increase during exercise, when the ambient temperature rises, or while eating hot food. The sweating process accelerates stress, anxiety, and spicy foods.

Sweat removal is very important function human skin, thanks to it, if necessary, the body temperature decreases, toxic substances are removed. Normally, sweat is only noticeable when physical stress When the ambient temperature rises, it is mainly the legs, palms and armpits that sweat, since they have the highest density of sweat glands.

Causes of increased sweating

Some people also experience sweating when slight increase air temperature, and sometimes, on the contrary, when it decreases, with nervous tension, and at high air temperatures sweat "hail" is possible. This condition is already referred to as excessive sweating, and it can be both a physiological feature of the body and a consequence of any disease.

Diseases leading to excessive sweating

Increased sweating is observed when:

functional disorders of the autonomic nervous system,
neurasthenia, neuropathy,
hyperthyroidism ( enhanced function thyroid gland),
dysfunction of the pancreas,
kidney disease
diabetes,
syringomyelia,
neurosyphilis (stage 3 syphilis), AIDS, tuberculosis and other infections,
rickets (or simply a lack of vitamin D, especially in children),
chronic tonsillitis and other common diseases,
hyperplasia of sweat glands,
keratoderma,
flat feet.

Hyperhidrosis (excessive sweating) can be caused by external factors(wearing rubber airtight shoes, synthetic fiber stockings and socks, etc.), as well as unhealthy diet.

Symptoms of excessive sweating

Sweating often develops in limited areas of the body (sweat legs or arms, armpits, perineum). At the same time, the skin is moist, cold to the touch, and there are signs of acrocyanosis (bluish tint) on the hands and feet. Sweating is often accompanied by pyococcal (bacteria) and yeast (fungal) skin lesions.

Sweat itself has no smell, the familiar unpleasant spirit is given by bacteria that feed on the skin and multiply as a result. This unpleasant odor, which is observed in people with poor personal hygiene, is called bromhidrosis or osmidrosis. An unpleasant odor can occur both due to the decomposition of sweat by bacteria, and due to the release of substances with a pronounced odor with sweat (sulfur, ammonia, garlic, tobacco, etc.), as well as in violation of the menstrual cycle in young women, with sugar diabetes, some dermatoses (pemphigus, vegetative syphilides). These conditions often require medical advice and treatment.

Chromhidrosis is manifested by the staining of sweat in people in contact with cobalt, copper, iron, and other chemicals.

People with hyperhidrosis are drawn into a vicious circle - they sweat, worry about it, and because of this they sweat even more.

Treatment of excessive sweating

Treatment of hyperhidrosis should be aimed primarily at eliminating the cause of increased sweating. It is necessary to be carefully examined by a therapist, phthisiatrician, neuropathologist, endocrinologist and, if a disease is detected, start with its treatment.

If the increased sweating is caused by the characteristics of the body, the essence of the treatment is to block the activity of the sweat glands in order to reduce sweat discharge. The choice of the method of treatment depends on many factors, including the general condition of the patient, his lifestyle and the area of the lesion.

Topical treatment for excessive sweating

Minor sweating can be dispensed with local treatment, which includes applying preparations to problem areas of the skin containing:

1. Aluminum chloride salts- temporarily close sweat ducts. The effectiveness depends on the concentration of the drug. These are mainly gel and solid antiperspirant deodorants. They are used mainly at night. At the initial stage, daily, and then the frequency of application is reduced to once every 2-3 weeks. Alunite, chermigite, alum-potassium alum have a similar effect.
2. Aldehydes (formaldehyde, glutaraldehyde, urotropine) - block excretory function sweat glands. This is a fragrant talcum powder and a solid antiperspirant deodorant (Johnson & Johnson baby powder, Lady Sleep Stick Deodorant, Adidas. Due to its high irritant and allergenic effect, it is used only locally in problem areas.
3. Denatured Keratin, closes the ducts of the sweat glands. Part of soap and powder.

Combined cosmetics (deodorants, gels, powders, creams) contain a complex of substances that prevent unpleasant odor of sweat: preparations from VICHI, Belordizayn, Belita, Oriflame, Avon, Faberlik, which produce special lines of skin care products.

Herbal medicine for excessive sweating

Outwardly, the following herbs are used in the form of infusions:

1. Peppermint - calming, relaxing effect.
2. Walnut leaves - contains various fruit acids that act as a peeling.
3. Sage - contains useful essential oils to help eliminate unpleasant sweat odor.
4. Chamomile - eliminates inflammation.
5. Bark of birch and oak - has pronounced antibacterial and tanning properties.
6. Nettle - contains the necessary vitamin complex and minerals for the skin.
7. Irish moss - antimicrobial action.
8. Lemon - eliminates unpleasant odors, effective in the fight against skin fungi.

Infusions of these herbs should be rubbed into the skin up to 2 times a week. massage movements about 30 minutes. In case of excessive sweating of the feet, you can prepare foot baths.

Salon procedures

1. Electrophoresis and iontophoresis- treatment by acting on the ion channels of the sweat glands.

2. Subcutaneous injections botulinum toxin- inhibit the release of acetylcholine in nerve endings, thus blocking their activity. Several injections are made on the problem area, their number depends on the area of the site. To exclude possible unpleasant or painful sensations, an anesthetic cream is used. The effect of treating hyperhidrosis with botulinum toxin injections appears after 2 to 6 days and lasts from 3 to 8 months.

Surgery for excessive sweating

Surgical methods guarantee the maximum result of getting rid of sweating, but they have more possible complications:

1. Removal of sweat glands in the armpits(sometimes occurs with the removal of the skin). The effectiveness of such treatment is up to 90%. But there is a risk of complications associated with the formation of scar tissue, which leads to limited limb mobility.
2. Sympathectomy - This procedure involves the destruction of the sympathetic nerves responsible for excessive sweating.
3. Liposuction - removal of sweat glands in the deep layers of subcutaneous adipose tissue using special probes (cannulas) through microscopic incisions on the skin surface.

General treatment of hyperhidrosis

Inside take vitamin complexes, sedatives(valerian, motherwort). If necessary, in the complex, the doctor prescribes:

1. Antibacterial ointments, lotions (baneocin, zinerit, chloramphenicol ointment, metronidazole)
2. Antifungal ointments, gels (terbinofine, mycospore, orungal, nizoral, lamisil)
3. Antibiotics by mouth (more often antibiotics wide range actions).
4. Anticholinergic drugs (atropine, belloid). Treatment with these drugs is used only in severe cases due to the severity of side effects (dry mouth, dry eyes, mydriasis, urinary retention, bradycardia, sedation)
5. Vitamins B, E, A.
6. Blockers calcium channels(diltiazem).
7. Psychotropic drugs (diazepam, xanax, amitriptyline).

Diet with increased sweating

If you have problems with overactive sweat glands, you need to reconsider your diet. You should not eat foods such as onions and garlic, fish, hot spices (pepper - chili).

Hygiene: frequent washing of problem areas several times a day.
- Wearing clothes made of natural fibers with a porous structure.
- Frequent change of clothes and shoes.
- Avoid drinking coffee, alcohol and spicy foods.
- Eliminate the causes of stress, tension and anxiety.
- Ventilate the area in which you are often.

Doctor cosmetologist N.A. Kondratenko

Hyperhidrosis (excessive sweating)- Excretion of sweat that is outside the normal range. He might be congenital feature a person or a symptom of the disease: tuberculosis, obesity, thyroiditis.
Hyperhidrosis can be local and cover specific areas of the body (palms, feet, armpits) or common(generalized) when excessive sweating occurs throughout the body.
Sweating mainly manifests itself paroxysm in response to stimuli (stress, alcohol, increased hormone levels, etc.), in a small number of patients it is constantly present.

Why is hyperhidrosis dangerous?

First of all, hyperhidrosis provokes social problems. An unpleasant smell and sweat stains cause discomfort for the person himself and the hostile attitude of others. The disease can ruin personal life and affect the choice of profession. Such people try to avoid public speaking, which is incompatible with teaching, working on television, etc. With a severe degree of hyperhidrosis, the patient severely restricts communication and begins to lead a secluded lifestyle.

Hyperhidrosis can cause the development of certain diseases. So, sweating of the feet creates favorable conditions for the development of fungus. And hyperhidrosis of the axillary and groin areas increases the risk of hydradenitis - inflammation of the sweat gland and purulent lesions of the surrounding tissues. In addition, the constant moisture of the skin is often accompanied by the appearance of diaper rash and pustular rashes.

Who suffers from hyperhidrosis?

Sweating is quite common. About 2% of the population are familiar with its manifestations. However, this indicator can be several times higher, because most people do not go to a specialist with this problem. Women account for more than half of patients with hyperhidrosis, which is associated with their increased emotionality and hormonal activity at certain periods of life. The problem is widespread among adolescents - in the transitional age, the axillary sweat glands are activated. Among adults, the number of patients remains unchanged. And after 50 years, people complain less about sweating due to the deterioration of the work of all glands, including sweat.

How does hyperhidrosis proceed?

Most people develop seasonal hyperhidrosis, which is exacerbated in the spring and summer. Persistent hyperhidrosis is less common. In this case, sweating is expressed in any weather, and does not depend on stress or work. Sometimes hyperhidrosis has a recurrent course, when, after a period of increased sweating, the work of the glands returns to normal, but over time the problem returns. This course of the disease is associated with hormonal surges or malfunctions in the autonomic nervous system.

How is sweat produced in humans?

Sweat represents water solution salts of calcium, potassium, phosphorus, lactic and uric acid, ammonia and other substances. At the exit from the sweat glands, it is transparent and odorless. The waste products of bacteria living on the skin give it a specific aroma.

Sweat glands, which are skin appendages, are responsible for the secretion of sweat in humans. In total, there are about 2.5 million of them on the surface of the body. At room temperature and low activity, they secrete from 400 ml to 1 liter of sweat per day. With physical exertion and in the heat, the amount of sweat can exceed 2 liters per day. Such indicators are considered the norm.

Sweat glands are divided into eccrine and apocrine. On the body, they are located unevenly - some areas of the skin are more saturated with them. In these places, local hyperhidrosis often appears. It is divided according to the place of manifestation:

axillary;
palmar;
plantar;
facial;
groin-perineal.

Eccrine sweat glands give off odorless transparent sweat. It contains a large amount of acids and salts, therefore it prevents the growth of bacteria and protects the skin from inflammation. Most of the eccrine glands are found on the palms of the feet, chest, back and forehead.

Apocrine sweat glands emit a whitish secret with a specific odor. It contains cholesterol, fatty acid and other biologically active substances. This sweat is a breeding ground for bacteria to multiply. It is believed that the secret of the apocrine glands contains pheromones, the smell of which attracts individuals of the opposite sex. The apocrine glands are found in the axillary and groin areas, as well as in the vicinity of the genitals.

Why does a person need sweat glands?

Sweating has many useful functions:

Overheating prevention... Sweat evaporates from the surface of the skin and lowers the body temperature.
Protecting the skin from bacteria. Acidic environment the sweat of the eccrine glands prevents the reproduction of microorganisms.
Signals for the opposite sex... Depending on the phase of the menstrual cycle, the composition and smell of the sweat of the apocrine sweat glands changes, which signals opposite sex ready or not ready to play. Although in recent centuries this function has lost its significance.

What makes sweating worse?

Increase in ambient temperature... Heat receptors sense an increase in temperature and send impulses to the corresponding parts of the spinal cord and brain, which are responsible for thermoregulation. From there, signals are sent to the sweat glands that make you sweat more.
Stress and nervous tension ... In this case, the level of stress hormones - adrenaline and norepinephrine - increases. They lead to agitated state the entire nervous system. Including, the processes in the centers that regulate the work of the sweat glands are activated. As a result, they are instructed to generate more sweat. Increased sweating during stress is called - psychogenic hyperhidrosis.
Active physical work... When the muscles work, a lot of energy is released, which raises the body temperature. In this case, sweat provides protection against overheating.
Spicy and hot food. This phenomenon is based on reflex connections between the centers of salivation and sweating. Sweat production is enhanced by:

extractive substances of meat, fish, mushrooms;
spices;
alcohol;
tea, coffee and other drinks containing caffeine.

Disturbances in the work of the nervous system. The hypothalamus and the centers of the autonomic nervous system in the medulla oblongata and the spinal cord, as well as the sympathetic nerve nodes (ganglia) located near the spine, are responsible for heat regulation and excretion of sweat. Nerve impulses travel along nerve fibers (trunks). If a malfunction occurs in any of these parts of the NS, this can increase the production of sweat. The reason may be:

trauma to the brain or spinal cord;
inflammation of the surrounding tissues;
mental shock;
disautonomy - centers of destruction in vegetative system;
diencephalic syndrome of newborns is a congenital lesion of the hypothalamic-pituitary region of the brain in newborns. Accompanied by a constantly high or low temperature, continuous crying, trembling, vibrations blood pressure;
Parkinson's disease - chronic neurological disease senior age group characterized by increased muscle tone, tremors in the body, slow motion, inability to maintain balance;
stroke - acute violation cerebral circulation. Signs strong headache with nausea and vomiting, lethargy or agitation, speech impairment, paralysis of certain muscles;
epilepsy - the sudden onset of seizures;
damage to the hypothalamus, in addition to increased sweating, is manifested by sleep disturbances, surges in blood pressure, impaired vascular tone;
concussion or contusion of the brain - loss of consciousness, amnesia, headache, nausea, vomiting, pallor of the skin.

Acute and chronic infectious diseases... The appearance of viruses and bacteria in the blood is accompanied by the production of pyrogens - substances that affect the neurons of thermal sensitivity. The development of fever and excessive sweating causes:

Tuberculosis. Its symptoms are weakness, pallor, fatigue, apathy, a slight increase in temperature, cough (with pulmonary form);
Influenza - fever, weakness, headache, muscle and joint pain, dry cough;
Angina - fever, sore throat, purulent plaque on palatine tonsils or accumulation of pus in lacunae;
Septicemia - entering the bloodstream a large number pathogenic microbes... Manifested by fever, malaise, pain in the muscles and abdomen, diarrhea, severe intoxication, a characteristic rash in the form of small hemorrhages;
Malaria is a disease caused by infection with Plasmodium malaria. Fever, chills, headache, and vomiting
Brucellosis - infection caused by brucella. It can be infected by contact with domestic animals (cows, goats, pigs), through their meat and dairy products. It is manifested by high fever and headache, soreness in muscles and joints.

Syphilis a sexually transmitted disease that affects the mucous membranes, internal organs and the nervous system. Leads to damage to the nerve fibers of the dorsal roots, which is accompanied by asymmetric local hyperhidrosis.
Hormonal disorders cause endocrine hyperhidrosis. The production of sweat is influenced by hormones of the gonads, hypothalamus, pituitary gland and thyroid gland. High sweating occurs:

in adolescents with high concentration sex hormones;
in women during menopause, with a decrease in estrogen levels and an increase in follicle-stimulating hormone;
with hyperthyroidism and other pathologies of the thyroid gland;
with pheochromocytoma - tumors of the nervous system that synthesize adrenaline and norepinephrine;
with carcinoid syndrome - a tumor that produces hormonal substances that stimulate sympathetic fibers of the NS.

Elevated levels of catecholamines. These substances ensure the transmission of impulses in the nerve trunks and the interaction of cells in the body. They appear in the blood:

with intense physical work;
with pain of various origins;
with drug or alcohol abstinence, "withdrawal" arising from a sharp rejection of these substances;

Tumor diseases cause an increase in temperature and sweating through the effect on the center of thermoregulation in the hypothalamus. Hyperhidrosis appears in the evening and night hours and is observed throughout the body. It provokes.

lymphocytic lymphoma is a malignant tumor of lymphatic tissue. Symptoms: weakness, weight loss, sleep and digestion disturbances;
histiocytic lymphoma is an oncological lesion of lymphoid tissues. Manifestations depend on the location of the tumors;
mixed lymphoma - malignant tumor lymph nodes, in which their increase, fever, swelling and cyanosis of the skin of the face and weight loss are characteristic;
Burkitt's lymphoma - single or multiple oncological tumors jaws, which can later affect other internal organs. It proceeds with fever and worsening of the general condition.

Systemic diseases. Autoimmune process (attack of own immune cells) damages the blood capillaries that feed the nerve trunks. This leads to dysfunction of the organs for the work of which these nerves are responsible.

Raynaud's disease. It is manifested by a spasm of the vessels of the fingertips. They get colder, acquire a bluish color. The spasm is quickly replaced by vasodilation;
rheumatoid arthritis - symmetrical lesion small joints, weakness, morning stiffness. Symptoms of damage to the spine and large joints gradually join - headaches, tingling of the fingers, a feeling of crawling, pain when breathing, etc.

Taking medications. Some drugs that affect the autonomic nervous system stimulate the production of sweat. This side effect is possessed by:

propranolol;
pilocarpine;
physostigmine;
antiemetics;
antidepressants.

Hereditary predisposition. It has been found that the propensity for excess sweat formation is passed on from generation to generation. The reasons for this phenomenon have not been established. People who develop hyperhidrosis without obvious reasons, diagnose " primary hyperhidrosis". This distinguishes it from secondary hyperhidrosis which is always associated with disease.

As you can see, the list of causes of increased sweating is very extensive. Often, to eliminate hyperhidrosis, it is enough to exclude the cause that causes it.

Psychogenic hyperhidrosis

Psychogenic hyperhidrosis- increased sweating associated with stressful situations and strong emotions. During stress and anxiety, large doses of adrenaline are released into the bloodstream. This hormone increases activity sympathetic division the autonomic nervous system, which is responsible for the work of internal organs, including the sweat glands. A large number of commands are generated in the nerve centers that make the sweat glands work harder.

In people suffering from psychogenic hyperhidrosis, even minor irritants cause strong sweating. For example, if in a healthy person, with embarrassment, the armpits sweat only slightly, then the patient's face may be covered with large drops of sweat, and wet spots will appear on the clothes. This is often accompanied by facial redness. This feature of the body is probably associated with an increased sensitivity of the receptors responsible for binding adrenaline.

Due to the fact that during sleep the sympathetic nervous system is resting, and inhibition processes prevail in it, sweating decreases at night.

Causes of psychogenic hyperhidrosis

Psychoemotional stress- any situations that cause strong positive or negative emotions in a person.
Acute psychological trauma- a stressful situation that had a short-term effect on the psyche, but left serious consequences.

loss of a loved one;
a break up;
conflict;
loss of property, work;
fright;
speaking to an audience;
making a difficult diagnosis.

Chronic psychological trauma when a person has been in an unfavorable situation for a long time due to various factors:

Domestic violence;
Cheating spouse;
Divorce of parents;
Living in a dysfunctional family;
Lack of parental affection.

Neuroses- long-term reversible disorder of mental functions. It is caused by prolonged negative emotions and stress, overwork or severe illness. This condition is characterized by a tendency to tantrums. Neuroses are accompanied by autonomic disturbances, and often sweating.
Asthenia- a psychopathological disorder characterized by various violations the work of the autonomic nervous system. The main symptom is chronic fatigue, which is often accompanied by tachycardia, heart pain, sweating, and depression.
Prolonged insomnia, upsetting the balance of processes of excitation and inhibition in the nervous system.

Neurocirculatory dysfunction(vegetative-vascular dystonia) a disorder of the nervous system, in which the tone of the sympathetic section can be increased or decreased.
Pain... When the patient experiences pain and associated anxiety, adrenaline and catecholamines are released. These substances contribute to the emergence and transmission of impulses, due to which the stimulation of the sweat glands occurs, mainly on the palms and feet.

Diagnostics psychogenic hyperhidrosis

For the diagnosis and treatment of psychogenic hyperhidrosis, patients with excessive sweating turn to a neurologist or dermatologist.

Survey... At the first stage of diagnosis, the doctor collects an anamnesis. He is interested in:

When did the first signs of hyperhidrosis appear?
What preceded them (stress, illness)?
Where do you find the most sweating?
In what situations does it intensify, is there a dependence on stress and excitement?
Are there any complaints about night sweats?
Does the patient suffer from persistent sweating or does the problem recur periodically?
How often does the patient have to shower and change clothes during the day?
Does any of your relatives suffer from excessive sweating?
Does the patient have acute or chronic medical conditions?

Inspection... The doctor visually assesses:

The condition of the patient's clothes, the presence of sweat stains on it. They primarily appear in axillary area... Less commonly on the back and in places where skin folds form. By the size of the spot in the armpit, you can roughly estimate the degree of hyperhidrosis:

norm - up to 5 cm;
mild degree - up to 10 cm;
medium degree- up to 15 cm;
severe degree - over 20 cm.

The symmetry of the location of the spots. Unsymmetrical sweating indicates damage to the nerve fibers of the sympathetic nervous system.
Sweat on the face. Sweating is often limited to specific areas where the sweat glands are better innervated. This is the forehead, upper lip. In 70% of patients, an attack of psychogenic hyperhidrosis is accompanied by redness of the facial skin.

The diagnosis of "hyperhidrosis" is established on the basis of the patient's complaints if excessive sweating interferes with his daily life. In most cases, the doctor makes a diagnosis based on the survey data, since it is rarely possible to observe an attack of psychogenic hyperhidrosis with his own eyes.

Psychogenic hyperhidrosis is confirmed by the following symptoms:

sudden onset;
patients associate the appearance of hyperhidrosis with acute or chronic psychological trauma;
increased sweating in situations that cause anxiety in the patient;
reducing sweating during sleep;
recurrent course - exacerbations coincide with periods of increased anxiety (session, business trips);
sweat most of all on the face, palms and feet, less often intense sweating on the entire surface of the body.

Laboratory research. More research is needed to rule out sweating conditions.
List of necessary studies and analyzes:

biochemical analysis blood (AST, ALT, glucose, calcium, bilirubin);
blood test for hepatitis B, C and HIV viruses;
blood test for syphilis - Wasserman reaction;

With psychogenic hyperhidrosis, the test results are within the normal range- no acute or chronic diseases are detected. If the test results are not satisfactory, then the patient is referred for further examination to specialized specialists.

Qualitative and quantitative assessment of sweating

Treatment of psychogenic hyperhidrosis

Treatment of psychogenic hyperhidrosis is aimed at reducing sweating, as well as reducing anxiety, increasing stress resistance and reducing the excitability of the sympathetic part of the NA.

Treatment method	Efficiency	How is it produced
Psychological counseling	Up to 70% subject to completion of the full course. The method helps to reveal the problem or situation that provoked sweating, and to resolve it. The psychologist will also show you how to cope with anxiety situations and teach you how to reduce stress. Disadvantages: The course can take up to several months. Requires self-discipline and strict adherence to recommendations.	The patient, together with a psychologist, examines a stressful situation, learns to respond appropriately to it.
Medical method - sedatives, antipsychotics, tranquilizers and antidepressants	80-90%, subject to the correct preparation. The specialist individually selects the drug and dose, which reduces the likelihood of side effects. Disadvantages: There are contraindications and serious side effects (lethargy, increased appetite, obesity, addiction). Caution: Some antidepressants increase sweating.	Sedatives plant-based products (extract of valerian, motherwort, sedavit, sedatives herbal preparations, bromides) are used 3 times a day for 8-10 weeks. If there is no effect, consider the appointment of tranquilizers or antidepressants. Tricyclic antidepressants reduce stimulation of the sweat glands by the nervous system. Mianserin, Lerivon. The dosage is from 10 to 30 mg per day. Fluoxetine, Prozac. The dosage is 20 mg once a day. The effect of taking antidepressants occurs at 2-3 weeks of admission. The course is 6-8 weeks. Antipsychotics. Sonapax at a daily dose of 80-150 mg per day. The dose increase and withdrawal are carried out gradually. Tranquilizers prescribed when psychogenic hyperhidrosis is combined with autonomic disorder. Anaprilin and clonazepam can reduce sweating. They are prescribed at a dosage of 10 to 80 mg per day. Duration of admission from 4 weeks.
Physiotherapy methods	70-80%. Sedative electrotherapy methods restore the balance of inhibitory and excitatory processes in the cerebral cortex. They reduce the number of nerve impulses entering the areas responsible for sweating. Reduces stress hormones. Disadvantage: procedures can have a temporary effect that lasts from 20 to 40 days.	7-12 procedures are prescribed per course. Electrosleep... The duration of the procedure is 30 minutes. Pulse frequency 20 Hz. Frequency - every other day. Galvanic collar according to Shcherbak... Current strength up to 15 m A. Duration 7-15 minutes. Daily. in areas of increased sweating. Creates a depot of ions in the skin, which reduce perspiration. Current strength up to 15 m A. Daily or every other day. Coniferous salt baths. The water temperature is 36 degrees. Duration 15-25 minutes. Daily.
Medical antiperspirants	60-80%. They include salts of zinc, aluminum, salicylic acid, formaldehyde, triclosan, ethanol... These joints narrow or block the ducts of the glands, preventing sweat from flowing out. In this case, sweat is excreted through other parts of the body. Validity from 5 to 20 days. They contain antibacterial substances that stop the growth of bacteria, preventing the appearance of a specific odor. Disadvantages: eliminate manifestations, not the cause of sweating. Blockage of the ducts of the sweat glands can cause swelling and irritation of the skin, inflammation of the sweat glands.	Apply to washed and dried skin with the frequency specified in the instructions. Antiperspirants are applied after an evening shower and washed off with soap and water in the morning. Active substances remain in the ducts of the sweat glands, ensuring their narrowing.
Botulinum toxin injections - Botox, Dysport, Ipsen, Xeomin preparations	Over 95%. The toxin blocks the nerve endings that innervate the sweat glands. This leads to a complete stop of sweating in the treated area. Treatment areas: face, feet, palms, armpits. Disadvantages: temporary. Repeated injections are necessary after 6-8 months. Temporary side effects are possible: muscle weakness and numbness in the injection area. They go away on their own in 3-30 days. High cost - from 20 thousand rubles.	Before the procedure, a Minor test is performed to determine the boundaries of the area of increased sweating. A syringe with a thin insulin needle is injected into the area of increased sweating, injecting preparations of botulinum toxin. One procedure is enough to treat hyperhidrosis for 6-8 months.
Laser treatment	About 80%. The sweat glands are destroyed with the help of a laser inserted under the skin to a depth of 1-4 mm. Sweat production will no longer be restored in these areas. Suitable for the treatment of hyperhidrosis in the armpits, feet, palms and face. Disadvantages: only those glands that were near the punctures stop functioning. The high cost of treatment is over 30 thousand rubles.	Determine the area of hyperhidrosis and carry out local anesthesia... Optical fiber is inserted through punctures with a diameter of 1-2 mm to the depth of the sweat glands. With its help, part of the sweat glands is destroyed. A certain amount remains intact, which ensures minimal perspiration in the given area. During the session, hair follicles are damaged and hair growth in the armpit is reduced.
Local (local) surgery hyperhidrosis	Over 90%. After removal of the sweat gland, it has a lasting lifelong effect. Suitable for the treatment of axillary hyperhidrosis. Disadvantage: hematomas and fluid accumulations are often formed at the site of intervention. Scars may form at the site of the procedure. In most patients, compensatory hyperhidrosis develops in which sweating of the face, skin of the chest, back and thighs increases. Given the likelihood of complications, surgical treatment is used when other methods are ineffective.	Minor's test is preliminarily carried out to identify overly active sweat glands. The operation is performed under general anesthesia. Axillary curettage. After 1-2 punctures in the armpit, a surgical instrument is inserted, with the help of which the sweat gland is “scraped out”. At the same time, nerve endings are injured. This is the most common of local methods surgical treatment of hyperhidrosis. Excision of the skin of the armpit. Remove skin areas, sometimes subcutaneous tissue where the sweat glands are concentrated. This method is indicated for patients who develop inflammation of the sweat glands, hydradenitis ("bough udder"). Axillary liposuction indicated for obese patients. During the removal of adipose tissue, nerve fibers and sweat glands are injured.
Central surgical treatment of hyperhidrosis - sympathectomy	About 100%. The effect is lifelong. During the operation, the sympathetic trunk (nerve fibers) responsible for the work of the sweat glands are destroyed. It is indicated for severe hyperhidrosis of the armpits and palms. Disadvantages: numbness of the skin in the armpit. Local complications at the site of intervention (hematoma, edema). In 10% of patients, severe compensatory hyperhidrosis develops, which exceeds the initial one.	The operation is performed under general anesthesia. In the 3rd intercostal space, a 5 mm puncture is made. 1 liter of carbon dioxide is injected into the chest in order to displace organs, to give the surgeon the opportunity to view and manipulate. An endoscopic surgical instrument is introduced through the hole, with the help of which the destruction (destruction) of the nerve ganglia is performed. When treating sweating of the armpits and palms, they act on the centers that are located at the level of 2-5 vertebrae of the thoracic region. Perhaps clipping(the imposition of a clip) on the sympathetic trunk going to the sweat glands. There are also more gentle methods of destroying the sympathetic trunk using chemicals or high-frequency electric current. However, in these cases, partial destruction of the nerve occurs. Therefore, there is a small chance that the nerve fibers will recover and the hyperhidrosis will return.

Also, the necessary measures to complement the conservative treatment of hyperhidrosis (without surgery) are:

Compliance with the rules of personal hygiene. Warm or contrast shower 2 times a day, if necessary and more often. Daily change of linen, which should consist only of natural fabrics that are breathable and absorbent.
Taking vitamins of group B: B3 and B5.
General strengthening of the body, including air baths, contrast showers and other hardening methods.
Baths with a decoction of oak bark 2-3 times a week for 15 minutes. For the treatment of hyperhidrosis in the armpits, you can use gauze wipes soaked in broth.
Spa therapy. Sea bathing, sunbathing, brine baths (with salt concentrate).

Features of the treatment of psychogenic hyperhidrosis of the armpits, legs and palms

Type of hyperhidrosis	Treatment stages
Type of hyperhidrosis	1	2	3	4	5	6
Axillary (axillary)	Antiperspirants based on aluminum chloride Dry Control, Odaban, NO SWEAT	Sedative physiotherapy	Injection of the axillary zone with botulinum toxin	Systemic treatment sedatives	Axillary curettage	Sympathectomy - destruction of the nerve ganglion or trunk
Palmar (palmar)	Antiperspirants with aluminum chloride over 30% - Dabomatic 30%, Max F 30% or 35%,	Sedative physiotherapy and iontophoresis	Injection with botulinum toxin		Thoracoscopic sympathectomy
Plantar (plantar)	Aluminum chloride or glycopyrrolate topically Dabomatic 30% Dry Dry 30.5%, Max F 35%	Treatment of feet with preparations containing formaldehyde Formidron Formagel.	Botulinum toxin injection	Systemic treatment with sedatives and anticholinergics

If desired, the patient can skip the second stage and move on to the third.

Primary hyperhidrosis

Primary hyperhidrosis- increased sweating in the absence of pathologies that may be accompanied by active work sweat glands. At severe course the skin on the face, feet and palms does not just get wet, but beads of sweat.

Primary hyperhidrosis appears in childhood or adolescence, and after 40 tends to decrease. This form of the disease has little to do with emotional state and ambient temperature.
Primary hyperhidrosis is more often permanent, less often it is paroxysmal. Patients cannot clearly determine what exactly provokes an attack of sweating, since it occurs at rest, at normal temperature, in a well-ventilated room.
Primary hyperhidrosis is predominantly local. It covers one or more areas: feet, palms, armpits, face.

Causes primary hyperhidrosis

The main cause of primary hyperhidrosis is the increased excitability of the nervous system, namely, its sympathetic division. A large number of nerve impulses passing through the sympathetic trunks activate the secretion of sweat glands.

Hereditary predisposition is also called among the reasons. In the course of the survey, as a rule, it turns out that the patient's relatives also suffer from increased sweating.
This feature of the body can be associated with various factors that affect the excitability of the sympathetic nervous system:

high sensitivity of the body to adrenaline and norepinephrine;
high, but within the normal range, the level of hormones - sex, thyroid;
features of the functioning of the nervous system, when a large number of nerve impulses are synthesized in the subcortical centers and ganglia of the autonomic nervous system;
an excess of the mediator serotonin, which provides high conductivity in the trunks of the sympathetic nervous system.

Diagnostics primary hyperhidrosis

Survey... Taking an anamnesis is often central to making a diagnosis. The doctor is interested in:

When did sweating first start?
Do other family members have similar problems?
In what situations does it increase?
How strong is it?
How much does it interfere in everyday life?
Which general state health? Are there any chronic diseases?

The doctor can use various questionnaires to assess the quality of life in hyperhidrosis for people with sweating in the armpit.

Factors confirming primary hyperhidrosis:

the onset of the disease early, in childhood or adolescence;
other relatives also suffer from increased sweating;
there is no unambiguous connection with strong emotions and stress;
sweating is symmetrical, usually affecting the feet, palms and armpits. Less commonly, the whole body;
there is no heavy sweating during sleep. Night sweats indicate other diseases and require additional diagnosis;
there are no signs of infectious or other acute and chronic diseases.

Inspection... During the examination, a dermatologist can identify:

sweat stains on clothes;
diaper rash and rashes in places of sweating;
in some cases, beads of sweat are found on the skin.

These signs are present in all forms of hyperhidrosis, therefore, examination does not make it possible to determine the form of the disease, but only confirms its presence.

Laboratory research:

general analysis blood;
biochemical blood test (AST, ALT, glucose, calcium, bilirubin);
blood test for hepatitis B, C and HIV viruses;
fluorography or x-ray of the lungs;
blood test for syphilis - Wasserman reaction;
a blood test to determine the level of glucose;
blood test for thyroid hormones (T3, T4, TSH, parathyroid hormone);
general urine analysis.

With primary hyperhidrosis, the test results do not exceed the norm.
Qualitative and quantitative methods for assessing perspiration

In practice, determining the amount of sweat secreted during hyperhidrosis does not matter much. Therefore, quantitative methods for assessing hyperhidrosis are rarely used. The most requested is the Minor test.

Treatment primary hyperhidrosis

Treatment is prescribed on the basis of how much the illness brings a person to the inconvenience.

Treatment method	Efficiency	How is it produced
Medicated	About 60%. Cholinolytic agents block the transmission of excitation from postganglionic nerve fibers to sweat and other glands. This reduces sweating. The effect appears on the 10-14th day of taking the drug. The course of treatment is 4-6 weeks. Disadvantages: Large doses are required to treat sweating. Anticholinergics have an extensive list of contraindications and side effects after taking drugs.	Natural anticholinergics drugs Bellataminal or Bellaspon. 1 tablet 3 times a day. Synthetic anticholinergics Atropine - 1 mg twice a day. Scopolamine in solution - 0.25-0.5 mg. Deprim Forte 1 capsule 1-2 times a day.
Physiotherapy methods - iontophoresis	Up to 70%. Exposure to a current of low voltage and constant frequency temporarily narrows the channels of the sweat glands at the site of exposure. The accumulation of aluminum and zinc ions in the skin causes a temporary narrowing of the ducts of the sweat glands. It is used to reduce sweating on the palms and feet. Disadvantages: Regular use is necessary. Repeated courses in 3-4 months.	To reduce sweating of the feet and palms, use baths filled with tap water. Under the influence of a low voltage current, ions penetrate into the skin. The action of the current on the receptors causes a reflex narrowing of the duct of the glands. Iontophoresis with tap water and electrophoresis with local anticholinergics showed the same effectiveness.
Medical antiperspirants	Up to 70%. The compounds penetrate into the mouth of the sweat glands and create an insoluble sediment there, which causes a narrowing or temporary blockage of the excretory duct. Disadvantages: Risk of irritation and hydradenitis. Temporary validity from 5 to 50 days.	Prepare the skin. In the armpit, hair is shaved off. It is important that the skin is clean and dry, otherwise it will burn and irritate. The drug is applied at night, when perspiration is minimal, and in the morning the residues are washed off.
Botulinum toxin injections (Botox, Dysport, Ipsen, Xeomin)	About 95%. Considered the best treatment for antiperspirant and physiotherapy ineffectiveness. The drugs disrupt the transfer of acetylcholine, which blocks the passage of impulses along the nerve fibers to the sweat gland. Disadvantages: temporary effect up to 8 months. In rare cases, side effects develop - temporary paralysis of the facial muscles, muscle weakness of the arms. In patients with a high titer of antibodies against botulism toxin, injections are not effective.	The focus of hyperhidrosis along the perimeter is injected with botulinum toxin. Preparations based on it are identical and have the same effect. The doctor determines the dose individually. After 1-3 days, the conduction of impulses going to the sweat glands is blocked, and the secretion of sweat stops for 6-8 months.
Laser treatment	Up to 90%. Thermal energy laser destroys the cells of the sweat gland and hair follicles. Disadvantages. The high cost of the procedure. Insufficient number of laser systems and specialists performing this procedure.	Make a test of Minor. Local anesthesia is performed on the site. A hollow needle is inserted to a depth of several mm, in the channel of which an optical fiber passes. The laser beam destroys the sweat glands. A small part of the glands remains unaffected and continues to function, this avoids compensatory hyperhidrosis.
Local (local) surgical treatment	Up to 95%. The operation is performed on the armpit. The surgeon removes the sweat gland, or part of the skin and fatty tissue. Disadvantages: There are contraindications. Traumatic. Postoperative scars need care. There is a risk of complications: hematomas, overgrowth of scar tissue.	Curettage axillary zone. A curette (surgical spoon) is inserted through a puncture with a diameter of less than 1 cm, with the help of which the sweat gland is removed. Liposuction... Removing some of the fatty tissue allows you to destroy nerve fibers and stop the activity of the sweat glands.
Central surgical treatment - percutaneous or endoscopic sympathectomy	About 95%. With percutaneous up to 80%. By electric current, laser, chemicals or surgical endoscopic equipment the doctor damages or completely destroys the nerve fibers that transmit impulses to the sweat glands. Disadvantages: edema, hematoma, risk of scarring, hindering movement, drooping of the eyelids. In 50% of the operated patients, compensatory hyperhidrosis develops - sweating of the trunk, thighs and inguinal folds appears. In 2% of cases, this brings more inconvenience than primary hyperhidrosis. Based on this, sympathectomy is recommended for patients with secondary hyperhidrosis when there is no other way to cure the disease.	Endoscopic surgery. An endoscope is inserted through a puncture in the armpit with an endoscope attached to it. surgical instrument... With its help, the surgeon cuts the sympathetic trunk or puts a clip on it - a clip to prevent impulses from the nerve ganglia to the sweat glands. For percutaneous surgery the doctor inserts the needle into the area near the spine. Further, he destroys the nerve with electric shock or chemical means. However, in this case, he cannot see the nerve itself. This becomes the reason for the ineffectiveness of the procedure and damage to nearby organs. Open operation

Features of the treatment of primary hyperhidrosis of the armpits, legs and palms

Type of hyperhidrosis	Treatment stages
Type of hyperhidrosis	1	2	3	4	5
Axillary (axillary)	Medical antiperspirants MAXIM 15%, KLIMA 15%, AHC20 classic 20%			Local Surgical Treatment - Removal of Sweat Glands	Central surgical treatment sympathectomy
Palmar (palmar)	Aluminum treatment with Dabomatic chloride 30%, Max F 30% or 35%,	Botox injections, Dysport, Ipsen, Xeomin	Systemic drug treatment with anticholinergics		Central Surgical Treatment - Sympathectomy
Plantar (plantar)	Aluminum treatment with "DRYDRAY" chloride 30.5%, foot powder "ODABAN" 20% Dabomatic 30% Dry Dry 30.5%, Max F 35%, Teymurov's paste	Treatment with formaldehyde preparations Formidron liquid, Paraformbetonite powder.	Botulinum toxin injections	Systemic drug treatment with anticholinergics

Endocrine hyperhidrosis

Endocrine hyperhidrosis- increased sweating accompanying diseases of the endocrine glands. In this case, the patient suffers about generalized hyperhidrosis when sweating intensifies all over the body.
With endocrine pathology, the level of hormones in the blood of patients increases. These substances have several mechanisms for controlling the sweat glands:

directly affect the center of thermoregulation;
increase excitability and conduction of impulses along the sympathetic fibers of the nervous system;
enhance metabolism;
dilate blood vessels and increase blood flow, bringing more fluid to the sweat glands.

Causes endocrine hyperhidrosis

Diabetes... There are changes in the autonomic nervous system. Myelin, a substance that protects nerve roots and fibers, is destroyed, which affects the innervation of the sweat glands. In patients, sweating occurs only in the upper half of the body, while the skin of the pelvis and lower extremities suffers from dryness. In diabetes mellitus, in addition to hyperhidrosis, there are: dry mouth, thirst, increased urine volume, muscle weakness, decreased immunity and wounds that do not heal for a long time.
Hyperthyroidism and other diseases of the thyroid gland, accompanied by an increase in thyroid hormones, which increase the number of heart contractions, blood flow rate and metabolism. These processes cause an increase in the generation of heat. Sweating in this case is a thermoregulatory mechanism. Hyperthyroidism is indicated by: increased irritability and tearfulness, weight loss, a slight increase in temperature, increased heart rate, increased upper (systolic) and lowering lower (diastolic) pressure, protrusion eyeballs, increased appetite, heat intolerance.
Obesity... Redundant body fat under the skin and around internal organs, the mechanisms of thermoregulation are disturbed. Fat retains heat in the body, and to reduce the temperature, the body increases the rate of sweating. Also, the ability of adipose tissue to produce sex hormones - estrogens, affecting the center of thermoregulation has been proven.
Acromegaly. Benign tumor the pituitary gland, which produces growth hormone. This disease in 80% of cases is accompanied by a decrease in the level of sex hormones and an increase in the level of thyroid hormones. An imbalance in hormones activates metabolic processes, increases heat production and increases sweating. With acromegaly, characteristic symptoms occur: an increase in bones, including facial (lower jaw, browbones, cheekbones, nose), an increase in the skull, thickening of the fingers, joint pain. The skin thickens, tightens, gathers in folds. The sebaceous glands work actively.
Climacteric syndrome. Restructuring in female body caused by a decrease in estrogen levels and an increase in follicle-stimulating hormone levels. Estrogens have a direct effect on thermoregulation. Their deficiency affects the hypothalamus, which erroneously diagnoses overheating of the body. This gland turns on the mechanism for getting rid of excess heat, expanding peripheral vessels and increasing sweating, which provokes hot flashes and an attack of hyperhidrosis. These symptoms accompany menopause in 80% of women. The onset of menopause is also indicated by: anxiety, tearfulness, dryness of the mucous membranes of the genitals, accompanied by burning and itching, weight gain, deterioration of the skin.
Pheochromocytoma- tumors of the nervous system that synthesize adrenaline and norepinephrine. These hormones stimulate the nervous system and increase the number of impulses going to the sweat glands. Associated symptoms: paroxysmal increase in blood pressure. During a crisis, a characteristic picture develops: fear, chills, headaches and heart pains, disturbances heart rate, nausea, vomiting, abdominal pain. After an attack, there is a strong perspiration (the person is "drenched in sweat") and the discharge of a large amount of urine, up to 5 liters.
Carcinoid syndrome- tumors that produce hormonal substances that stimulate sympathetic fibers of the NA. In addition to excessive sweating, patients are worried about: abdominal pain, loose stools, disturbances in the work of the heart, caused by damage to the valves, narrowing of the bronchi - bronchospasm, accompanied by shortness of breath and wheezing. The expansion of superficial vessels leads to redness of the face, neck and upper body.
Puberty... During this period, the work of the gonads is not stable. Constant fluctuations in hormone levels affect the state of the nervous system. Stimulation of her sympathetic region causes sweating of the face, feet, palms and armpits. This situation can last 1-2 years or accompany a person all his life.

Diagnostics endocrine hyperhidrosis

Survey... At the appointment, the doctor will ask a standard list of questions:

When did you start sweating?
What are the circumstances of its appearance?
In what areas is it most pronounced?
In what situations do seizures occur?
Are evening and night sweats typical?
What is your general health? Are there any chronic diseases?

Typical signs of endocrine hyperhidrosis:

generalized sweating all over the body;
sweating worse in the evening and at night;
symmetrical arrangement of sweating zones;
bouts of hyperhidrosis have little to do with nervous or physical stress;
the attacks are so severe that you have to change your clothes.

It is important for the patient to report symptoms chronic diseases: hot flashes, palpitations, dry skin and wounds that do not heal for a long time, an increase in the amount of urine. This will help the doctor correctly diagnose and prescribe treatment or send for additional examination to identify hidden pathologies.

Inspection. On examination, the doctor may reveal the following signs:

sweating areas are located symmetrically;
in the majority, generalized sweating - over the entire surface of the body;
redness of the skin of the face and body associated with the expansion of superficial capillaries.

Laboratory diagnostics
In addition to general analyzes (fluorography, general and biochemical blood tests, general urinalysis), great importance is attached to determining the level of glucose and hormones.

Endocrine hyperhidrosis may indicate following results analyzes:

A blood test to determine the level of glucose - over 5.5 mmol / l;

Blood test for thyroid hormones

Free T3 hormone (triiodothyronine) - over 5.69 pmol / l;
Free T4 hormone (thyroxine) - over 22 pmol / l;
Thyroid stimulating hormone (TSH) - over 4.0 μIU / ml;
Parathyroid hormone - over 6.8 pmol / l;

Sex hormone test (for women and men)

Follicle-stimulating hormone (FSH) - for women less than 1.2 IU / L (the phase of the menstrual cycle must be taken into account), for men less than 1.37 IU / L;
Estradiol / estrone index - less than 1;
Inhibin - less than 40 pg / ml for women, less than 147 pg / ml for men;
Testosterone-estradiol-binding globulin or SHBG - less than 7.2 nmol / L. ml for women, less than 13 nmol / l for men.

Qualitative and quantitative methods for assessing hyperhidrosis are rarely used for endocrine form illness. Due to the low information content and laboriousness of the procedure.

Treatment endocrine hyperhidrosis

Endocrine hyperhidrosis is treated by an endocrinologist, together with a dermatologist. The mainstay of treatment is hormone therapy for recovery normal work endocrine glands. Other methods are aimed at alleviating the condition of patients, but they do not eliminate the cause of the disease.

Treatment method	Efficiency	How is it produced
Medical antiperspirants	About 60%. Antiperspirant ingredients constrict the ducts and slow down the sweat glands. Disadvantages: the risk of irritation and suppuration of the sweat glands in people with low immunity. Allergy development is possible.	An antiperspirant (aerosol, sticker, powder, cream) is applied in the evening to intact skin. Before applying, the body is washed with soap, the areas of hyperhidrosis are dried with dry napkins or a hairdryer. In the morning, the leftovers are washed off warm water with soap. The frequency of repetition of the procedure is indicated in the instructions (every other day, once a week).
Physiotherapy methods	60-70%. Under the influence of low-frequency current, a reflex contraction of the duct of the sweat glands and skin vessels occurs. This leads to less perspiration. Disadvantages: often the effect is not pronounced enough. The action ends in a few days.	The trays are filled with tap water and connected to an iontophoresis apparatus. Water is a conductor of current and a source of ions. Submerged parts of the body are affected by a galvanic current, and ions are deposited in the skin for several days. The procedures are carried out every other day, 7-12 per course.
Botulinum toxin injections (Botox, Dysport, Ipsen, Xeomin)	95%. The toxin disrupts the conduction of nerve impulses that control the work of the sweat gland. Disadvantages: 5% of people are insensitive to botulinum toxin. The procedure can cause numbness and muscle weakness. With endocrine hyperhidrosis, sweating often occurs throughout the body. Therefore, chipping off individual zones does not bring significant relief.	Using the Minor test, the boundaries of sweating are determined. Then they are injected with the drug. The manipulation is carried out using a thin insulin needle with a step of 2 cm. After 1-2 days, the toxin blocks the nerve fibers, and the glands stop working.
Local surgical treatment	95%. It is used to treat local hyperhidrosis of the armpits and palms, which is rare in the endocrine form. Disadvantages: trauma. Not effective for sweating all over the body.	Removal of individual sweat glands - curettage. Removal of subcutaneous fat, which damages the nerve fibers leading to the glands. After such an intervention, sweating is significantly reduced or completely stops.
Central Surgical Treatment - Sympathectomy	85-100%. With percutaneous up to 90%. The doctor damages or completely destroys the nerve nodes that transmit impulses to the sweat glands. It is indicated for hyperhidrosis of the armpits and palms. Disadvantages: edema, hematoma, risk of scarring, hindering movement. In 50% of the operated patients, compensatory hyperhidrosis develops - sweating of the trunk, thighs and inguinal folds appears. In 2% of cases, this brings more inconvenience than primary hyperhidrosis. Based on this, sympathectomy is recommended for patients when there is no way to cure the chronic disease that caused sweating.	The intervention is performed under general anesthesia. Endoscopic surgery. For palmar hyperhidrosis, surgery on the D2-D4 segment (ganglia in the vicinity of 2-4 vertebrae of the thoracic spine). Axillary - on the D3-D5 segment. For palmar and axillary - on the D2-D5 segment. In plantar hyperhidrosis, sympathectomy is not performed due to the risk of postoperative sexual dysfunction. For percutaneous surgery the doctor inserts the needle into the area near the spine. Further, he destroys the nerve with electric shock or chemical means. However, in this case, he cannot see the nerve itself. This becomes the reason for the ineffectiveness of the procedure and the risk of damage to nearby organs. Open chest surgery with cutting chest practically not used due to the high injury rate.

The medical method for endocrine hyperhidrosis is not used, since anticholinergic drugs can worsen the patient's condition.

Features of the treatment of endocrine hyperhidrosis of the armpits, legs and palms

Type of hyperhidrosis	Treatment stages
Type of hyperhidrosis	1	2	3	4	5
Axillary (axillary)	Medical antiperspirants MAXIM 15% KLIMA 15% BONEDRY 20% Everdry	Botulinum toxin injections. Preparations Botox, Dysport, Ipsen, Xeomin	Iontophoresis with tap water	Sweat gland removal - curettage	Sympathectomy - destruction of the nerve node
Palmar (palmar)	Medical antiperspirants: KLIMA, Everdry, Active Dry, Odaban 30%	Botulinum toxin injections	Iontophoresis with tap water	Nerve node destruction sympathectomy
Plantar (plantar)	Antiperspirants DRYDRAY 30.5%, foot powder ODABAN 20%	Treatment with formaldehyde preparations Formidron, Paraformbetonite powder.	Botulinum toxin injections	Iontophoresis with tap water

Prevention of hyperhidrosis

Wearing loose-fitting clothing made from natural fabrics. Sweat stains are less noticeable on dark garments or finely printed garments.
Wearing "breathable shoes" and open in summer.
Use of special antibacterial insoles and liners.
Fighting flat feet. An irregular foot structure is accompanied by increased sweating.
Cold and hot shower 2 times a day with general hyperhidrosis. Baths with contrasting water 2-3 times a week for local hyperhidrosis. The change in temperature improves blood circulation in the skin and contributes to the narrowing of the ducts of the sweat glands.
Trays or applications with decoctions of medicinal herbs containing tannins and stopping the growth of bacteria. They use oak bark, celandine, mint.
Trays with potassium permanganate (potassium permanganate). Every other day or 2-3 times a week. Duration 15 min.
Taking vitamins. Vitamins A, E, and group B affect the skin and sweat glands.
Taking sedatives to normalize the nervous system. Valerian, motherwort, Bechterew's medicine reduce the nervous stimulation of the sweat glands.
Treatment of chronic diseases that provoke sweating.

Let's summarize. According to experts, the most effective method of treating local hyperhidrosis (armpits, palms, feet) is the introduction of botulinum toxin. Its effectiveness is over 90%, and the likelihood of developing side effects is minimal, compared to other methods. The cost of such treatment for hyperhidrosis starts from 17-20 thousand rubles.