Hello Doctor, Trust you are doing great I am from

Patient

Q: Hello Doctor,
Trust you are doing great.
I am from Bangalore and have been living here for the last 12 years. It was in 2003 that I started to have the problem of excessive sweating – Hyperhydrosis. Occasions when I sweat:
• During anxiety/being conscious – It’s normal to be anxious at certain moments. We all do. But I start sweating as well which is embarrassing. Even if I come to your clinic tomorrow, I might sweat a little (especially forehead and nose area) while explaining in detail to you. Though I am an extrovert and a very confident guy with a good personality.
• When I move from normal to hot environment, say a room with no air. I sweat more than other people on such occasions.
I had suffered from Jaundice in 2003 and I feel this problem has started right after I recovered from it. I am pretty sure I didn’t have this problem before. I had my Thyroid checked few months back and it was normal. I have not taken any medications yet but now it has started getting really embarrassing. Request you to suggest me on this problem. If any tests need to be done, please let me know
Few more details:
Name: Karan
Age: 30 years
Height: 6.1 feet
Weight: 88 kg (Slightly overweight)
Where do I sweat – Forehead, nose, palm, feet
Any recent disease – None
Any skin related problem – None
Any other family member with same problem - No

Please let me know for any other details.
Appreciate your time !!

Regards,
Karan

Doctor

A:   Hello,
Thanks for the query to ATD for an opinion,
Hyperhidrosis, or excessive sweating, is a common disorder which produces a lot of unhappiness. A person can suffer from excessive sweating of the underarms (axillary hyperhidrosis) or of the palms and soles of the feet (palmoplantar hyperhidrosis). Underarm problems tend to start in late adolescence, while palm and sole sweating often begins earlier, around the age 13 (on the average). Untreated, these problems may continue throughout life.
Sweating is embarrassing, it stains clothes, ruins romance, and complicates business and social interactions. Severe cases can have serious practical consequences as well, making it hard for people who suffer from it to hold a pen, grip a car steering wheel, or shake hands.Although neurologic, endocrine, infectious, and other systemic diseases can sometimes cause hyperhidrosis, most cases occur in people who are otherwise healthy. Heat and emotions may trigger hyperhidrosis in some, but many who suffer from hyperhidrosis sweat nearly all their waking hours, regardless of their mood or the weather.
The approach to treating excessive sweating generally proceeds as follows:-
1. Over-the-counter antiperspirants containing a low dose of metal salt (usually aluminum) are usually tried first because they are readily available. Antiperspirants containing aluminum chloride may be more effective when other antiperspirants have failed.
2. Prescription strength antiperspirants, which contain aluminum chloride hexahydrate.
3. Iontophoresis, a device which passes ionized tap water through the skin using direct electricity.
4. Oral medications, Anticholinergics reduce sweating.
5. Botox (botulinum toxin)-A, has been approved for treating excessive axillary (underarm) sweating.
6. Surgery. A procedure called thoracic sympathectomy may be considered as a last resort. Thoracic sympathectomy is surgical interruption of the sympathetic nerves responsible for sweating. Sympathectomy is an operation intended to destroy part of the nerve supply to the sweat glands in the skin.
You may discuss in detail with your physician regarding the above mentioned options and take uninformed decision,
I hope i have addressed your concerns,
Wishing you good health,
Regards

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