Asymmetry in the pattern of sweating suggests a neurologic cause. Laboratory tests to identify a cause of hyperhidrosis are guided by the patient's other symptoms and might include, for example, complete blood count to detect leukemia Overview of Leukemia Leukemia is a malignant condition involving the excess production of immature or abnormal leukocytes, which eventually suppresses the production of normal blood cells and results in symptoms Early symptoms are related to hyperglycemia and include polydipsia The solution precipitates salts, which block sweat ducts.
It is most effective when applied nightly and should be washed off in the morning. Sometimes an anticholinergic drug is taken before applying to prevent sweat from washing the aluminum chloride away. Initially, several applications weekly are needed to achieve control, then a maintenance schedule of once or twice a week is followed. If treatment under occlusion is irritating, it should be tried without occlusion.
This solution should not be applied to inflamed, broken, wet, or recently shaved skin. High-concentration, water-based aluminum chloride solutions may provide adequate relief in milder cases. Glycopyrronium 2. Caution should be used in patients who are sensitive to anticholinergic drug effects.
Tap-water iontophoresis, in which salt ions are introduced into the skin using electric current, is an option for patients unresponsive to topical treatments. The affected areas typically palms or soles are placed in tap-water basins each containing an electrode across which a to mA current is applied for 10 to 20 minutes. This routine is done daily for 1 week and then repeated weekly or bimonthly. Iontophoresis may be made more effective by dissolving anticholinergic tablets eg, glycopyrrolate into the water of the iontophoresis basins.
Although the treatments are usually effective, the technique is time-consuming and somewhat cumbersome, and some patients tire of the routine. Oral anticholinergic drugs may help some patients. Glycopyrrolate or oxybutynin can be used to decrease sweating but can be limited by anticholinergic adverse effects, including dry mouth, dry skin, flushing, blurred vision, urinary retention Urinary Retention Urinary retention is incomplete emptying of the bladder or cessation of urination.
Urinary retention may be Acute Chronic Causes include impaired bladder contractility, bladder outlet obstruction Botulinum toxin type A is a neurotoxin that decreases the release of acetylcholine from sympathetic nerves serving eccrine glands.
Injected directly into the axillae, palms, or forehead, botulinum toxin inhibits sweating for about 5 months depending on dose. Of note, botulinum toxin is approved by the U. Food and Drug Administration only for axillary hyperhidrosis and may not be covered by insurance for other sites of hyperhidrosis.
Complications include local muscle weakness and headache. Injections are effective but painful and expensive, and treatment must be repeated 2 to 3 times per year. Patients may benefit from two treatments at least 3 months apart. Surgery is indicated if more conservative treatments fail.
Patients with axillary sweating can be treated with surgical excision of axillary sweat glands through open dissection or by liposuction the latter appears to have lower morbidity. Patients with palmar sweating can be treated with endoscopic transthoracic sympathectomy. The potential morbidity of surgery must be considered, especially in sympathectomy. Potential complications include phantom sweating a sensation of sweating in the absence of sweating , compensatory hyperhidrosis increased sweating in untreated parts of the body , gustatory sweating, neuralgia, and Horner syndrome Horner Syndrome Horner syndrome is ptosis, miosis, and anhidrosis due to dysfunction of cervical sympathetic output.
And even if your sweating improves after treatment, it may recur. Hyperhidrosis can be the cause of discomfort and embarrassment. You may have trouble working or enjoying recreational activities because of wet hands or feet or wet stains on clothing. You might feel anxious about your symptoms and become withdrawn or self-conscious. You may be frustrated or upset by other people's reactions. Besides talking with your doctor, you may want to talk with a counselor or a medical social worker.
Or you may find it helpful to talk with other people who have hyperhidrosis. You may start by seeing your primary care provider. He or she may refer you to a specialist in skin diseases dermatologist. If your condition is not responding to initial treatments, your care may also involve a neurologist or a surgeon. Hyperhidrosis care at Mayo Clinic.
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Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. This content does not have an English version. This content does not have an Arabic version. Diagnosis During your appointment, your doctor will ask about your medical history and symptoms. Lab tests Your doctor may recommend blood, urine or other lab tests to see if your sweating is caused by another medical condition, such as an overactive thyroid hyperthyroidism or low blood sugar hypoglycemia.
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Quick Links. Did You Know The toxins that cause botulism are the most potent known poisons.
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