Sweat Disorders

Excessive sweating (Hyperhydrosis), bad body odour (Bromhydrosis) and colouring of sweat (chromhydrosis) are common sweat gland related problems. Hyperhydrosis can be generalized or localized to palms, soles and axillae.

Generalised Hyperhydrosis: There is a marked physiologic variation in the amount of sweating from person to person. Commonly, generalised hyperhydrosis is seen during attacks of fever; this can persist for a few days to months and subsides as the fever subsides. Other causes for generalised hyperhydrosis are:

  • Emotional
  • Obesity
  • Menopause
  • Diabetic autonomic neuropathy
  • Hypoglycemia
  • Hyperthyroidism
  • Hyperpituitarism
  • Phaeochromocytoma
  • Lymphoma
  • Idiopathic

Localised Hyperhydrosis: It occurs especially on the palms, soles and the axillae and to a lesser extent over the groins and face. It is usually related to emotional factors. The sweating of palms and soles could be continuous or phasic. When continuous, it is worse in the summer and not so clearly precipitated by emotional factors. The phasic type is usually precipitated by minor emotional or mental activity and is not markedly different in summer and winter. Excessive sweating of palms and soles predisposes to a type of eczema called as pompholyx, contact dermatitis and infections.

Treatment:
Generalised hyperhydrosis:

  • Treatment of the underlying disease
  • Systemic anticholinergic agents
  • Reassurance

Localised hyperhydrosis:

  • Reassurance and relaxation
  • 1% formaldehyde soaks
  • 10% glutaraldehyde solution
  • 20% aluminium chloride in absolute ethanol
  • 1-4% poldine methosulfate in alcohol
  • 5-10% methanone
  • Iontophoresis using tap water or anticholinergic agents
  • Oral medications: Propantheline 15mg three times daily, diltiazem
  • Surgical correction: Sympathectomy
  • Injection of Botulinum toxin (Botox)

Bromhydrosis: Secretions are odourless by themselves, but bacterial action on the secretions results in formation of bad odour (commonly in the axilla, groins, feet). Treatment includes topical antibiotic creams, deodorant antiperspirant preparations containing acidic aluminium or zinc salts, 10-20% aluminium chloride (Drysol) for nights.

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