Nothing but the truth! Palmar and plantar HH By Dr Davin Lim...
The majority of patients who have sweating will exhibit primary essential hyperhidrosis- this means that there is no cause for excess sweating. Secondary hyperhidrosis can be due to drugs or diseases and present in a different way compared to essential sweating.
Primary Hyperhidrosis/ essential hyperhidrosis features
The onset of sweating is usually early, mostly in the teens
Sweating stops when you are sleeping
Your sweating is symmetrical, meaning you sweat equal amounts on both sides of your body
There is no apparent cause for your sweating, and the onset is gradual
You may have a positive family history of sweating
Most often you sweat in localised areas such as the hands, feet, armpits of face
Secondary hyperhidrosis / secondary sweating features
You sweat in your sleep, or wake up sweating
The onset is sudden
The onset of sweating is usually later in life
Sounds confusing? If in doubt our Sweat Free team will determine the differences for you and guide you to further treatments or investigations.
Many patients will have no cause of generalised sweating, and may sweat everywhere for no apparent reason, however it is very important to exclude disorders that may cause of worsen this condition.
Disorders implicated in generalised sweating include the following:
Drugs can also worsen or cause excessive sweating: the most common drugs include Energy drinks and caffeine.
Patients who have generalised hyperhidrosis should see a GP for review. In some cases our Specialist at Sweat Free may consult with a General Physician for more investigations.
In some cases, a dietician can be of benefit. This is especially so for patients who have underlying diabetes or who maybe overweight. Eating a well balanced diet, with minimal caffeine intake can decrease sweating.
Ok, here is the truth- secondary generalised sweating is exceedingly rare, but it is vitally important to rule out causes. Most patients say they sweat everywhere, but in reality sweat more in areas like the hands, feet and armpits. Distinguishing primary essentially sweating in these areas compared to generalised secondary hyperhidrosis is important.
Your first port of call is your General Practitioner, your doctor can rule out the most common causes of secondary sweating such as drugs, infections, thyroid disease, and diabetes. More complicated cases can be investigated by a general physician.
Our team can guide your GP for further investigations prior to seeing us. We may suggest special tests, x-rays and review prior to treatments. As we are Specialist in the management of sweat disorders working with your GP for investigations and treatment will give patients best outcomes.
The very first step is to exclude potential causes of generalised sweating, including medical conditions and drugs. Decreasing caffeine intake is super important.
We can now concentrate on specific areas of sweating, and methods to decrease sweat production in these areas.
Sweaty armpits can be treated with Driclor, creams and sweat stopping treatments
Excessively sweaty hands and feet can be treated with iontophoresis.
Sweating of the head and neck can be treated with creams or ETS.
Tablets treatment of sweating with Propantheline Bromide can be successful, however side effects are seen in the majority of patients.
A useful approach is to minimise or decrease sweating in the areas which affect you the most- this maybe the hands or feet, face and neck area, or under the armpits. Targeting these areas will give the greatest benefit.
Dr Davin S. Lim
Sweat Free Clinics
If you sweat everywhere, its called generalised hyperhidrosis. Most patients say they sweat in all places, but in reality they sweat more in places such as the hands, feet, face, and armpits. Secondary generalised hyperhidrosis is exceedingly rare and investigations are a must.
How I approach excessive sweating in many places is simple. I treat in accordance to the importance for the patient. Most patients choose to get their hands treated first, others prefer armpits. Listening to where patients prioritise their treatments is important. In widespread sweating, a combination of treatments will yield the best results, for example patient A may require iontophoresis for the hands and feet, sweat stopping treatments for the armpits, and forehead, whilst another patient maybe well controlled with compounded Glycopyrrolate wipes for the face and Driclor for the armpits. Individualizing treatments is the key for best outcomes.
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