Dermatology Hospital of Chinese Academy of Medical Sciences
Yang Xueyuan
(Chief Physician) Review
Dermatology Hospital of Chinese Academy of Medical Sciences
Chen Min
(Deputy Chief Physician) Review
Dermatology Hospital of Chinese Academy of Medical Sciences
Hyperhidrosis refers to the abnormal increase of local or systemic skin sweating.The causes of hyperhidrosis are divided into disease and functional disorder.The clinical manifestations are divided into general hyperhidrosis and local hyperhidrosis.Genuine systemic hyperhidrosis is rare, and even hyperhidrosis caused by systemic diseases mainly occurs in some parts.Systemic hyperhidrosis is mainly caused by other diseasesUniversalityHyperhidrosis, such as infectious high fever;Local hyperhidrosis often first occurs in children or adolescents, often withfamily history, which tends to decrease naturally after adulthood.
The causes of hyperhidrosis can be divided into disease and functional disorder:
one
Illness:Mostly seen in endocrine disorders and hormone disorders, such asHyperthyroidism、Hyperhypophysis、gestation、diabetes, nervous system diseases, febrile diseases, and some hereditary syndromes.
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Functionality:Most of them are related to mental factors, such as mental tension, emotional excitement, anger, terror and anxiety, which are caused by sympathetic imbalance.
It often first occurs in children or adolescents, oftenfamily history, which tends to decrease naturally after adulthood.The sweaty parts are mainly in the palms and solesarmpitThe perineum is followed by the nose tip, forehead and chest, among which the palms, soles and armpits are the most common, and the skin can be soaked and whitened.Hyperhidrosis is transient or persistent, and it is more obvious when mood fluctuatesSeasonality。Hyperhidrosis of palms and soles is often accompanied by cold and damp hands and feet orCyanosisPhenomenon, plantar causesweatDecomposition can produce special odor.Armpit hyperhidrosisUsually no odor, different fromArmpit osmidrosis。Sweating at the tip of nose, forehead and chest is often related to stimulating food, and people often eathot food , hot coffee, hot tea, drinkLiquorIt is also called gustatory hyperhidrosis.
treatment
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Systemic hyperhidrosis is difficult to control, and the key is to treat the relatedBasic diseases。Palmoplantar hyperhidrosis is mainly treated locally.The treatment effect of axillary hyperhidrosis is often inferior to palmoplantar hyperhidrosis.
medication
External use:Common antiperspirants include 20%~25% aluminum chloride solution, 0.5% aluminum acetate solution, 3%~5% formaldehyde solution, 5% alum solution, and 5% tannic acid solution.Excessive use of topical drugs may cause local dryness, mild cracking or serious irritation.
Internal medication:Systemic hyperhidrosis is a primary disease related to treatment.Sedatives (phenobarbital, isopentabarbital, scobarbital, clomazazone, etc.) and low-dose anti anxiety drugs (diazepam, hydroxyzine, doxepine, etc.) are effective for emotional hyperhidrosis.Only large doses of anticholinergic drugs have the effect of inhibiting sweat secretion and can cause intolerable dry mouth, so they tend to be eliminated.
Physiotherapy: Tap water ion electrophoresis therapy is applicable to patients who fail to receive local (palmoplantar, armpit) external treatment.installpacemakerDisabled by.Superficial X-ray irradiation can inhibit sweat gland secretion, which is only applicable to other patients with severe palmoplantar hyperhidrosis who fail in treatment.
Local injection of botulinum toxin A (BTX-A):It is mainly used to treat palmoplantar and axillary hyperhidrosis.In general, 5 to 7 days after injection, it can stop perspiration significantly, and can last for an average of 9 to 12 months.
surgical treatment
Selective resection of the second to fourth chest pairssympathetic nerveIt has significant effect on palmar, axillary, chest and facial hyperhidrosis, but it is not suitable for patients with plantar hyperhidrosis.And surgery can lead toPermanentAnhidrosisAnd other parts of the body, so it should be used with caution.Only those with hyperhidrosis in the armpit can selectively remove the part of the axillary sweat gland that secretes the most active sweat. This method has a definite effect.
prevention
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one
Simple gustatory hyperhidrosis should avoid eating spicy and stimulating food and drinks.
two
The hyperhidrosis caused by mental factors should actively self adjust their mentality to avoid mental tension, emotional excitement, anger, terror and anxiety.
