Hyperhidrosis is the perspiration that arises from emotional or thermal stimuli over the physiological level. Normally, perspiration is part of the thermal adjustment mechanisms: it arises when the body overheats and through the evaporation of the water situated on the body’s surface it determines the the fall in the body’s temperature and the pleasurable sensation of coolness. In pacients with hyperhidrosis, perspiration can appear even when they find themselves in rooms equipped with AC and can determine psychological, social or occupational dysfunctions: the croupier cannot deal the cards in a normal fashion and the banker shows his anxiety during negotiations because of Hyperhidrosis.
-appears early in childhood
-is worsened when reaching puberty
-lessens with age
-is determined by thermal or emotional stimuli and is mediated by the vegetative sympathetic nervous system
-is more present in certain parts of the body
-there is a dominantly autosomal genetic aggregation with variable penetration in the population (30-65% of the cases)
-is generalized on the level of the body and arises as a side effect of another condition: tuberculosis, diabetes, hyperthyroidism, pheochromocytoma, carcinoid tumors, leukemia etc.
Hyperhidrosis is not a new condition. In 1850, in David Copperfield, Dickens, describing Uriah Heep, sketched palmar hyperhidrosis in two rows:
“I found Uriah reading a great fat book, with such demonstrative attention, that his lank forefinger followed up every line as he read, and made clammy tracks along the page (or so I fully believed) like a snail.”
According to the zone where it mainly appeared, primary hyperhidrosis was divided into:
In the same person, several associations of the enumerated forms may appear. Facial hyperhidrosis can be associated with hyperaemia or social phobias.
Severe case of palmar hyperhidrosis 90 seconds after a complete wipe of the hand
Axillary hyperhidrosis and especially plantar hyperhidrosis can be associated with unpleasant odors. Although perspiration doesn’t smell badly, it favors the development of bacteria that decomposes it into fatty acids. The treatment of hyperhidrosis almost always leads to the vanishing of these unpleasant odors. The secretion of the sweat glands is not homogeneous over the body’s surface: the ones situated on the back and arms produce salt-rich perspiration that does not favor bacterial development and thus, the perspiration from these areas will not have the same smell as the one from the axillary or inguinal areas.