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Question
Posted by: Miki | 2004/01/14

Exccesive perspiration

Dear Cyberdoc

My son, who is 19 years old really has a perspiration problem,which increases in summer. He will come out of the shower, dry, and within minutes he will have rivulets running from his armpits. He finds this embarrasing and uncomfortable.
What are his options? We have heard of an op where the glands are removed, will a medical aid pay for this? My other son (25) has the same problem, and my husband as well, although his perspiration is more on his head and in his face. I mention this as I know it can sometimes be ascribed to certain diseases, I suspect that in this instance it is hereditary. Unnecessary to say, my menfolk prefer winter!!
I will appreciate any advice.

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Our expert says:
Expert ImageCyberDoc

Miki, it sounds like they might suffer from hyperhidrosis. Hyperhidrosis is excessive perspiration due to overactivity of the sweat glands. It may be a contributory factor in various skin diseases (fungal or pyogenic infections; contact dermatitis). Generalized hyperhidrosis frequently accompanies fever. An endocrine dysfunction (eg, hyperthyroidism) or, occasionally, a CNS disorder may also cause generalized sweating. Localized hyperhidrosis usually occurs in otherwise healthy persons. It usually is confined to the palms, soles, axillae, inframammary regions, or groin. Excessive sweating of the palms and soles may be psychogenic.
In hyperhidrosis, the skin in affected areas is often pink or bluish white. In severe cases, the skin, especially on the feet, may be macerated,fissured, and scaling.
Treatment
For generalized hyperhidrosis, the underlying systemic disease must be treated, yet the hyperhidrosis may be refractory. Systemic anticholinergic drugs have only a temporary effect, and side effects (eg, dry mouth, blurred vision, difficulty with urination) are problematic. For localized hyperhidrosis, a 20 to 25% solution of aluminium chloride hexahydrate in absolute ethyl alcohol applied at night to the dried axillae, palms, or soles and covered tightly with a thin polyethylene film is usually effective. In the morning, the polyethylene film is removed and the area is washed free of salt. Two applications usually protect the area for 1 wk. If the aluminum chloride under occlusion is irritating, it should be tried without occlusion. This solution should not be applied to inflamed, broken, wet, or recently shaved skin. In some patients, tap-water iontophoresis may be effective. A 5% solution of methenamine (available in some countries) in water may also be effective. Topical solutions containing glutaraldehyde or formaldehyde may be effective but can be irritating. If the anhydrous aluminium chloride treatment fails, extreme axillary hyperhidrosis may be relieved by surgically excising the concentrated group of glands in the axillary vault or injecting the area with Botox®. An operation called a sympathectomy can also be done where the nerve supply to the offending glands is cut off and keeps them from secreting any sweat. This operation is not possible for excessive sweating of the head.
Good luck and if you have more questions, please post them as a new question or I won’t get them.

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