Focal Hyperhidrosis - Diagnosis & Management
Courtesy of Aamir Haider, Nowell Solish
Abstract :
HYPERHIDROSIS, A CONDITION CHARACTERIZED by excessive sweat-
ing, can be generalized or focal. Generalized hyperhidrosis in-
volves the entire body and is usually part of an underlying con-
dition, most often an infectious, endocrine or neurologic
disorder. Focal hyperhidrosis is idiopathic, occurring in other-
wise healthy people. It affects 1 or more body areas, most often
the palms, armpits, soles or face. Almost 3% of the general pop-
ulation, largely people aged between 25 and 64 years, experi-
ence hyperhidrosis. The condition carries a substantial psycho-
logical and social burden, since it interferes with daily activities.
However, patients rarely seek a physician’s help because many
are unaware that they have a treatable medical disorder. Early
detection and management of hyperhidrosis can significantly
improve a patient’s quality of life. There are various topical, sys-
temic, surgical and nonsurgical treatments available with effi-
cacy rates greater than 90%–95%.
82% of patients with palmar hyperhidrosis have reported
onset in childhood.5 Focal hyperhidrosis appears to have
an onset in childhood; however, people may not seek
medical help until early adulthood. Armpits are affected
in 51% of patients, feet in 29%, palms in 25% and the
face in 20%.4,6 No studies have documented the natural
course of the disease with increasing age, but in our expe-
rience, the severity of sweating seems to decrease in pa-
tients older than 50 years.