HYPERHIDROSIS OR EXCESSIVE PERSPIRATION

Perspiration is a physiological phenomenon, it is only when it becomes a disability that one speaks about hyperhidrosis.

These hyperhidrosis contrary to the preconceived ideas is relatively frequent (0,5% to 1% of people).
The hyperhidrosis in general is well dissimulated and those which suffer from it implement all kinds of stratagems to hide their disability. That goes from the collection of handkerchiefs in the pocket or the drawer of the office, with the pluri daily change  of the shoes, to the complete social avoidance.
The sweat glands of the patients reached of hyperhidrosis do not show significant deterioration compared to those of the normal individuals. That it is anatomically or numerically, no change could be detected.

Topography:
It is the palmar face of the hands and the fingers which perspires more, in partnership with:

- feet in 83% of the cases
- armpits in 53% of the cases
- the face in 1% of the cases
- the neck, trunk, legs in 12% of the cases

However, it is unusual to find the foot affected with a degree as significant as the hands.

Clinical elements associated with hyperhidrosis

a) Acrocyanosis: the hands have a purplished color.

b) Associated dermatological disorders:

1) Infections: mycosic or bacterial prevalent with the feet and related to the maceration due to the constant moisture of the skin.

2) Eczema: often associated, especially with the hands, without obvious relation of cause for purpose.

3) Bromhydrosis: it is an unpleasant odor of the sweat, which comes from the bacterial products of decomposition.

The professional problems psycho socio:

a) The social handicap:

Especially felt by the female population and probably in connection with the social contingencies related to the physical aspect in our society. The plantar hyperhidrosis  embarrassment sometimes social reports because of the bad smells which it can generate; but, it is especially the palmar hyperhidrosis which constitutes a real social handicap, the handshake being almost inevitable daily at the time of normal social reports.

b) The professional handicap:

The exercise of many professions can be obstructed by a significant palmar hyperhidrosis: secretariat, drawing, electronics, metallurgy, clock industry, musicians, schoolboys, students…

c) Psychological profile:

The psychological examinations undertaken at subjects hyperhidrosic did not show a significant statistical rise in the level in anxiety; on the other hand they showed a low capacity to face the stress and the frequent need for psychological assistance.

Diagnosis of the essential hyperhidrosis.

The hyperhidrosis can be the symptom of a general pathology (hyperthermia, hyperthyroidism…). In this case the treatment applies to the initial cause and a medical opinion is necessary
In practical, a bilateral palmo-plantar hyperhidrosis supported by the emotion at a young subject, in good health, can hardly make doubt diagnosis.