Sweating: Too much or not at all?
Sweating has an essential function in temperature regulation, i. Thermoregulation. This is controlled by the brain hormone center, eg. hypothalamus and mediated by the sympathetic nervous system. Sweating and skin moisture are regulated by this part of the neurovegetative (autonomic) nervous system. The impulses are transmitted via small-sized nerve fibers (small fibers) to the sweat glands in the skin. Of course, a whole range of factors affect skin hydration and sweating. These include, for example, age, gender, climate or time of day. Various medications influence sweating and temperature regulation.
Excessive sweating
The permanent excessive sweating, i. hyperhidrosis can occur as a result of various diseases such as disorders of the thyroid function, infections, tumors, etc. Increased sweating also occurs as a side effect of drug treatments (eg psychotropic drugs such as neuroleptics, tricyclic) known. Excessive sweating can either affect the whole body or be confined to the head, trunk. In rare cases, sweating is pronounced on only one side of the body.
The causes of sudden sweating include not only a high ambient temperature but also mental tension, emotions, physical activity and meals. For example, it can lead to the appearance of the taste sweating during eating. Triggered by certain foods or by the food in general, those affected can suddenly sweat not only in the area of the face and head. Sudden sweating can affect the entire body.
Those affected sweat not only excessively but also on parts of the body that are usually rarely involved in sweating. These include, for example, the forearms, thighs and lower legs or the scalp. As a result of excessive sweating, it may be necessary to change clothing several times a day or even at night.
Lack of sweating
But this also reduced the lack of sweating, i. For example, anhidrosis can occur in the context of neuropathies such as polyneuropathies. These include diseases of the autonomic (autonomic) nervous system and small-caliber nerve fibers in the skin, small-fiber neuropathies. Sweating disorders can occur in the context of neuromuscular diseases such as certain forms of pathological muscle fatigue, myasthenia but also in neurodegenerative diseases of the brain such as Parkinson's disease. Anhidrosis or lack of sweating can also be the result of medical treatment, for example with anticholinergics. As a result of reduced sweating, there may be less protection against overheating of the body or even a heat intolerance.
Various examination procedures can help to detect a disturbance of sweating. For example, substances can be applied to the skin, which lead to a change in color when in contact with perspiration. Instead of these elaborate methods, different stimulation tests can now be applied to the question of a disorder of sweating.
For example, we use an electrical stimulation test on the hands and feet as a diagnostic standard. This estimates the reaction of the sweat glands to an electrical stimulus on the hands and feet. The response strength to the electrical stimulus is judged by the change in skin resistance. Another stimulation test will test the response time and extent of sweat production after stimulation on the arms and legs.
Causes and treatment
In the treatment of excessive sweating, hyperhidrosis plays a major role in finding the cause of the disorder. Metabolism, nutrition, fever or drug side effects, for example, for the treatment of high blood pressure or pain can lead to increased sweating in the short term. Careful research and individual measures derived from it can quickly provide relief. Examination of thyroid function, sugar metabolism, blood count and hormonal changes may give rise to the causes of increased perspiration, which require specialized medical, endocrinological or oncological treatment. If the disorder of the sweat gland function is a symptom of polyneuropathy, further disturbances of nerve functions may exist - such as muscle weakness, altered touch sensitivity or disturbances of the coordination services. Organ functions such as cardiovascular regulation, gastrointestinal functions and bladder function may also be altered.
Even if no causative factors such as medication, nutritional content, or mental stress factors or chronic diseases can be found there are a number of measures that can be taken to reduce sweating. These range from herbal remedies via local applications, medications or the botulinum toxin injection. The appropriate therapy is chosen in cosideration of the extent and cause of hyperhidrosis.
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Prof. Dr. Med. Christina Haubrich