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Scenario: Hyperhidrosis

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Scenario: Hyperhidrosis

Rachel Williams is worried about the amount her son is sweating, so she asks to speak to pharmacist Parveen about it in confidence...

“I know Rhys is 12 and going through puberty, but the amount he sweats is horrific. He’s drenching his clothes on a daily basis. At least he’s showering a couple of times a day, so the mountain of laundry isn’t too smelly! I’ve tried the usual deodorant-type products you can buy, but they’re not making much of a difference. Do you think he needs to see his GP?”

Answer

It sounds as though Rhys may be suffering from hyperhidrosis, or excessive sweating. The condition can affect the whole body or only certain areas and, while not harmful to health in itself, can be a cause of embarrassment or distress. If Rhys’s sweating has reached the point at which it is affecting his everyday life – for example, making him reluctant to exercise, or taking up a lot of time in terms of having to change clothes or shower frequently – Parveen should advise Rachel to encourage her son to seek help.

The most sensible first step that Parveen can recommend is for Rhys to try an antiperspirant containing aluminium chloride hexahydrate 20 per cent, or obtain a supply on prescription, which should be applied every one or two nights to dry skin and washed off in the morning. Rhys could also try simple lifestyle changes – for example, avoiding triggers such as spicy food, and wearing light and loose clothing in natural fibres.

If these measures don’t help, Rhys may need referring by the GP to a dermatologist. Interventions that may be tried include stronger aluminium salt preparations, an anticholinergic agent, iontophoresis (passing a weak electrical current through a wet contact pad attached to the affected body part), or injections of botulinum toxin. Occasionally, surgery is carried out.

The bigger picture

Hyperhidrosis affects around 3 per cent of the population and is thought to be due to a dysfunction of the sympathetic nervous system. Primary hyperhidrosis has no known cause, although it may be genetic, but some people suffer hyperhidrosis as a consequence of another condition such as obesity, Parkinson’s disease, hyperthyroidism or anxiety, or as a side-effect of medication (e.g. some antidepressants and propranolol). Secondary hyperhidrosis can also occur during pregnancy and the menopause.

Skin problems, particularly fungal infections but also eczema exacerbations, warts and boils, are not uncommon in hyperhidrosis sufferers. Body odour is rarely an issue as patients with the condition are often very self-conscious and scrupulous about washing as a result. However, the psychological impact should not be underestimated, with social withdrawal and depression well documented as a consequence.

Extend your learning

Find out about surgical options by looking at the ‘localised hyperhidrosis’ section of the BAD leaflet available here.

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