Hyperhidrosis

Question 1

What is hyperhidrosis?

Answer 1

Excessive sweating beyond what is necessary for normal body temperature regulation.

Question 2

How is hyperhidrosis classified?

Answer 2

By location (localized/focal or generalized) and cause (primary or secondary).

Question 3

What areas are most commonly affected by primary focal hyperhidrosis?

Answer 3

Axillae, palms, soles, face, scalp, and groin.

Question 4

What conditions can cause secondary hyperhidrosis?

Answer 4

Anxiety, infections, malignancy, endocrine/metabolic disorders, Parkinson’s disease, epilepsy, certain drugs, and alcohol.

Question 5

What is the first-line treatment for primary focal hyperhidrosis?

Answer 5

Topical 20% aluminium chloride hexahydrate applied nightly to dry skin.

Question 6

How should topical aluminium chloride hexahydrate be applied?

Answer 6

At night to dry skin, washed off in the morning, every 1–2 days initially, then as needed.
Avoid shaving or using hair removal products within 12 hours before or after application.

Question 7

When should a patient with hyperhidrosis be referred to a specialist?

Answer 7

If topical treatments are ineffective or not tolerated after 6 weeks.

Question 8

What specialist treatments are available for hyperhidrosis?

Answer 8

Higher strength aluminium salts, topical glycopyrrolate, oral antimuscarinics, iontophoresis, botulinum toxin A injections, and surgery.