Understanding Disorders of Sweat Glands: Causes, Symptoms, and Management

What is it?

-Anhidrosis is the inability to sweat normally. It may be caused by many factors such as skin trauma, diseases like neuropathies and connective tissue diseases, and medications. It could be either congenital or acquired. By sweating, the body regulates its temperature. Not being able to sweat may result in a heatstroke.
-Hyperhidrosis means that there is an excessive sweating that is not related to heat or exercise. When it’s focal it means a specific area of the body is affected- usually the hands, feet, underarms or face. It is usually symmetric- it occurs on both sides. In primary focal hyperhidrosis, the nerves that signal the sweat glands are overactivated.
-Dyshidrosis, or dyshidrotic eczema, is a common chronic skin condition. Dyshidrosis causes blisters and dry, itchy skin. It is not contagious and is more common between ages 20-40 and in women. Risk factors include a family history, a medical history of atopic or contact dermatitis, or IVIG treatment. Dyshidrosis can be caused by increased stress, allergies, frequently moist hands and feet, exposure to substances such as nickel and cobalt.
-Hidradenitis suppurativa is a skin condition in which small, painful lumps develop under the skin. It usually occurs in places when the body rubs together such as armpits, groin, buttocks and breasts. It typically begins after puberty, and usually gets worse with time.These lumps can cure, recur and may even lead to tunnels under the skin and scarring. Obesity and smoking are linked to worse symptoms. Complications include infections, scars, skin changes, restricted movement, skin cancer, swelling, and psychological effects such as depression and anxiety.

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Additional names

This group contains additional names:
- Hypohydrosis
- Dyshidrotic eczema
- Vesicular eczema of hands and/or feet
- Dyshidrosis
- Anhidrosis
- Hypohydrosis

Signs & symptoms

-Anhidrosis symptoms may include little or no persiation, dizziness, muscle cramps, flushing, feeling hot. It can either be generalized, in a single area or scattered.
-Hyperhidrosis symptoms include excessive sweating in a certain area, at least once a week, during waking hours. It could induce social anxiety and embarrassment. This usually affects the palms, soles and face. Secondary hyperhidrosis can be due to another medical condition, and is less common.
-Dyshidrosis symptoms may include small, firm blisters of fingers, palms of hands and soles of feet. Itchy skin, pain around the blisters, heavy sweating around blisters, dry skin, thickened skin.
-Hidradenitis suppurativa symptoms may include blackheads, painful small lumps, sores that drain pus with an odor, tunnels under the skin which connect the lumps.

Diagnosis

-Diagnosis may be based upon findings from medical history and physical examination. In order to confirm the diagnosis, a sweat test or a skin biopsy may be performed.
-Diagnosis is usually based upon medical history and finding in physical examination. Blood tests can be performed to look for a medical condition causing the sweating (hypoglycemia, hyperthyroidism). There are also sweat tests that can be performed.
-Diagnosis of dyshidrosis is usually done on a physical examination.
-Diagnosis of hidradenitis suppurativa is usually based on medical history and physical examination, but it is difficult to diagnose. There is no lab test that confirms the diagnosis.

Treatment

-Treatment depends on the reason and extent of the disorder. Typically, anhidrosis that affects a small part of the body does not require any treatment. When the disorder affects larger areas should be treated, depending on the cause. Drugs causing anhidrosis must be stopped.
-Hyperhidrosis treatment may include antiperspirants, creams, nerve-blocking medicayions., antidepressants and botulinum toxin injections. Other procedures like microwave therapy, sweat gland removal and sympathectomy (nerve surgery) may be suggested.
-Treatment for dyshidrosis starts with washing hands with warm water, soaking hands and feet in cool water, applying cool compresses and moisturizers. If these don’t work- corticosteroids, immunosuppressants, and phototherapy may be suggested.
-Treatment may include topical antibiotics, steroid injections, hormonal therapy, biological therapy such as adalimumab and infliximab, oral retinoids and pain medications. Surgical procedures may also help.

☝️ This is not a substitute for professional medical advice. Please consult with your physician before making any medical decision.

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Source of Information - We analyze big data of more than 23 million patients de-identified medical records from the following sources:

National Institution of Health ∙ World Health Organization ∙ University of Illinois hospital