May 9, 2009 People with the excessive sweating condition known as hyperhidrosis already have to deal with a number of life-inhibiting social issues. Sweaty palms or unsightly underarm stains can make simple tasks such as shaking hands or raising an arm extremely embarrassing.
According to a new study, people with primary hyperhidrosis also have a higher risk of developing skin infections. Fortunately for those with the condition, appropriate treatment by a dermatologist can control these issues.
Dermatologist Hobart W. Walling, MD, PhD, FAAD, who maintains a private practice in Coralville, IA, has found that primary hyperhidrosis patients are more prone to skin infections than those without the condition.
Hyperhidrosis is categorized as either primary (not caused by a separate medical condition or medication) or secondary (caused by an underlying medical condition or medication). Primary hyperhidrosis affects nearly 3 percent of the U.S. population. Symptoms of primary hyperhidrosis include excessive sweating that lasts at least six months with at least two of the following additional characteristics: affects both sides of the body equally, occurs at least once weekly, begins at age 25 or younger, ceases during sleep, and has other family members with the condition.
Dr. Walling and a team of researchers collected medical records for 387 patients who had visited the University of Iowa Department of Dermatology and were diagnosed with primary hyperhidrosis. They also collected records for 410 age- and gender-matched patients who visited the same dermatology department during the same time period and were diagnosed with an unrelated condition.
“Many studies have focused on the social and psychological effects associated with hyperhidrosis, but few studies have focused on the medical consequences of the condition,” said Dr. Walling. “Our study set out to examine the physical signs and symptoms of primary hyperhidrosis and to determine the condition’s relationship to skin infections in the affected areas.”
Of the patients with primary hyperhidrosis, almost three-fifths (58.9%) were female and more than two-fifths (41.1%) were male. More than half of the patients (53.4%) experienced hyperhidrosis in one area of the body, while the remaining patients (46.6%) had multiple affected sites. The most frequently affected sites of hyperhidrosis reported by the patients were the soles (50.1%), followed by the palms (45.2%) and the underarms (43.4%). Other areas affected included the face, scalp, groin and torso, and some reported hyperhidrosis throughout the body.
In addition, a number of the primary hyperhidrosis patients (38.6%) gave information regarding factors that aggravated their condition. Patients noted stress, emotion, anxiety or social situations as the most common (56.7%). Some found that heat or humidity worsened their condition (22%), while others denied any aggravating factors (15.3%).
Dr. Walling and his research team examined the medical records of the primary hyperhidrosis patients in search of coexisting skin infections that affected the areas involved by hyperhidrosis. They then compared these results to the patients without hyperhidrosis who had been diagnosed with a skin infection that affected any area of the body.
The overall risk of developing a skin infection caused by bacteria, fungi or viruses was significantly higher for the patients with primary hyperhidrosis than those without (30% of patients with hyperhidrosis developed a skin infection versus 12.0% of those without). In particular, patients with primary hyperhidrosis had a significantly higher risk of developing a fungal infection in the areas affected by hyperhidrosis (12.1%) than the control group (2.7%). Similarly, the risk of bacterial infection was heightened in primary hyperhidrosis patients (5.4%) versus those in the control group (2.2%) as was the overall risk of viral infection (12.4% of patients versus 7.1% of controls). Also of note, an increased association with atopic or eczematous dermatitis was observed in patients with primary hyperhidrosis (9.3%) versus those without (3.4%).
“The patients in the study waited, on average, nearly nine years after experiencing symptoms of hyperhidrosis before they visited a dermatologist,” said Dr. Walling. “It is important that patients know that seeking treatment for hyperhidrosis not only will positively impact their quality of life, but it may help prevent skin infections from occurring and deter other associated complications.”
Dr. Walling recommends that if you experience excessive sweating over a prolonged period of time or perspiration that is not triggered by obvious factors, you should consult a dermatologist.
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- Walling et al. Primary hyperhidrosis increases the risk of cutaneous infection: A case-control study of 387 patients. Journal of the American Academy of Dermatology, 2009; DOI: 10.1016/j.jaad.2009.02.038
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