Other Types of Hyperhidrosis

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Hyperhidrosis and Facial Blushing


- Hyperreactivity of the Sympathetic Nervous System -

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Other Types of Hyperhidrosis


Focal hyperhidrosis may occasionally occur in other locations.


Upper lip, nose wings

Not infrequently facial hyperhidrosis is limited to the upper or lower lip and / or to the nose wings. In these cases, the surgical block of the sympathetic nerve (interganglionic level T1-2) is not recommended, since, in addition to the side effects, it is significantly less effective than in hyperhidrosis that involves the entire face. Instead, infiltration of botulinum toxin have shown to control sweating for months (injections should be inoculated intradermally, i.e. as superficial as possible, in order to avoid weakening of the lip muscle).

Upper lip and nose wings infiltrated with botulinum toxin.


Intergluteal and inguinal region

Excessive sweating in the groin and / or intergluteale and / or in the perineum may often create embarrassment, as it can cause wet marks on underwear and pants to the degree that it could be interpreted as incontinence. Typically, in these intertriginous areas, botulinum toxin is more effective than treatment with antiperspirants.

Large area treated effectively with botulinum toxin injections.

Botulinum toxin treatment in the groin area.


Less common types of focal hyperhidrosis


1. Frey's Syndrome


It is characterized by unilateral sweating on either cheek overlying the parotid gland. The cause is usually traumatic or surgical (eg, results from operations for cancers of the gland). Sweating occurs after intake of food, especially spicy or acidic (gustatory sweating).
Infiltration of the skin with botulinum toxin has been proven to be the most suitable treatment, lasting on average 6-8 months (period that tends to increase after several applications).


2. Other (rare) manifestations of focal hyperhidrosis


Idiopathic hyperhidrosis localized in a well defined area of the forearm and the proximal part of the backside of the hand (highlighted by the Minor test).

Circumscribed area with formation of droplets before treatment.

After infiltration with botulinum toxin.



Bibliography

  1. Otolaryngol Head Neck Surg 2000 Feb;122(2):237-40 Botulinum toxin treatment for symptomatic Frey's syndrome. Arad-Cohen A, Blitzer A New York Center for Voice and Swallowing Disorders at St Luke's/Roosevelt Hospital Center, New York, USA