cased by axillary hyperhidrosis,
brings underarm stains,
Armpit odor,armpit smell,underarm odor,cased by axillary hyperhidrosis, brings underarm stains,
How common is over sweating ,scientifically called axillary hyperhidrosis:
-axillary hyperhidrosis affect 1% of population
-it can be generalized or localized.
.armpit alone,affect 37%,
.hand alone,affect 20%,
.hand and armpit in 43%
Causes of over sweating,armpit smell:
-sweating is centrally controlled process
-sweat gland is connected by
1.noradrenergic sympathetic nerve,affected by emotion
2.cholinergic sympathetic nerve,affected by hot environment
patient having over sweating has ;
1.over functioning sympathetic nerve
2.increased signal of [sympathetic] out flow.
[apocrine] sweat gland in armpit produce vicious fluid rich in odor causing substance
It is interesting to know that people having armpit over sweating do not complaint odor
Lesions /specific nerve blockade cause localized area of absent sweating(called anhidrosis) eg in Horner syndrome. We use this advantageously to our benefit in treatment
Tips on prevention or cure.
1. Antiperspirant,anti-perspirant, given topically, is the 1st line of treatment.
-it contain aluminum chloride ,10-15%.
-initially, given each night,then weekly,or fortnightly , once condition is under control
2. Use anticholinergic.
- work by blocking at nerve-gland junction,the last of nerve pathway,
-this compete for acetlycholine ,reversibly
-can be given topically,transdermally (rarely orally,as it gives lot of side effect,eg glaucoma,dry mouth,urinary retention,constipation)
-technique is to transport charged particle /molecules into a tissue,
-this is cumbersome,time consuming, costly
4.Botulinium toxin injection
-is derived from anaerobic spore forming Clostridium botulinum bacteria
-it bind rapidly ,irreversibly,to pre-synaptic nerve membrane,at neuro-gland junction
-is the latest treatment modality
-is the treatment of choice,
-has a high level of treatment satisfaction
-rapid onset, and sustained effect,
-given for severe cases,
-however,result is not permanent,as new sprouts grow from nerve terminal,
-definitely improve QoL,quality of life,
-RCT trial confirm the above
Special treatment options:
-is severing nerve supply to sweat gland
-thoracic 2nd,3rd,4th ganglia are cut, by laser, electrocautery,surgical clippings
-now is done by key-hole surgery,endoscopically
-compensatory hyperhidrosis may return causing dissatisfaction
2.local excision ,removal of sweat gland
3. suction assisted lipolysis
Reurn to mid life crisis
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