2023-07-02 08:19:47
by Vera Martinella
Over half of patients suffer in silence thinking of an aesthetic defect, but there are effective therapies and for the first time a cream can solve the disorder in a lasting way
Those suffering from hyperhidrosis sweat excessively in specific areas of the body: mostly hands, feet, armpits or head. The problems generally appear in adolescence and persist throughout life, creating great embarrassment and many inconveniences to those concerned who, especially if they have a serious form, can also drip copiously. There is a new effective treatment that offers hope to patients with this disorder who suffer a major impact on their social, working and emotional lives.
Not just an aesthetic defect
There are few targeted investigations into this pathology, a condition that has long been underestimated – underlines Giuseppe Monfrecola, councilor of the Italian Dermatology Society SIDeMaST -. Precise numbers regarding patients are lacking: statistics speak of approximately 1-3% of the population, but we know for sure that they are underestimated, also because more than half of patients suffer in silence considering it as an “aesthetic defect”, they resign themselves without going to the doctor and therefore does not receive an accurate diagnosis. There are not even official guidelines (national or international) on treatments, each specialist adjusts according to his own knowledge. And what’s worse: as happens with many diseases that people are ashamed of, most of those interested look for remedies on the internet, where, however, many false myths circulate and there are products that do not help, rather they are irritating and often have important side effects. collateral. Now for the solutions to keep hyperhidrosis at bay there are, but it is essential to talk to a doctor and receive an accurate diagnosis.
New cure
Today there are effective and safe therapies, better than those available until recently, easier to manage – explains Anna Campanati, associate professor at the Dermatological Clinic of the Polytechnic University of the Marches -. The dermatologist must be the point of reference who can evaluate the individual case and prescribe the most appropriate treatment. The most recent therapy, recently approved by the Italian Medicines Agency (Aifa), is a 1% glycopyrronium bromide-based cream to be applied to the affected area twice a week: studies indicate that after eight days the therapy is able to reduce sweat production and 60% of treated patients stated that their life changed for the better. Long-term data have shown that the decrease is maintained over time up to 76 weeks (19 months), without side effects – says Campanati, member of the SIDeMaST scientific committee – because the drug acts on acetylcholine receptors, a neurotransmitter that stimulates secretion of our sweat glands innervated by cholinergic fibers of the sympathetic nervous system. It gives us hope for a revolution, for a cure that for the first time can solve the problem in a lasting way.
What is the use of sweating
It is important to remember that sweating is a necessary mechanism for regulating body temperature: it acts as a cooler for the body, protecting it from overheating, it promotes skin hydration and the balance of liquids and salts. This is why we have about three million sweat glands distributed throughout the body, but in people with hyperhidrosis, they overreact to stimuli and are generally overactive, thus producing more sweat than necessary.
What other treatments? In general, antiperspirants based on aluminum salts, which should not be confused with traditional deodorants, are the first choice treatment – concludes the expert -. These are products that must be applied to the skin several times a day, they are often irritating and not entirely effective, because they block the outflow of perspiration instead of limiting its production. In the second line, injections of botulinum toxin are used: it allows the blockage of the nerve endings that activate the sweat glands, temporarily inhibiting their activity, but it is very expensive and must be repeated every 6-9 months. Finally, for more severe cases of hyperhidrosis, surgery can be performed that cuts or compresses the nerves that transmit signals to the sweat-producing glands, but it is an invasive procedure with potential side effects.
Understand the origin of the disturbance
The first signs of hyperhidrosis usually appear in childhood or adolescence and then persist throughout life. In most cases it is a chronic idiopathic primary condition, which means that the precise causes are not known – concludes Giuseppe Argenziano, president of the Italian Society of Dermatology SIDeMaST and full professor of dermatology at the University of Campania Luigi Vanvitelli -, but there is also a secondary form due to the intake of certain drugs or other conditions: chronic infections, endocrine pathologies (hyperthyroidism) or a therapy or hormonal dysfunction, as in the case of menopause. It is therefore essential to have a well-defined diagnosis which can be reached with a thorough visit to the specialist. The choice of the most suitable treatment should be made together with the dermatologist, after evaluating the pros and cons. Medical treatments are usually well tolerated, but have no definitive effect. For this reason they must be repeated over time.
July 2, 2023 (change July 2, 2023 | 08:19)
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