Hyperhidrosis is commonly localized on palms, soles of the feet and in the armpit on… Sweating is a normal function of the body to the control of the heat budget. The man has about 2 million sweat glands, which have the highest density on the palms of the hands, soles of the feet and in the armpit. The so-called eccrine sweat glands, which lie in the bottom layer of the DermIS and just below, are the only structures in the skin, which are controlled by the sympathetic nervous system with acetylcholine as a neurotransmitter by nerve impulses. Neurotransmitters are substances that mediate the transfer of nerve impulses to the target organs.
The so-called idiopathic (without known cause) Hyperhidrosis occurs most commonly localized on palms, soles, and/or axillae and starts a family cluster not rare in childhood and adolescence. Even in peace, especially under stress of any kind the sympathetic nervous system is activated in the affected the following increased sweating. The affected patients, this leads to significant psychosocial problems of social isolation, and occupational disability. In the affected areas of the body, patients are susceptible to infections of the skin due to bacteria, fungi and viruses. The previously established forms of treatment are the drug treatment with so-called anticholinergic agents, the local application of aluminum chloride and the tap water iontophoresis on the hands and feet.
In refractory cases, for example a Symphathektomie is performed in which the sympathetic nerves are severed in the chest cavity. All of these methods are either not very reliable or afflicted by serious side effects (dry mouth with anticholinergic or additional nerve damage in the sympathectomy). A newer form of treatment of Hyperhidrosis is the intradermal injection of botulinum toxin A (Botox, Dysport). Botulinum toxin is a naturally occurring bacterial toxin produced by Clostridium botulinum a toxin. Botulinum Toxin type A blocked the cholinergic Impulsubetragung at the motor endplate by stopping the release of acetylcholine and causes a chemical denervation of the muscle.