Anhidrosis and hyperhidrosis are disorders both referencing the body’s inability to sweat normally. Perspiration is the process in which the body’s sweat glands release a salt-containing liquid in order to help the body maintain its normal temperature, sweating usually commencing in cases when a cooling-down of the system is needed due to over-heating. Sweating is controlled by the autonomic nervous system, which is not under direct, conscious control.

Anhidrosis, also known as hypohidrosis (or Dann-Epstein-Sohar syndrome), is the condition in which the body produces abnormally low to no perspiration at all.

Hyperhidrosis is the condition in which the body produces abnormally excessive sweating that occurs outside conditions of high temperature or exercise.

Causes

Anhidrosis:

Congenital conditions – certain disorders such as congenital dysplasias (abnormalities of tissue) that affect the development of sweat glands

Inherited conditions affecting the metabolic system – Fabry’s disease

Connective tissue diseases – Sjogren’s syndrome (dryness of mouth and eyes)

Skin damaging resulting from burns, radiation therapy, or psoriasis

Conditions causing nerve damage – diabetes, alcoholism, Guillain-Barre syndrome

As a side effect due to an intake of certain drugs – morphine, botulinum toxin Type A or medications used in treating psychosis

Severe dehydration

Hyperhidrosis:

If no specific condition can be identified as causing it, then this situation refers to primary hyperhidrosis and in some cases it may be inherited

If the excessive production of perspiration is attributable to an underlying medical condition, then this situation refers to secondary hyperhidrosis, possible factors being: an intake of certain medications, diabetes, menopausal ‘hot flashes’, low blood sugar levels, heart attacks, nervous system disorders, infectious diseases, an overactive thyroid gland, certain types of tumors

Symptoms and signs

Anhidrosis:

Little to no perspiration

Sensation of dizziness

Muscle cramps, muscle weakness

Flushing, the sensation of high temperature

The lack of perspiration may be generalized (to the entire surface of the body), localized in a single area, or scattered in patches

Hyperhidrosis:

Heavy sweating accompanied by chills and lightheadedness

Chest pains, nausea

A body temperature higher than 40C (104F)

Increase of night sweats with no apparent reason

It usually affects areas such as the hands, feet, underarms or face and cause unpleasant episodes at least once a week during waking hours

It usually occurs on both sides of the body

Advice

Anhidrosis:

If it affects a small area of the body, the disorder does not pose a problem

But if large areas of the body are not perspiring properly, then severe issues can occur, namely heat-related illnesses such as heat cramps, heat exhaustion and heatstroke

By treating the signs of these various heat-related illnesses, one is in essence treating the effects of anhidrosis

In the case of heat cramps, in order to relieve cramping, one should rest and cool down, drink liquids containing electrolytes, while also being aware that sufficient time must pass before returning to a demanding physical activity

In the case of heat exhaustion (signs of its onset being the sensation of dizziness, nausea and rapid heartbeats) one should immediately find shelter in a cool place and slightly elevate legs, loosen any constraining piece of clothing, drink a cooling beverage, lowering body temperature with the aid of cold water (spray or sponge)

In the case of heatstroke one should immediately call for professional medical help, since left untreated the illness is fatal (until help arrives the tasks mentioned in the case of heat exhaustion should be lightly employed)

Hyperhidrosis:

Medications: prescription antiperspirants containing aluminum chloride (Drysol, Xerac Ac) or cortisone cream, nerve-blocking medications, antidepressants or botulinum toxin injections that function on the premise of blocking the nerves triggering the sweat glands into action

Surgical and other procedures: iontophoresis (a procedure in which a low level electrical current is induced in the patient’s water-soaked hands, feet or underarms), it is a procedure that has to be repeated twice a day for three to four weeks, it requires regular maintenance and it is not beneficial in cases of pregnancy or patients with pacemaker implants; sweat gland removal or nerve surgery

MISCONCEPTIONS
  • Anhidrosis is not always seen in relation to the extent of its potentially harmful repercussions

    Hyperhidrosis is mistakenly correlated with poor hygiene practices

Statistics

A recent study of five members of a consanguineous Pakistani family that suffer from anhidrosis (exhibiting normal morphology and normal number of sweat glands) revealed that the condition might be caused by a mutation in the 1,4,5-triphosphate receptor, type 2 gene (ITPR2) *

German (1988) indicated that primary palmar hyperhidrosis may be unusually frequent in China**

Cloward (1957) stated that primary palmar hyperhidrosis occurred over 20 times more frequently in Japan than in other Asians or Caucasians in Hawaii**

Did you know?

A person is born with a number of approximately two to four million sweat glands

Sweat glands become fully active during puberty

Women have more sweat glands than men, but the latter’s are more active

Children are especially vulnerable if they suffer from anhidrosis due to the fact that their core body temperature rises faster than in the case of adults, while their bodies are improperly equipped for efficient release of body heat

People suffering from hyperhidrosis have higher chances of contracting skin infections

Heatstroke can cause hallucinations, loss of consciousness, coma and if left untreated, eventually death