Focal hyperhidrosis is a condition characterized by excessive or profuse sweating in certain body regions. It is also referred to as primary hyperhidrosis. Unlike its counterpart, that is, generalized or secondary hyperhidrosis, it is idiopathic in nature or is not associated with an underlying condition. Typical regions of excessive sweating include the underarms, palms, soles, groin and craniofacial (face/scalp) areas. Sweating patterns are typically bilateral or symmetric and rarely occur in just one palm or one underarm. Night sweats or sweating while sleeping is also rare. The onset of focal hyperhidrosis is usually before the age of 25 years. This is in contrast to generalized hyperhidrosis which tends to occur in an older age group. Evidence demonstrates that a positive family history is also present.
The condition occurs in approximately 3% of the general population. Prevalence among men and woman is relatively the same. Profuse sweating is present mostly in the underarms, followed by the feet, palms and facial region.
Focal hyperhidrosis can have a significant impact on quality of life. Individuals can be affected from a social, psychological, emotional and professional perspective. The condition has been referred to as "The Silent Handicap" for this reason. The Canadian Hyperhidrosis Advisory Committee has published a comprehensive set of guidelines which outlines key aspects of treatment related to this condition. Topical hyperhidrosis gels containing aluminum chloride hexahydrate are usually first choice treatments for this condition.
In addition to topical antiperspirants (prescription or over-the-counter/OTC clinical strength such as Secret, Dove or DryDerm; main active ingredients usually being aluminum or zirconium salts) treatment options include: iontophoresis (hands, feet), onabotulinumtoxinA (Botox) injections (underarms, hands, feet, and other localized areas), electromagnetic/microwave energy thermolysis of underarm sweat glands (miraDry), laser-assisted removal of the sweat glands (underarms), other local procedures such as liposuction and curettage of the sweat glands (underarms), oral prescription medications/anticholinergics, and ETS surgery (hands).
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