Upon scaring or exciting, heart rate and respiration get faster and shallower. Our mouth gets dry, muscles become tense and our palms get sweated. Autonomic nervous system (ANS) mediates these kind of changes in our body. ANS controls either the involuntary muscles and the exocrine glands as well. ANS has three main divisions in itself as sympathetic, parasympathetic and enteric nervous systems. The sympathetic nervous system controls the sweating glands and prepares the body against threats and urgent situations. That is why this system is being mentioned as “fight or run off” system. This system can activate the thyroid and the adrenal glands. It supplies energy for the “fight and run off” behaviors by increasing the functions that augment the blood flow to the brain and the muscles leading to
- increase in the blood pressure (hypertension)
- increase in the blood sugar (hyperglycemia)
- increase in the heart rate (tachycardia)
- blood vessels shrink (vasospasm)
- adrenal secretion increases
- SWEATING INCREASES (hyperhidrosis)
- body temperature increases (hyperthermia)
- body hairs become upright
- face turns pale
- hands and feet get cold
- saliva secretion decreases
- digestive system slows down
- stress arises in the body
Naturally, we do feel stressed while the sympathetic nervous system works.
- Figure 1- |
The sympathetic nervous system consists of the neural nodes (ganglions) alined one on the top of the other along the both sides of the vertebral column (these are the nodes being cut or clipped during sympathectomy (ETS – endoscopic thoracic sympathectomy or open surgical sympathectomy) (Figure 1 – the yellow chain of sympathetic nerves along side the vertebral column). |
The other component of the ANS, the parasympathetic system, enables healing and renewal of the body. Resting, relaxation and happiness are the situations stimulating this system.
Sweating is a normal body function being controlled by the sympathetic nervous system. It is a normal body response decreasing body temperature during hyperthermia (raise in the temperature). This response occurs typically during exercise or exposure to excessive heat. But, in some, especially under stress, this system works extremely high leading to excessive sweating (hyperhidrosis). But, this ANS's extreme response to stress is generally normal during exercise or exposure to excessive heat.
The excessive sweating which might be due to a regulatory failure (unknown cause) generally starts during childhood or adolescence (puberty).
- Figure 2- |
Sweat glands are placed in the skin throughout the body (Figure 2). They are intensively found in face, hands, feet, armpits and the genital area. Therefore, patients with excessive sweating complain about sweating mostly in these body parts.
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Apart from that, excessive working of the thyroid gland, some diseases originating from the adrenal gland, obesity, menopause, severe psychiatric disorders and some hormonal therapy in cancer might all cause excessive sweating.
Excessive sweating is continuous in some, whereas intermittent in the others (phasic). In the continuous sweating group, sweating gets worse in the summer and in contrast the mental factors as gladness, sadness, anger and jealousy don't have any impact on the sweating.
In the intermittent sweating group, sweating takes place unrelated to the season, and complains flare up with emotional conditions and mental activity.
Regional sweating can continue for many years. Because there is some differences in the amount of sweating between individuals, no absolute standard in differential diagnosis has been determined uptill now.
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PREVALENCE IN THE POPULATION |
Approxiamtely, 1% of the adults suffer from the excessive sweating. Typically, the excessive sweating starts during childhood and puberty and gets worse while puberty and adulthood. Men and women are affected equally by the excessive sweating. Clinic is mild in most of the patients and it is not annoying socially most of the time. But, some times daily life is being influenced considerably negative.
Daily activities (taking notes in the school, sitting for written exams, shaking hands, etc) get depressing and these unfavorably affect the social life.
Complaints seen during the puberty are mild or increase as time goes by and while adulthood. Spontaneous decrease in the complaints is very seldom.
The most frequent complaint is the palmar (hand) sweating, and it is the most socially bothersome one. Patients usually avoid handshaking. Thus, this affects negatively the communication and the interaction in the workplace and has destructive and back breaking affects on the social contact to the opposite sex.
