What is Hyperhidrosis & how is it treated?

what is hyperhydrosis sweating hands

What is Hyperhidrosis & how is it treated?

what is hyperhydrosis sweating hands

What is hyperhidrosis?

The main purpose of sweating is the regulation of body temperature. Sweat transfers heat from within the body outwards through the skin, released through evaporation into the air. Hyperhidrosis is defined as excessive sweat production that exceeds the body’s thermoregulatory needs. This condition affects 4.8% of the U.S. population and it is widely under-treated, often because of lack of awareness.

Hyperhidrosis is classified into two types: primary and secondary. Secondary hyperhidrosis is caused by an inciting medical or physiological condition. Causes can include

  • Cancer
  • Infections (TB, malaria, HIV)
  • Endocrine or metabolic disorders (hyperthyroidism, adrenal dysfunction)
  • Medications

In secondary hyperhidrosis, sweating is widespread. It occurs during sleep and tends to have onset at age 25 and up.

Secondary hyperhidrosis accounts for only a small fraction of cases of hyperhidrosis. 93% of cases are classified as primary hyperhidrosis. Primary hyperhidrosis is not caused by an underlying health issue, but rather by excessive neurological stimulation of sweat glands. It typically begins in patients age 14-23 and is often limited to specific body sites such as the axillae, palms, soles and sometimes craniofacial areas. It can be either intermittent or continuous and occurs only when patients are awake.

Although the vast majority of cases of hyperhidrosis are considered primary, this is considered a diagnosis of exclusion and should only be made after secondary hyperhidrosis has been excluded. This can usually be done by discussing the patient’s specific circumstances, and usually doesn’t required any lab tests.

Hyperhidrosis Affecting Your Daily Life

Hyperhidrosis can affect daily activities, social interactions and work function. It can cause embarrassment, low self-esteem, and interfere with social and intimate relationships. In one study, 32% of affected people described it as unbearable and causing constant disruption to their life. 63% of people with hyperhidrosis feel unhappy or depressed.

Treatment Options

There are a variety of treatment strategies for hyperhidrosis:

  • Topical agents
  • Oral medication
  • Botox
  • Iontophoresis
  • Microwave ablation
  • Surgery

Topical Agents

The first topical agent is Aluminum chloride hexahydrate, sold under the trade name Drysol. This treatment blocks sweat gland openings and is applied either once daily or once every other day. The biggest advantage is that it’s inexpensive, but the disadvantage is that it can cause skin irritation.

Another useful topical medication is glycopyrronium cloths, sold under the trade name QBREXZA. The cloths contain a medication that blocks communication between nerves and sweat glands. Although this treatment lacks the irritation that may accompany aluminum chloride, it is very expensive and poor coverage by insurance plans.

Here we see the difference in how antiperspirants function versus how qbrexza functions.

Oral Medication

Oral medications can be used for hyperhidrosis. They block signaling between sweat glands and the nerves that control them. This is similar to the mechanism of qbrexza, except these medications work everywhere, not just on a limited application area. The most commonly used oral medication for hyperhidrosis is glycopyrrolate. Oral treatment is a good option for people with multiple affected areas. The downside is that sometimes they can have side effects such as dry mouth or nausea.

Botox

Botox is a great option for treating hyperhidrosis. It’s highly effective, usually covered by insurance, and each treatment lasts from 4mo to as long as 1yr, depending on the patient.

Iontophoresis

Iontophoresis is a treatment that uses electric current to occlude sweat glands. It’s mostly used for hyperhidrosis of the hands. The hands are placed in trays of water and a current is applied using an external device. Treatments are performed every other day for 3 weeks, then once weekly for maintenance. The advantage of this is that it is drug free and can be self-administered at home. The disadvantage is that each treatment takes 20 minutes and the device must be purchased by the patient at an out of pocket cost of usually $700.

Microwave Ablation

This photo shows the use of a medical device called MiraDry. MiraDry uses microwaves to permanently destroy axillary sweat glands. The advantage of this treatment is that it’s permanent. The disadvantage is that it is uncomfortable, takes about an hour, and is costly. A typical cost might be $2500 for one session, with possible need for a second session.

Surgical Options

There are surgical options as well, including liposuction and neurosurgery. Neurosurgery is mostly used for hyperhidrosis of the hands. The advantage is that the result is permanent. The disadvantage is that after surgery about 20% of people develop what’s known as compensatory hyperhidrosis, which is excessive sweating of other parts of the body.

If you are interested in learning more about hyperhidrosis, visit the website of the International Hyperhidrosis Society www.SweatHelp.org. For a personalized consultation about individual symptoms and treatment options, contact Windsor Dermatology today.

Dr. Bagel Presents at the American Academy of Dermatology

Dr. Bagel Presents at the American Academy of Dermatology

Dr. Bagel presented data to his peers on psoriasis and eczema at the American Academy of Dermatology, in Washington D.C. on March 1, 2019! Congratulations on the honor, Dr. Bagel, we are so proud of your hard work!

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The Overall Benefits of Clinical Trials

The Overall Benefits of Clinical Trials

Clinical trials have become a vital part of the medical industry, specifically when it comes to the introduction of new treatments and medications. These trials are held in every category imaginable, including that of dermatology. There are different medicines and creams used in dermatology that need to be tested first on participants to determine if they are worth developing further and offering to the general public. Let’s take a look at the overall benefits of clinical trials to help you better understand if you want to participate.

Take an Active Role

One of the biggest benefits of participating in clinical trials is the fact that you can take an active role in your own care. Even if you are participating in a trial for something non-life-threatening, such as eczema, you still know that you are playing an important role in fighting this skin issue. There are more serious cases however, such as clinical trials for melanoma, which may save your life if you suffer from it.

Regular Attention from Doctors

Aside from taking an active role in your skin care, another benefit of taking part in a clinical trial is that you will receive regular attention from doctors within the dermatology industry. The team compiled to run a clinical trial is usually comprised of doctors who are known across the country for their work within dermatology. Because you will be closely monitored by a team of doctors, any issues or side effects you suffer will be noted and cared for in an appropriate timeframe.

Access to New Treatments

One of the biggest reasons why patients take part in clinical trials is the fact that they can gain access to new treatments, many of which have not yet been made available to the general public. This is an incredible benefit for those who suffer from melanoma or who have exhausted all other efforts in caring for their eczema, acne, or other skin conditions.

Low Cost or Free Treatment

Many patients who take part in clinical trials do so for a stipend, which means they likely don’t have to pay for the treatment they are receiving. If they do have to pay, it’s likely at a very low cost to them. There are some clinical trials that will even pay for travel costs incurred, other medical care, and quite a few other expenses required during the length of the trial. You should always find out upfront what costs are covered before enrolling in a clinical trial.

Make Major Contribution to Research

Another benefit of participating in clinical trials is that you are making a major contribution to medical research. You could very well wind up not benefiting medically from the trial, but down the road what you took part in could help countless people deal with different skin issues.

Contact the experienced and friendly staff at Windsor Dermatology today to discuss your skin issues and find out if there are clinical trials available for your situation. The staff can be reached in their East Windsor, NJ office at (609) 443-4500.

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Q&A with Dr. Simon

Q&A with Dr. Simon

Dr. Jessica Simon is one of six board certified dermatologists at Windsor Dermatology. She is double board certified in dermatology as well as pediatric dermatology. Dr. Simon is an active member of both the American Academy of Dermatology and the Society of Pediatric Dermatology. In her free time, Dr. Simon enjoys running, singing, traveling, reading, and spending time with her family.

We sat down with Dr. Simon to ask her some questions regarding her experience as a dermatologist.

What is your favorite thing about working at Windsor Dermatology?

Most importantly, Windsor Dermatology provides a warm and supportive environment to work in and my colleagues and staff members have become like a second family. This practice also emphasizes quality patient care, which has always been my top priority. Finally, every dermatologist here has developed their own niche within the field of dermatology, which compliments the others very nicely.

How has the practice changed since you have started working here?

We have become more pediatric centric having a pediatric dermatologist on board. We also have started to become involved with more pediatric clinical trials.

How do you recommend children stay safe this summer?

I cannot emphasize the importance of sun protection. This not only includes use of sunscreen, but also wide-brim hats, sunglasses, long-sleeve shirts and pants and UV protective clothing, and staying under the shade when possible. Avoid activities outside when the sun is the strongest between the hours of 10am to 2pm. In terms of sunscreen, use a broad spectrum sunblock with spf 30 or greater and reapply every 2 hours.

What are your tips for treating poison ivy?

Those who are exposed should wash thoroughly with soap and water and as rapidly as possible, preferably between 5-10 mins of exposure. If the poison ivy oil is not removed shortly after exposure, it may be transmitted by fingers to other parts of the body. We also recommend to change clothing and to wash contaminated shoes and clothing with soap and water. Treatment of mild poison ivy dermatitis can be achieved with calamine lotion and cool compresses. If severe or persistent, go to a local dermatologist or pediatrician for a topical steroid, and antihistamines by mouth may also be prescribed. In most severe conditions or if involves the entire body, then oral steroids may be prescribed.

What is the latest update in pediatric dermatology?

There are many updates! One that I find particularly interesting is the utility of melatonin in facilitating sleep in children with atopic dermatitis. In recent studies, melatonin has been shown to have sleep-inducing and anti-inflammatory properties. One of parents’ most common complaints is that their child (and as a result their parents) are not getting enough sleep at night. Aside from topical steroids, our first line treatment for this is anti-histamines. Many parents, however, are reluctant to use anti-histamines, and melatonin may be used as a safe alternative.

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Dermatological Decisions

Dermatological Decisions

How Can You Tell If Your Dermatologist Is Top Notch?

Decisions, especially ones that involve a person’s health or well-being can sometimes be stressful, overwhelming and even scary depending on the type of decision you are making. Regardless of your reasons for wanting to seek out a dermatologist, there are certain questions that will help you to tell if a dermatologist is one that can be trusted with your skin care needs.

The credentials of any medical professional should always be the cornerstone of any decision you are making when it comes to choosing a doctor. A dermatologist should be no different.  Your dermatologist should be Board Certified in Dermatology.  This verifies they are equipped to deal with any dermatologic condition. Do they have additional training for specific situations? Prior to your appointment, make a list of questions that are most important to you.

Your doctor should take the time to address your concerns and potential treatment options. Is your doctor active in research to advance the field? It is important to find a doctor that is up to date with new cutting edge treatments that are coming to the medical field. You want to be aware of all options you may have.

Finally, the hours of your dermatologist are very important. If an emergency arises, it is important that you have a doctor who works late hours and weekends. While office staff can address nearly all follow up questions, it is important to be able to contact your doctor if needed. If you have a skin care procedure done, are you going to be able to reach your doctor if you have any other questions or concerns after your appointment?

Windsor Dermatology has been in practice for over 35 years, and all patients are seen by Board Certified Dermatologists in a caring and compassionate environment while respecting your busy schedule.  We will work with you and give you the best options for tackling your skin problems, restoring your healthy skin.

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