Facial hyperhidrosis, commonly referred to as excessive facial sweating, is a rare condition characterised by excessive sweating of the face. This condition is generally embarrassing and uncomfortable for the sufferer due to social implications and the difficulty suffers experience attempting to hide the problem. While most treatments for facial hyperhidrosis are surgical, there are some non-surgical options available for sufferers.
There are two different types of hyperhidrosis including primary and secondary hyperhidrosis. With primary hyperhidrosis, doctors believe the excessive sweating occurs due to emotional stimuli; however, a concrete cause is unknown. Craniofacial primary hyperhidrosis is also the rarest form. Secondary hyperhidrosis occurs due to an underlying medical condition, such as an endocrine disorder, infection or malignancy.
Diagnosis and Testing
Typically, a dermatologist begins the diagnostic process with a physical examination and a family history. Generally, during the physical examination the doctor will see indications of hyperhidrosis such as sweat droplets on the body. To confirm, a doctor performs a test, such as the minor-starch iodine test. With the minor-starch iodine test, the doctor applies an iodine solution and dry starch powder to the skin. Any excessive sweating causes the powder to turn dark blue. The doctor then measures the volume of the sweat with a filter paper to determine the severity of the hyperhidrosis.
One non-surgical treatment for facial hyperhidrosis is topical medication. For light to moderate facial hyperhidrosis, doctors generally recommend an over-the-counter antiperspirant lotion or gel for applying to the face. For more severe facial hyperhidrosis, doctors generally recommend prescription antiperspirants. Patients apply these prescription antiperspirants to a dry face and wash off after six to eight hours. In some cases, prescription antiperspirants cause swollen, red and itchy skin.
Another non-surgical option for treating facial hyperhidrosis is oral medication. There are several types of effective oral medications including clonidine, anticholinergics, carbonic anhydrase inhibitors and antidepressants. Clonidine reduces sweat output by reducing the nerve stimuli. Anticholinergics reduce sweat output by blocking the nerve impulses to sweat glands. Carbonic anhydrase inhibitors are useful for inhibiting sweating. Antidepressants not only reduce sweating, but also assist patients in emotionally coping with facial hyperhidrosis. In some cases, oral medications cause blurred vision, dry mouth and difficulty with urination.
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