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I am an 18 year old girl. I started sweating excessively in the plantar, palmar, and axillary regions when I was about 14. I sweat uncontrollably during the day, even when I’m relaxed. At night time however my sweating decreases dramatically and becomes normal. My skin is also reddish, marbley, and cold during the day too, but at night it gets warm and returns to it’s normal color. I also don’t sweat much when I exercise or when its cold outside .My doctor gave me a prescription for 20% aluminum chloride solution but it didn’t really help.. What could possibly be the cause of the excessive sweatiness throughout the day and the normalcy at night? What can I do to make it stop?

Hyperhidrosis is a medical condition characterized by uncontrollable and/or excessive perspiration. Common areas affected are the face, axillary regions, palms, groin, and soles of the feet. It is believed that hyperhidrosis is caused by an increased activity of sympathetic nerve fibers – the same nerves responsible for the “fight or flight” response when a person is stressed. Spicey foods, caffeine, and nicotine can also trigger hyperhidrosis in susceptible individuals.

There are a number of treatments available for the treatment of hyperhidrosis. Your doctor prescribed you topical aluminum chloride which is often the first line treatment. Anticholinergic drugs such as oxybutynin, benztropine, or glycopyrrolate can also used for their inhibition of normal nerve responses which may reduce perspiration. However, these drugs have numerous side effects that may make them less desirable.

Anxiolytics such as benzodiazepines are often prescribed to patients who sweat due to anxiety. From your question, it appears as if you sweat mainly during the day – which is when most social situations occur – and return to normal at night. This treatment method might be best suited for your symptoms.

A more invasive procedure include Botox injections which can temporarily paralyze the nerves that innervate the sweat glands but this requires a trained professional, is mainly used for axillary sweating, and the effects only last for a few months.

There are two main surgical techniques used to treat hyperhidrosis. Direct sweat gland removal is a surgical procedure whereby the cosmetic surgeon directly removes the sweat glands. This technique is almost exclusively used for axillary hyperhidrosis. Another surgical technique involves removing or disabling the sympathetic nerve ganglion – known as a sympathectomy. Although this is one of the more effective procedures, it also has the most serious side effects including permanent paralysis of nerves of the face, neck, and arms.

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