• What are the potential causes of profuse sweating?
• Describe the treatment options for patients with profuse sweating.
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Identify the most common triggers of hyperhidrosis. A variety of lifestyle factors can cause hyperhidrosis, including hot weather, stress, and nervousness. Patients should be educated about these triggers so they can identify them in themselves or their family members and take appropriate action to avoid triggering situations that cause excessive sweat production (e.g., removing articles of clothing when outdoors).
Hyperhidrosis is a common problem among older adults and persons with mental illnesses such as dementia-related psychosis and bipolar disorder.7 Treatments include topical antiperspirants or oral medication such as terbutaline or propantheline bromide; both work by inhibiting sympathetic nerve activity resulting in reduced peripheral vasoconstriction and lessening secretion from eccrine glands (Table 19-1). However, medications cannot cure hyperhidrosis because affected individuals still experience excessive sweating during episodes despite appropriate treatment; drug resistance may also occur over time due to multiple uses of these drugs at different times during life or adverse side effects from improper dosage use or interactions with other prescription medications (e.g., amitriptyline).8–10 Orlistat is another class 1c antiacne agent approved for weight loss that has been used successfully in treating mild cases of hyperhidrosis since 2006