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Hyperhidrosis – Sweating Sites Matter: Quality of Life in Primary Hyperhidrosis according to the Sweating Sites Measured by SF-36
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology.
2017 (English)In: Dermatology, ISSN 1018-8665, E-ISSN 1421-9832, Vol. 233, no 6, p. 441-445Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Primary hyperhidrosis has negative impacts on quality of life. The aim of this study was to investigate whether the impacts of primary hyperhidrosis on quality of life are different depending on the localisation of the sweating.

METHOD: We compiled background data, Hyperhidrosis Disease Severity Scale (HDSS), and Short-Form Health Survey (SF-36) post hoc results from 2 previous studies. Cases who described only 1 site as their most problematic area of sweating were included (n = 160/188) while individuals with multifocal primary sites of hyperhidrosis were excluded (n = 28/188).

RESULTS: Individuals included were 11-62 years old with a mean age of 30.2 ± 10.4 years, and axillary hyperhidrosis (65.6%) was the most common type of hyperhidrosis. Comorbidities were more common when hyperhidrosis was reported in other than the axillary, palmar, and plantar regions. Excluding comorbidities showed the lowest SF-36 mental component summary scores for axillary (41.6 ± 11.6), palmar (40.0 ± 9.4), and plantar hyperhidrosis (41.1 ± 13.7). The HDSS showed the highest proportion of severe cases in axillary (60.6%) and palmar (51.5%) hyperhidrosis (p < 0.01) while mild cases were more often observed in plantar (60%), facial (83.3%), and other sites (85.7%) in primary hyperhidrosis (p < 0.01).

CONCLUSION: Our results indicate that impairments in quality of life can be different depending on the manifestation of primary hyperhidrosis on the body. This can have an influence on how patients with hyperhidrosis could be prioritised in health care. Subgroup samples affected by facial hyperhidrosis and other sites of primary hyperhidrosis were however small, and more research is required to verify our findings.

Place, publisher, year, edition, pages
S. Karger, 2017. Vol. 233, no 6, p. 441-445
Keywords [en]
Hyperhidrosis, Quality of life, Survey
National Category
Dermatology and Venereal Diseases
Identifiers
URN: urn:nbn:se:umu:diva-145944DOI: 10.1159/000486713ISI: 000430505800005PubMedID: 29502112Scopus ID: 2-s2.0-85043695825OAI: oai:DiVA.org:umu-145944DiVA, id: diva2:1192544
Funder
Västerbotten County CouncilAvailable from: 2018-03-22 Created: 2018-03-22 Last updated: 2018-09-12Bibliographically approved
In thesis
1. Primary hyperhidrosis: prevalence and impacts for the individual
Open this publication in new window or tab >>Primary hyperhidrosis: prevalence and impacts for the individual
2018 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Primary hyperhidrosis, excessive sweating, is a condition with unknown prevalence in many parts of the world. The disease debuts in adolescence and it affects men and women in equal proportions. A genetic background exists and the most common localisation on the body for excessive sweating is the axillary region. It is known that primary hyperhidrosis reduces quality of life and interferes with daily activities. Affected individuals often hide their sweating problems and the disease may lead to social withdrawal and isolation. Although botulinum toxin is an effective and available treatment, relatively few persons with primary hyperhidrosis seek medical healthcare and a minority of those are men.

We investigated the prevalence of primary hyperhidrosis in Sweden and how the disease impairs quality of life, changes in daily activities, signs of depression and anxiety and alcohol consumption before and after treatment with botulinum toxin. The severity of hyperhidrosis according to the affected body sites was also investigated. Further on we explored mens experiences living with primary hyperhidrosis by interviews and content analysis.

Our results showed that primary hyperhidrosis occurs in 5.5% of the Swedish population. The disease reduces quality of life and affects mainly the psychological health of the individuals. Persons with palmar and axillary hyperhidrosis rated their symptoms more severe and with much higher impact on their quality of life compared to persons suffering from hyperhidrosis elswhere on the body. Individuals with axillary hyperhidrosis more often reported a later debut and signs of peripheral vasoconstrictions were more common in this group compared to individuals with palmar hyperhidrosis. This made us believe that factors other than genetics seem to play a role in triggering axillary hyperhidrosis. Treatment with botulinum toxin A had a significant effect in reducing the symptoms and their interferences on daily life while increasing the overall quality of life. Signs of depression, stress and anxiety were also significantly reduced by treatment. This treatment was safe and no serious side-effects were noted. Qualitative content analysis of interviews with 15 men suffering from primary hyperhidrosis resulted in the theme: To be captured in a filthy body. The experiences of men with excessive sweating were thus interpreted as stigmatising. Stigma has a negative effect on mental health which reinforces our findings in quantitative studies when investigating quality of life. It is our assumption that the symptoms act as a vicious circle reducing quality of life, stigmatising the individual and limiting daily interactions. Addressing hyperhidrosis with information when the disease debuts in young people could reduce the stigma and enable early intervention via healthcare which may have a significant effect on the life of those affected.

Place, publisher, year, edition, pages
Umeå: Umeå universitet, 2018. p. 49
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 1940
Keywords
primary hyperhidrosis, prevalence, characteristics, localization, quality of life, botulinum toxin, depression and anxiety, stigma, content analysis
National Category
Dermatology and Venereal Diseases
Research subject
Dermatology and Venerology
Identifiers
urn:nbn:se:umu:diva-145946 (URN)978-91-7601-822-4 (ISBN)
Public defence
2018-04-20, Lionsalen, NUS, byggnad 7, målpunkt Y22, Umeå, 09:00 (Swedish)
Opponent
Supervisors
Funder
Västerbotten County Council
Available from: 2018-03-28 Created: 2018-03-22 Last updated: 2018-06-09Bibliographically approved

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Shayesteh, AlexanderJanlert, UrbanNylander, Elisabet

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