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Anhidrosis: causes, signs, treatment

by Josephine Andrews
Published: Last Updated on 365 views

People with anhidrosis cannot sweat. Most of the time, only individual areas of the skin are unable to sweat, but sometimes the entire skin is affected. The evaporation of sweat is important to cool the body, with pronounced anhidrosis temperature regulation is more difficult. Find out here which diseases cause anhidrosis and what you can do about it.

Anhidrosis: description

One speaks of anhidrosis (also: anhidrosis) when sweating in a person is greatly reduced or not possible at all. A reduced ability to produce sweat, on the other hand, is called hypohidrosis. There are forms of anhidrosis in which no sweat can be formed all over the body. More common, however, are variants that only affect certain areas of the skin.

Why do people sweat?

The most important function of sweat is cooling, which occurs through evaporation on the skin . The body must always keep its temperature within a certain range, as deviations from the normal that are too great disrupt vital metabolic processes. It is therefore dependent on being able to compensate for increases in temperature, for example due to physical activity or changes in the ambient temperature. In the case of pronounced anhidrosis, this possibility is absent. The body heats up. This can lead to heat stroke .

In addition to thermoregulation, sweat also has other functions, such as helping to protect against pathogens that could penetrate the skin through an acidic pH value . Furthermore, people also sweat in emotionally stressful situations, but then sweat production has no special function.

Anhidrosis: causes and possible diseases

There are many clinical pictures that can be associated with anhidrosis, but mostly other symptoms are in the foreground. Diseases in which anhidrosis is so severe that it is a serious complication in itself are rare.

Anhidrosis in skin diseases

With certain damage and diseases of the skin, the sweat glands are also affected. The result is then anhidrosis on the diseased or injured skin areas.

For example, exposure of the skin to higher doses of radioactive radiation or X-rays can lead to a temporary loss of perspiration (radiodermatitis).

Anhidrosis can also occur in scleroderma , which leads, among other things, to hardening of the connective tissue of the skin. Another skin condition that affects sweating is ichthyosis. The keratinization of the skin, which is very dry and scaly, is disturbed. Severe skin aging due to too much UV radiation can also lead to anhidrosis.

In miliaria, also known as tropical lichen, the ducts of the sweat glands close. The sweat that is formed can therefore no longer be transported to the surface of the skin. In addition to anhidrosis, an itchy rash usually occurs. Miliaria is often the result of increased sweating over a long period of time. There are many other skin diseases in which perspiration is disturbed, the ones mentioned here are just examples.

Anhidrosis in nervous diseases

In addition to direct damage to the sweat glands, certain nerve diseases can also trigger anhidrosis. Sweating is disrupted when the sympathetic nerve fibers that control the sweat glands are damaged.

In polyneuropathy, for example, damage occurs to large parts of the peripheral nervous system. In addition to sensory and movement disorders, anhidrosis can also occur. The triggers for polyneuropathy include chronic alcohol consumption, long-standing diabetes (diabetes mellitus), or a vitamin deficiency. In some cases, no specific cause is found.

Horner’s syndrome refers to a failure of the sympathetic nervous system in the head area. Usually only one side of the face is affected. Symptoms include constricted pupils (miosis), a drooping eyelid ( ptosis ) and a sunken eyeball (enophthalmos). In addition, localized anhidrosis often occurs.

Brain and spinal cord damage and disease can also disrupt sweating. Examples of this are Parkinson’s disease and Parkinson’s-like diseases or spinal cord damage such as syringomyelia.

Anhidrosis in hereditary diseases and syndromes

Anhidrosis is also a symptom of some rare hereditary diseases. This includes:

  • anhidrotic ectodermal dysplasia. In addition to malformations on the skin, there are usually also disorders on the hair, teeth or nails.
  • Fabry disease, a complex metabolic disease with various symptoms, including anhidrosis.
  • the Naegli syndrome. Various skin changes appear. Anhidrosis affects the entire body surface and is the biggest problem for patients.
  • the Ross syndrome. Here the anhidrosis is only on one half of the body. To compensate for the defect, the unaffected half of the body usually produces more sweat.

Anhidrosis caused by dehydration, hormonal imbalances or medication

Other reasons for anhidrosis can be, for example, an underactive thyroid gland (hypothyroidism) or a pronounced lack of water (dehydration). The latter occurs mainly in older people because they often drink too little. Heat stroke is also often associated with anhidrosis.

There are also some medications whose side effects also include suppressed perspiration. These include, above all, antidepressants and so-called anticholinergics, which are used, for example, to treat urinary incontinence and an overactive bladder.

Anhidrosis: when do you need to see a doctor?

Anhidrosis is usually not the only symptom. Because it also does not cause any relevant problems as long as it is limited to smaller areas of skin, those affected often do not notice the lack of sweat production itself. Instead, they see a doctor for other symptoms, such as pain, severe itching, or paralysis. In the context of the diseases mentioned, anhidrosis is often only a secondary diagnosis.

However, if you notice that you are not sweating despite physical exertion or higher ambient temperatures, you should not hesitate to see a doctor. Because without the cooling effect of sweat, the body can overheat, which can lead to health problems.

Anhidrosis: what does the doctor do?

To clarify whether anhidrosis is present, the doctor can carry out a provocation test. Sweating is stimulated, for example through physical exertion at elevated ambient temperatures and high humidity, or by injecting certain active ingredients under the skin. In addition, the skin is coated with a special substance that changes color as soon as it comes into contact with sweat. There is no color change in anhidrosis.

The treatment always depends on the underlying disease. In the case of incurable diseases, however, the best that can be done is to alleviate the symptoms. Other symptoms usually predominate. If anhidrosis is the main problem, patients should avoid heat and physical exertion if possible.

There are special care products for treating dry skin. If medication is the trigger for anhidrosis, it may be possible to change or discontinue it.

Anhidrosis: You can do this yourself

If anhidrosis is pronounced, those affected should avoid heat and physical exertion in order not to overheat. In this case, swimming is suitable . Moisturizing sprays, which are sprayed onto the skin to replace sweat, can also help.

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