Sweating is a normal metabolic activity of the human body, anyone will sweat after exercise, it is also easy to sweat in the heat, some people will also have sweating performance when they are nervous. But some people will sweat down their hands even in cold weather, this abnormal performance often makes people very annoyed, is not caused by any disease? Today we will talk about the knowledge of hyperhidrosis of the hands and feet. What is the cause of sweating Sweating is divided into two kinds of physiological sweating and pathological sweating. Sweating in hot weather and after heavy exercise is a physiological phenomenon, a physiological function of the body to excrete and regulate body temperature. It is controlled by the sympathetic nerves in the vegetative nervous system. When the ambient temperature or body temperature exceeds the body’s own body temperature set point, the sympathetic nerves are excited to prevent further increase in body temperature, which governs the secretion of sweat glands and the evaporation of sweat to take away heat to cool down. Sweat gland secretion is closely related to exercise intensity, and there are individual differences in the amount of sweating. There are two most common types of pathological hyperhidrosis: one is night sweating, which occurs involuntarily during sleep at night. The other is spontaneous sweating, which occurs during the day, not because of labor, thick clothing or heat and sweating, or a little exercise is sweating profusely. Sweating can also be divided into primary sweating and secondary sweating. Primary hyperhidrosis refers to a state of hypersecretion of the sweat glands for no apparent reason, and is a functional autonomic disorder in which the sweat glands are overproductive. Secondary hyperhidrosis is caused by neuroendocrine and other systemic diseases (e.g., hyperthyroidism, diabetes, hypoglycemia, poisoning, drug side effects, cardiovascular disease, respiratory failure, carcinoid syndrome, Hodgkin’s disease). In addition, hyperhidrosis can be divided into generalized hyperhidrosis and localized hyperhidrosis according to the location of sweating. Generalized hyperhidrosis is mostly secondary hyperhidrosis, while localized hyperhidrosis is mostly primary hyperhidrosis. Hand and foot hyperhidrosis is actually a primary localized hyperhidrosis, which is caused by excessive sympathetic nerve activity that governs the secretory function of the sweat glands in the hands, armpits and soles of the feet. It is possible to pass it on to your offspring because of family susceptibility and autosomal dominant inheritance. The primary hand sweating disorder is a phytodysfunctional disease that affects about 0.6-1.0% of the population, and is higher in the East than in the West, and about 40% of patients have a family history of the disease. The main manifestation is bilateral sweating on the palms of the hands, independent of the external temperature. In mild cases, the palms are only moist, while in severe cases, the palms can produce beads of sweat visible to the naked eye, and in severe cases, they can drip down the fingers. Sweating is extremely related to emotional activity, and sweating is more frequent when the mind is tense, and some people’s hands sweat immediately when they think of sweating. However, the appearance of symptoms is sudden and intermittent, and the duration of each attack is 5 to 30 minutes, and the number of attacks per day is variable, while sweating is not much during sleep. The symptoms are more severe in summer and relatively mild in winter. Usually, 40% to 45% of people with hand sweating also have excessive sweating on the soles of the feet, 25% to 30% have excessive sweating in the axillae, and 1% to 5% have excessive sweating on the head and face. The sweaty hands and feet are mostly “wet and cold” when sweating, the temperature of the hands and feet is only about 33 ℃, 2-3 ℃ lower than those without sweat, easy to frostbite in winter, the phenomenon of “peeling”, and occasionally sweat herpes (sweat ducts in the hands and feet when the mouth of the sweat glands are blocked, causing sweat to be stored in the palm and toe skin of an eczema-like changes). The skin of the palms and toes is blocked by the sweat glands. What are the treatment options for hand sweating? 1. Topical lotions. The external lotion is mainly applied with astringent alum, glutaraldehyde and other solutions soaked for tens of minutes, can have a certain effect within a few days, but there will be skin damage on the hands, wrinkling, cracking and other skin lesions, and the effect is not lasting. 2, oral use of anticholinergic antiperspirant. Systemic use of anticholinergic drugs such as urotropine can inhibit sympathetic activity to a certain extent, combined with a relative reduction in sweating, but the drug is discontinued that relapse, and during the use of drugs often appear dry mouth, rapid heartbeat and other complications. 3, oral anxiolytics sedative anxiolytics can have some therapeutic effect. Commonly used drugs are tranquilizers: Valium tablets, Xuloxane tablets, Imipramine tablets, Synthroid tablets, anxiolytic Amitriptyline tablets, Prozac, Dalixin, etc.. But sedative anti-anxiety drugs often cause mental depression, fatigue, inattention. A long time to take also appears drug dependence. 4, local injection of carnitine. Carnitine palm surface skin injection within the injection site can be made to stop or reduce sweating within 1 to 3 months. But this method of pain is serious, need to multi-point injection, repeated injection, easy to cause palm surface infection and other complications, and the cost of high Pleiades, each hand injection treatment requires nearly a thousand dollars, and can only be effective for 1 ~ 3 months. In 1920, Kotzareff first reported the application of sympathetic nerve chain dissection for hand sweating; in 1992, Landrenesu first applied television thoracoscopic sympathetic nerve chain dissection for the treatment of hand sweating, the surgical treatment of hand sweating incision in each side of the axilla 1~3 small incisions, each about 1-2 centimeters, through the hole into the thoracoscope, then under the television surveillance cut off the innervation of sweating. Then the thoracic sympathetic nerve, which governs sweat gland secretion, is cut under television surveillance. Its operation time and recovery period are shorter and less painful than traditional open-heart surgery, but the operation still requires general anesthesia and is more expensive (more than 10,000 yuan). Postoperative complications such as overdry palms, pneumothorax, hemothorax, pulmonary atelectasis, and lung infection may occur. Minimally invasive treatment —- keyhole method of thoracic sympathetic pouchotomy, which is a more minimally invasive new method of treating hand sweating, has only one 0.5cm keyhole in both axillae, through which a thoracoscope and special instruments are placed to complete the surgery, at a cost of only about $8,000. Although hand and foot hyperhidrosis is a disease, but there is no major harm to health, if the symptoms are not very serious, and generally do not affect their normal life, can not be too concerned, as the age of the condition will ease, wipe your hands regularly, go out with a packet of tissues, do not always think that your hands will sweat, do not be too anxious when you encounter an emergency or stressful situation, can also partially relieve the symptoms of excessive sweating. However, moderate and severe hand sweating can bring problems to our lives: for example, students have to write with a piece of paper under their hands because their hands sweat a lot when they take exams and get wet; when operating a computer, sweat can wet the keyboard, and after the sweat dries, sweat stains will be left on the keyboard and mouse; when working as an electrician, sweaty hands can easily lead to electrocution; when socializing, they are afraid to shake hands with others because of the severe sweaty palms. To avoid these embarrassments in life, patients with more severe symptoms can choose minimally invasive treatment —- keyhole method thoracic sympathetic pouchotomy.