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Abstract: A 20-year-old female college student, Xiao Zhou, presented to the hospital with chronic profuse sweating of the hands due to psychiatric factors, which had affected her normal life. The diagnosis of hyperhidrosis of the hands was confirmed by talking to the patient and by physical examination. Since the patient was still in school, I prescribed injections of botulinum toxin type A. The patient’s symptoms gradually improved, and the symptoms of excessive sweating had completely disappeared at the 3-month follow-up.
Basic information】Female, 20 years old
Disease Type】Hyperhidrosis
Hospital】Wuhan University Central South Hospital
Date of consultation】August 2021
Treatment Plan】Medication (Botulinum toxin type A for injection)
Treatment Period】3 months
Results】The symptoms of excessive hand sweating disappeared and the condition recovered well.
I. Initial consultation
On the morning of my visit, a 20-year-old female college student came to my clinic and reported that her hands had been sweating a lot since junior high school, and she sweated more when she was nervous. She had tried to buy various antiperspirants, but they were not very effective and her hands would still sweat frequently. I had a hand nerve check and a blood test, and all the indicators were normal and no problems were found. Now that the weather is hot, hand sweating is even more pronounced, and many things that you touch will leave sweat marks. Since the person I liked had a cleanliness problem, I was afraid to confess to him, so I wanted to get rid of it completely. I also learned from the patient’s parents that they did not have sweaty hands and had no previous allergies, and that they were prone to sweating even in quiet situations.
II. Treatment process
I told the patient that since her hand nerve examination and blood test were normal and her parents’ elders’ hands were also normal, it indicated that there was no endocrine disorder or genetic factors causing hyperhidrosis, and that it might be a hand hyperhidrosis induced by mental factors. Direct surgical removal of sweat glands is recommended to avoid longer recovery time and postoperative adverse effects such as nerve damage. Treatment with injectable botulinum toxin type A also provides better suppression of sweat gland secretion over time and can be repeated if there is a recurrence. The patient agreed to this treatment plan and received the injections.
III. Treatment results
One week after the injection, I learned from the follow-up visit that the sweating of the patient’s hands was significantly reduced, and he did not sweat as much as before the treatment, which relieved the patient’s psychological burden. Two weeks after the injection, the patient reported that his hands were basically free of sweating, which had no effect on his life, and now he could easily help other people to carry things, and was not afraid of leaving sweat marks that would cause embarrassment. 3 months later, the symptoms of hand sweating had not recurred, and the treatment effect was good.
IV. Notes
Seeing that the patient’s symptoms are gradually improving, my heart is also very comforting, I instructed the patient to pay attention to the following matters: 1.
1, the hands often sweat easily sweat smell, also easy to stain dirty, so daily need to pay attention to hand hygiene, diligent cleaning, to avoid causing hand bacteria, fungus and other infections, aggravating the discomfort symptoms.
2, hands often sweat will lead to more water loss in the body, resulting in the lack of some trace elements, so daily need to drink more water, replenish water and trace elements to maintain the health of the body;.
3, patients do not need to be anxious and nervous because of sweaty hands, they need to keep a calm state of mind to avoid getting caught in the cycle, aggravating the symptoms of sweaty hands, and actively cooperate with the doctor’s treatment can be.
4, daily diet should avoid or reduce the consumption of spicy and stimulating foods, such as hot pot as well as strong tea, coffee or wine, in order to avoid aggravating sweating symptoms.
V. Personal insight
Most patients with hyperhidrosis of the hands are more or less accompanied by mental stress because of the impact on their daily lives, and this patient is affected by mental factors that induce hyperhidrosis of the hands, and then daily anxiety and tension affected by hyperhidrosis of the hands and then fall into a cycle that leads to aggravation of the condition. For hand hyperhidrosis, there is usually no real danger to your health, so patients need to pay attention to calmness and self-regulation. If it affects interpersonal communication, it is advisable to seek medical treatment in time to avoid greater psychological stress.