Anhidrosis

Marian Grosser studied human medicine in Munich. In addition, the doctor, who was interested in many things, dared to make some exciting detours: studying philosophy and art history, working on the radio and, finally, also for a Netdoctor.

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People with anhidrosis cannot sweat. Usually the ability to sweat is only lacking in individual areas of the skin, but sometimes the entire skin is affected. The evaporation of sweat is important in order to cool the body; with pronounced anhidrosis, temperature regulation is difficult. Find out here which diseases cause anhidrosis and what you can do about it.

Anhidrosis: description

One speaks of anhidrosis (also: anhidrosis) when a person's perspiration 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 sweat cannot be formed all over the body. However, variants that only affect certain areas of the skin are more common.

Why do people sweat?

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

In addition to thermoregulation, sweat also has other functions, for example, through an acidic pH value, it helps protect against pathogens that could penetrate the skin. Furthermore, people also sweat in emotional 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 in itself a serious complication are rare.

Anhidrosis in skin diseases

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

If the skin is exposed to high doses of radioactive radiation or X-rays, this can lead to a temporary loss of perspiration (radiodermatitis).

In scleroderma, which among other things leads to hardening of the connective tissue of the skin, anhidrosis can also occur. Another skin disease with impaired perspiration is ichthyosis. The keratinization of the skin, which is very dry and flaky, is disturbed. Severe skin aging caused by too much UV radiation can also lead to anhidrosis.

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

Anhidrosis in nerve diseases

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

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

Horner's syndrome is a failure of the sympathetic nervous system in the head area. Usually only one side of the face is affected. Symptoms are a constriction of the pupil (miosis), a drooping eyelid (ptosis) and an eyeball that has sunk into the eye socket (enophthalmus). In addition, localized anhidrosis often occurs.

Damage to and diseases of the brain and spinal cord can also interfere with 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, disorders of the hair, teeth or nails usually also occur here.
• Fabry disease, a complex metabolic disorder with various symptoms, including anhidrosis.
• the Naegli syndrome. Various skin changes appear. Anhidrosis affects the entire surface of the body and is the greatest problem for patients.
• the Ross syndrome. Here the anhidrosis only exists on one half of the body. In order to compensate for the defect, the unaffected half of the body usually produces more sweat.

Anhidrosis due to lack of fluids, hormonal imbalances, or medication

Other reasons for anhidrosis can be, for example, an underactive thyroid (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 drugs whose side effects 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 does not cause any relevant problems as long as it is limited to smaller skin areas, 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 no perspiration occurs 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 perform a provocation test. Sweat is stimulated, for example through physical exertion at high ambient temperatures and high levels of 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 thing to do is to alleviate the symptoms. Usually other symptoms are in the foreground. If anhidrosis is the main problem, patients should avoid heat and physical exertion whenever possible.

There are special care products to treat dry skin. If medication is the cause of anhidrosis, it may be possible to change it or stop it.

Anhidrosis: you can do that yourself

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

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