Diaphoresis
Encyclopedia
Diaphoresis is excessive sweating commonly associated with shock and other medical emergency
conditions.
Diaphoretic is the state of perspiring profusely, or something that has the power to cause increased perspiration.
Diaphoresis is the medical term for profuse sweating or perspiring. It is performed by the skin's sweat glands as they release a salty fluid and aid in fever management. Sweating is an essential function that helps the body stay cool and is commonly found under the arm
s, on the feet, and on the palms of the hands. The amount of sweat
that is released by the body is determined by the number of sweat glands a person is born with. There are approximately two to four million sweat glands throughout the body that will become completely active during puberty
. Although women tend to have more sweat glands, men's are generally more active. For this reason men's bodies are better able to regulate core temperature.
When the body temperature rises, the autonomic nervous system
stimulates the eccrine glands to secrete fluid onto the surface of the skin, where it cools the body as it evaporates.
, fever, spicy foods, and high environmental temperature. Strong emotions (anger, fear, etc.) and remembrance of past trauma can also trigger profuse sweating.
The vast majority of sweat glands in the body are innervated by sympathetic "cholinergic" neurons. Sympathetic postganglionic neurons usually secrete norepinephrine and are named sympathetic adrenergic neurons. However, when sympathetic postganglionic neurons innervate sweat glands they secrete acetylcholine and hence are termed sympathetic "cholinergic" neurons, the only sympathetic postganglionic neurons known to secrete acetylcholine instead of norepinephrine.
and shock. If it is accompanied by unexplained weight loss
or fever
or by palpitation
s, shortness of breath
, or chest discomfort, a physician
should be consulted. Diabetics relying on insulin
shots or oral medications may have low blood sugar
(hypoglycemia
), which can also cause diaphoresis.
Various drugs (including caffeine
, morphine
, alcohol
, and certain antipsychotics) may be causes, as well as withdrawal
from alcohol or narcotic
painkiller dependencies. Sympathetic nervous system
stimulants such as cocaine
and amphetamines have also been associated with diaphoresis. Diaphoresis due to ectopic catecholamine
is a classic symptom of a pheochromocytoma
, a rare tumor
of the adrenal gland
. Acetylcholinesterase
inhibitors (e.g. some insecticides) also cause contraction of sweat gland smooth muscle leading to diaphoresis.
Mercury is well known for its use as a diaphoretic, and was widely used in the 19th and early 20th century by physicians to "purge" the body of an illness. However, due to the high toxicity of mercury, secondary symptoms would manifest which were erroneously attributed to the former disease which was being treated with mercurials.
Infantile acrodynia (childhood mercury poisoning) is characterized by excessive perspiration. A physician should immediately consider acrodynia in an afebrile child who is sweating profusely.
Diaphoresis is also seen in an acute myocardial infarction
(heart attack), from the increased firing of the sympathetic nervous system
, and is frequent in serotonin syndrome
. Diaphoresis can also be caused by many types of infections, often accompanied by fever
and/or chills. Most infections can cause some degree of diaphoresis and it is a very common symptom in some serious infections such as malaria
and tuberculosis
. In addition, pneumothorax can cause diaphoresis with splinting of the chest wall.
Neuroleptic malignant syndrome
can also cause diaphoresis.
. Odor develops due to yeast
or bacteria
that live naturally in the skin
. As the skin becomes moist and mixes with these, odor is released. Another explanation is when the apocrine gland release sweat directly into the tubule of the glands. When placed under stress
, these tubules contract and sweat is pushed to the surface of the skin. Bacteria will begin to break down and odor is released. Medications that are used for other treatments and diet will also affect odor. Medical conditions like kidney failure and diabetic ketoacidosis
will have the same effect. Areas that produce excessive sweat usually appear pink or white, but, in severe cases, may appear cracked, scaly, and soft.
, the woman may wish to ask her physician about estrogen replacement. Once potential pathological and environmental causes of diaphoresis are ruled out by a physician, it is more accurately referred to as hyperhidrosis
.
Medications such as topical antiperspirants
, iontophoresis
, Botox and surgery have been tried to treat hyperhidrosis. Treatment of diaphoresis most often begins at home with over-the-counter antiperspirants. These contain certain compounds that block the sweat pores and reduce the amount of sweat that can reach the skin. Another typical over-the-counter product is deodorant. It eliminates odor, but does not block the sweat pores like antiperspirants. They work by turning the skin to an acidic state which is not a desired place for bacteria. Many antiperspirants will contain deodorants. If these products are not effective, prescriptions strength versions can be prescribed.
If the typical over-the-counter treatments are not effective, a physician can prescribe treatment based on a person's age, overall health, the cause and severity of the condition, and a patient's tolerance. Some regimens are as simple as placing topical solutions on the area at night, while others like the use of Botox or iontophoresis requires more tolerance. Botox injections help inhibit nerve impulses and are injected directly into the area that is affected most by sweating, while iontophoresis is the application of electric currents to the area. Some oral medications called anticholinergics have been found to reduce the amount of sweating as well. If all previous methods fail to work to the patients expectancy, sympathectomy surgery can be performed. This procedure can be used to control sweating on the hands and feet and works by destroying portions of the nerve supply to the sweat glands in these areas.
Preventing sweat from happening can sometimes be helped by bathing, using antiperspirants, and trying relaxation techniques that will help keep the body calm.
, flushing
, muscle weakness, and little or no perspiration. Unaffected areas may try to compensate by producing more perspiration, so it's possible to sweat profusely on one part of the body and very little or not at all on another.
Medical emergency
A medical emergency is an injury or illness that is acute and poses an immediate risk to a person's life or long term health. These emergencies may require assistance from another person, who should ideally be suitably qualified to do so, although some of these emergencies can be dealt with by the...
conditions.
Diaphoretic is the state of perspiring profusely, or something that has the power to cause increased perspiration.
Diaphoresis is the medical term for profuse sweating or perspiring. It is performed by the skin's sweat glands as they release a salty fluid and aid in fever management. Sweating is an essential function that helps the body stay cool and is commonly found under the arm
Arm
In human anatomy, the arm is the part of the upper limb between the shoulder and the elbow joints. In other animals, the term arm can also be used for analogous structures, such as one of the paired forelimbs of a four-legged animal or the arms of cephalopods...
s, on the feet, and on the palms of the hands. The amount of sweat
SWEAT
SWEAT is an OLN/TSN show hosted by Julie Zwillich that aired in 2003-2004.Each of the 13 half-hour episodes of SWEAT features a different outdoor sport: kayaking, mountain biking, ice hockey, beach volleyball, soccer, windsurfing, rowing, Ultimate, triathlon, wakeboarding, snowboarding, telemark...
that is released by the body is determined by the number of sweat glands a person is born with. There are approximately two to four million sweat glands throughout the body that will become completely active during puberty
Puberty
Puberty is the process of physical changes by which a child's body matures into an adult body capable of reproduction, as initiated by hormonal signals from the brain to the gonads; the ovaries in a girl, the testes in a boy...
. Although women tend to have more sweat glands, men's are generally more active. For this reason men's bodies are better able to regulate core temperature.
When the body temperature rises, the autonomic nervous system
Autonomic nervous system
The autonomic nervous system is the part of the peripheral nervous system that acts as a control system functioning largely below the level of consciousness, and controls visceral functions. The ANS affects heart rate, digestion, respiration rate, salivation, perspiration, diameter of the pupils,...
stimulates the eccrine glands to secrete fluid onto the surface of the skin, where it cools the body as it evaporates.
Physiological causes
Normal physical causes of diaphoresis include physical exertion, menopauseMenopause
Menopause is a term used to describe the permanent cessation of the primary functions of the human ovaries: the ripening and release of ova and the release of hormones that cause both the creation of the uterine lining and the subsequent shedding of the uterine lining...
, fever, spicy foods, and high environmental temperature. Strong emotions (anger, fear, etc.) and remembrance of past trauma can also trigger profuse sweating.
The vast majority of sweat glands in the body are innervated by sympathetic "cholinergic" neurons. Sympathetic postganglionic neurons usually secrete norepinephrine and are named sympathetic adrenergic neurons. However, when sympathetic postganglionic neurons innervate sweat glands they secrete acetylcholine and hence are termed sympathetic "cholinergic" neurons, the only sympathetic postganglionic neurons known to secrete acetylcholine instead of norepinephrine.
Pathological causes
Diaphoresis may be associated with some abnormal conditions,such as hyperthyroidismHyperthyroidism
Hyperthyroidism is the term for overactive tissue within the thyroid gland causing an overproduction of thyroid hormones . Hyperthyroidism is thus a cause of thyrotoxicosis, the clinical condition of increased thyroid hormones in the blood. Hyperthyroidism and thyrotoxicosis are not synonymous...
and shock. If it is accompanied by unexplained weight loss
Weight loss
Weight loss, in the context of medicine, health or physical fitness, is a reduction of the total body mass, due to a mean loss of fluid, body fat or adipose tissue and/or lean mass, namely bone mineral deposits, muscle, tendon and other connective tissue...
or fever
Fever
Fever is a common medical sign characterized by an elevation of temperature above the normal range of due to an increase in the body temperature regulatory set-point. This increase in set-point triggers increased muscle tone and shivering.As a person's temperature increases, there is, in...
or by palpitation
Palpitation
A palpitation is an abnormality of heartbeat that causes a conscious awareness of its beating, whether it is too slow, too fast, irregular, or at its normal frequency. The word may also refer to this sensation itself...
s, shortness of breath
Dyspnea
Dyspnea , shortness of breath , or air hunger, is the subjective symptom of breathlessness.It is a normal symptom of heavy exertion but becomes pathological if it occurs in unexpected situations...
, or chest discomfort, a physician
Physician
A physician is a health care provider who practices the profession of medicine, which is concerned with promoting, maintaining or restoring human health through the study, diagnosis, and treatment of disease, injury and other physical and mental impairments...
should be consulted. Diabetics relying on insulin
Insulin
Insulin is a hormone central to regulating carbohydrate and fat metabolism in the body. Insulin causes cells in the liver, muscle, and fat tissue to take up glucose from the blood, storing it as glycogen in the liver and muscle....
shots or oral medications may have low blood sugar
Blood sugar
The blood sugar concentration or blood glucose level is the amount of glucose present in the blood of a human or animal. Normally in mammals, the body maintains the blood glucose level at a reference range between about 3.6 and 5.8 mM , or 64.8 and 104.4 mg/dL...
(hypoglycemia
Hypoglycemia
Hypoglycemia or hypoglycæmia is the medical term for a state produced by a lower than normal level of blood glucose. The term literally means "under-sweet blood"...
), which can also cause diaphoresis.
Various drugs (including caffeine
Caffeine
Caffeine is a bitter, white crystalline xanthine alkaloid that acts as a stimulant drug. Caffeine is found in varying quantities in the seeds, leaves, and fruit of some plants, where it acts as a natural pesticide that paralyzes and kills certain insects feeding on the plants...
, morphine
Morphine
Morphine is a potent opiate analgesic medication and is considered to be the prototypical opioid. It was first isolated in 1804 by Friedrich Sertürner, first distributed by same in 1817, and first commercially sold by Merck in 1827, which at the time was a single small chemists' shop. It was more...
, alcohol
Alcohol
In chemistry, an alcohol is an organic compound in which the hydroxy functional group is bound to a carbon atom. In particular, this carbon center should be saturated, having single bonds to three other atoms....
, and certain antipsychotics) may be causes, as well as withdrawal
Withdrawal
Withdrawal can refer to any sort of separation, but is most commonly used to describe the group of symptoms that occurs upon the abrupt discontinuation/separation or a decrease in dosage of the intake of medications, recreational drugs, and alcohol...
from alcohol or narcotic
Narcotic
The term narcotic originally referred medically to any psychoactive compound with any sleep-inducing properties. In the United States of America it has since become associated with opioids, commonly morphine and heroin and their derivatives, such as hydrocodone. The term is, today, imprecisely...
painkiller dependencies. Sympathetic nervous system
Sympathetic nervous system
The sympathetic nervous system is one of the three parts of the autonomic nervous system, along with the enteric and parasympathetic systems. Its general action is to mobilize the body's nervous system fight-or-flight response...
stimulants such as cocaine
Cocaine
Cocaine is a crystalline tropane alkaloid that is obtained from the leaves of the coca plant. The name comes from "coca" in addition to the alkaloid suffix -ine, forming cocaine. It is a stimulant of the central nervous system, an appetite suppressant, and a topical anesthetic...
and amphetamines have also been associated with diaphoresis. Diaphoresis due to ectopic catecholamine
Catecholamine
Catecholamines are molecules that have a catechol nucleus consisting of benzene with two hydroxyl side groups and a side-chain amine. They include dopamine, as well as the "fight-or-flight" hormones adrenaline and noradrenaline released by the adrenal medulla of the adrenal glands in response to...
is a classic symptom of a pheochromocytoma
Pheochromocytoma
A pheochromocytoma or phaeochromocytoma is a neuroendocrine tumor of the medulla of the adrenal glands , or extra-adrenal chromaffin tissue that failed to involute after birth and secretes excessive amounts of catecholamines, usually noradrenaline , and adrenaline to a lesser extent...
, a rare tumor
Tumor
A tumor or tumour is commonly used as a synonym for a neoplasm that appears enlarged in size. Tumor is not synonymous with cancer...
of the adrenal gland
Adrenal gland
In mammals, the adrenal glands are endocrine glands that sit atop the kidneys; in humans, the right suprarenal gland is triangular shaped, while the left suprarenal gland is semilunar shaped...
. Acetylcholinesterase
Acetylcholinesterase
"Acetylcholinesterase, also known as AChE or acetylcholine acetylhydrolase, is an enzyme that degrades the neurotransmitter acetylcholine, producing choline and an acetate group. It is mainly found at neuromuscular junctions and cholinergic nervous system, where its activity serves to terminate...
inhibitors (e.g. some insecticides) also cause contraction of sweat gland smooth muscle leading to diaphoresis.
Mercury is well known for its use as a diaphoretic, and was widely used in the 19th and early 20th century by physicians to "purge" the body of an illness. However, due to the high toxicity of mercury, secondary symptoms would manifest which were erroneously attributed to the former disease which was being treated with mercurials.
Infantile acrodynia (childhood mercury poisoning) is characterized by excessive perspiration. A physician should immediately consider acrodynia in an afebrile child who is sweating profusely.
Diaphoresis is also seen in an acute myocardial infarction
Myocardial infarction
Myocardial infarction or acute myocardial infarction , commonly known as a heart attack, results from the interruption of blood supply to a part of the heart, causing heart cells to die...
(heart attack), from the increased firing of the sympathetic nervous system
Sympathetic nervous system
The sympathetic nervous system is one of the three parts of the autonomic nervous system, along with the enteric and parasympathetic systems. Its general action is to mobilize the body's nervous system fight-or-flight response...
, and is frequent in serotonin syndrome
Serotonin syndrome
Serotonin syndrome is a potentially life-threatening adverse drug reaction that may occur following therapeutic drug use, inadvertent interactions between drugs, overdose of particular drugs, or the recreational use of certain drugs...
. Diaphoresis can also be caused by many types of infections, often accompanied by fever
Fever
Fever is a common medical sign characterized by an elevation of temperature above the normal range of due to an increase in the body temperature regulatory set-point. This increase in set-point triggers increased muscle tone and shivering.As a person's temperature increases, there is, in...
and/or chills. Most infections can cause some degree of diaphoresis and it is a very common symptom in some serious infections such as malaria
Malaria
Malaria is a mosquito-borne infectious disease of humans and other animals caused by eukaryotic protists of the genus Plasmodium. The disease results from the multiplication of Plasmodium parasites within red blood cells, causing symptoms that typically include fever and headache, in severe cases...
and tuberculosis
Tuberculosis
Tuberculosis, MTB, or TB is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. Tuberculosis usually attacks the lungs but can also affect other parts of the body...
. In addition, pneumothorax can cause diaphoresis with splinting of the chest wall.
Neuroleptic malignant syndrome
Neuroleptic malignant syndrome
Neuroleptic malignant syndrome is a life- threatening neurological disorder most often caused by an adverse reaction to neuroleptic or antipsychotic drugs...
can also cause diaphoresis.
Symptoms
The most commonly experienced symptom of excessive sweating is body odorBody odor
Body odor or body odour, sometimes colloquially abbreviated as B.O., is the smell of bacteria growing on the body. The bacteria multiply rapidly in the presence of sweat, but sweat itself is almost completely odorless to humans....
. Odor develops due to yeast
Yeast
Yeasts are eukaryotic micro-organisms classified in the kingdom Fungi, with 1,500 species currently described estimated to be only 1% of all fungal species. Most reproduce asexually by mitosis, and many do so by an asymmetric division process called budding...
or bacteria
Bacteria
Bacteria are a large domain of prokaryotic microorganisms. Typically a few micrometres in length, bacteria have a wide range of shapes, ranging from spheres to rods and spirals...
that live naturally in the skin
Skin
-Dermis:The dermis is the layer of skin beneath the epidermis that consists of connective tissue and cushions the body from stress and strain. The dermis is tightly connected to the epidermis by a basement membrane. It also harbors many Mechanoreceptors that provide the sense of touch and heat...
. As the skin becomes moist and mixes with these, odor is released. Another explanation is when the apocrine gland release sweat directly into the tubule of the glands. When placed under stress
Stress (biology)
Stress is a term in psychology and biology, borrowed from physics and engineering and first used in the biological context in the 1930s, which has in more recent decades become commonly used in popular parlance...
, these tubules contract and sweat is pushed to the surface of the skin. Bacteria will begin to break down and odor is released. Medications that are used for other treatments and diet will also affect odor. Medical conditions like kidney failure and diabetic ketoacidosis
Diabetic ketoacidosis
Diabetic ketoacidosis is a potentially life-threatening complication in patients with diabetes mellitus. It happens predominantly in those with type 1 diabetes, but it can occur in those with type 2 diabetes under certain circumstances...
will have the same effect. Areas that produce excessive sweat usually appear pink or white, but, in severe cases, may appear cracked, scaly, and soft.
Treatment
When diaphoresis is pathologic, the underlying cause should be treated. When the cause is menopauseMenopause
Menopause is a term used to describe the permanent cessation of the primary functions of the human ovaries: the ripening and release of ova and the release of hormones that cause both the creation of the uterine lining and the subsequent shedding of the uterine lining...
, the woman may wish to ask her physician about estrogen replacement. Once potential pathological and environmental causes of diaphoresis are ruled out by a physician, it is more accurately referred to as hyperhidrosis
Hyperhidrosis
Hyperhidrosis is the condition characterized by abnormally increased perspiration, in excess of that required for regulation of body temperature.-Classification:Hyperhidrosis can either be generalized or localized to specific parts of the body...
.
Medications such as topical antiperspirants
Deodorant
Deodorants are substances applied to the body to affect body odor caused by bacterial growth and the smell associated with bacterial breakdown of perspiration in armpits, feet and other areas of the body. A subgroup of deodorants, antiperspirants, affect odor as well as prevent sweating by...
, iontophoresis
Iontophoresis
Iontophoresis is a technique using a small electric charge to deliver a medicine or other chemical through the skin. It is basically an injection without the needle...
, Botox and surgery have been tried to treat hyperhidrosis. Treatment of diaphoresis most often begins at home with over-the-counter antiperspirants. These contain certain compounds that block the sweat pores and reduce the amount of sweat that can reach the skin. Another typical over-the-counter product is deodorant. It eliminates odor, but does not block the sweat pores like antiperspirants. They work by turning the skin to an acidic state which is not a desired place for bacteria. Many antiperspirants will contain deodorants. If these products are not effective, prescriptions strength versions can be prescribed.
If the typical over-the-counter treatments are not effective, a physician can prescribe treatment based on a person's age, overall health, the cause and severity of the condition, and a patient's tolerance. Some regimens are as simple as placing topical solutions on the area at night, while others like the use of Botox or iontophoresis requires more tolerance. Botox injections help inhibit nerve impulses and are injected directly into the area that is affected most by sweating, while iontophoresis is the application of electric currents to the area. Some oral medications called anticholinergics have been found to reduce the amount of sweating as well. If all previous methods fail to work to the patients expectancy, sympathectomy surgery can be performed. This procedure can be used to control sweating on the hands and feet and works by destroying portions of the nerve supply to the sweat glands in these areas.
Preventing sweat from happening can sometimes be helped by bathing, using antiperspirants, and trying relaxation techniques that will help keep the body calm.
Hyperhidrosis
In some people, the body's mechanism for cooling itself is overactive, so overactive that they may sweat four or five times more than is necessary, or normal. Millions of people are affected by this condition, but more than half never receive treatment due to embarrassment or lack of awareness. While it most commonly affects the armpits, feet, and hands, it is possible for someone to experience this condition over their whole body. The face is another common area for hyperhidrosis to be an issue. Sweating uncontrollably is not always expected and is embarrassing to everyone who suffers from the condition. It can cause both physiological and emotional problems in patients. It is generally an inherited problem that is found in each ethnic group. It is not life threatening, but it is threatening to a person's quality of life.Anhidrosis
While many persons with diaphoresis issues are experiencing an overproduction of sweat, an absence of sweat is also possible and can be harmful. The condition, anhidrosis or hypohidrosis, lowers the body's ability to sweat and remove excess heat from the body. It causes heat exhaustion when experienced throughout the body. Symptoms of this condition include dizzinessDizziness
Dizziness refers to an impairment in spatial perception and stability. The term is somewhat imprecise. It can be used to mean vertigo, presyncope, disequilibrium, or a non-specific feeling such as giddiness or foolishness....
, flushing
Flushing (physiology)
For a person to flush is to become markedly red in the face and often other areas of the skin, from various physiological conditions. Flushing is generally distinguished, despite a close physiological relation between them, from blushing, which is milder, generally restricted to the face, cheeks or...
, muscle weakness, and little or no perspiration. Unaffected areas may try to compensate by producing more perspiration, so it's possible to sweat profusely on one part of the body and very little or not at all on another.