Diaphoresis – definition, causes, diagnosis treatment and prevention

Diaphoresis: definition, causes, diagnosis treatment and prevention

What is diaphoresis?

Diaphoresis refers to abnormally increased sweating which is out of proportion to your level of activity and environment. Although Diaphoresis is some kind of an unfamiliar word, “sweating bullets” is something you may have heard frequently. Both diaphoresis and sweating bullets indicate that there is very severe or profuse sweating of the body. This is quite a common condition that many of us would have experienced in our day to day life. However, the only difference is that diaphoresis is something abnormal. The sweating is not in proportion to your level of activity or the environmental temperature. These people with diaphoresis often are drenched in their sweat or have to frequently wipe off the sweat or moisture off of their hands or face. And this is embarrassing and very uncomfortable to most of the patients who have to face this problem.

In diaphoresis, sweating is not localized to one part of the body but instead, it affects your entire body. Another similar word that refers to this same condition is secondary hyperhidrosis.

Diaphoresis is a symptom; it is not a disease. It is a symptom indicating that there is some sort of an underlying condition. Some of these conditions can be life threatening and require immediate medical attention and treatment. Another few cases of diaphoresis can be caused by certain medications.

What causes a person to sweat so much?
Fake Dictionary, definition of the word behavior.

What is sweat?

Before we go onto details about diaphoresis, let us first understand what sweat is and why our bodyproduces sweat.

So what is sweat made of?

Sweat is a watery fluid which contains of electrolytes such as sodium and chloride and other substances like proteins and lipids. This fluid is produced by a group of glands which are lovated on the skin and is known as sweat glands. Our skin contains nearly up to 5 million sweat glands which are located all over the skin of our body. However, in cases where sweating is triggered by some kind of an emotion or stress only happens from certain areas of the body such as the palms, head or arm pits. This is why many of us who become anxious just before a presentation or just before an exam develop sweating of the palms and arm pits.

How do we sweat? Why?

In our body, there are two types of sweat glands. They are the apocrine and eccrine sweat glands. These two glands differ from each other by its location. The apocrine sweat glands are located mainly in the arm pits whereas the eccrine glands are the ones that are found all over the skin of our body. Our body also has something called as the autonomic nervous system and this part of the nervous system is responsible for the control of the sweating mechanisms in our body. This control occurs without our knowledge or is involuntary or is under unconscious control. W have no conscious control over sweating as a result.
is sweating good or bad for your health

As mentioned earlier, the apocrine glands are located mainly within the arm pits and they usually become active during puberty. These glands commonly secrete sweat when we feel a lot of emotion, stress or pain. The eccrine glands are the ones that are abundantly found on our skin and these glands, unlike the apocrine glands become functional from the time of birth. They secrete a diluted salt solution where 99% of this solution comprises of water. Since these glands are found abundantly on the skin, these glands are responsible for the wet sensation of sweat. The main aim of producing sweat is to keep our body cool especially during the hot weather to maintain a normal body temperature. This is why we sweat during hot weather or soon after exercise and it is a completely normal and healthy process.

Increased sweating can be a normal event as well but it is not true always. There are certain group of people who sweat a lot more than the others and it is a normal event to them. For instance, one study has found that people who are fit physically has a tendency to sweat more than the others. The other instances where increased sweating is a normal phenomenon include:

  • Men sweat more than women.
  • Obese people have a larger body surface area compared to others and therefore tend to sweat a lot more than the others.
  • Some people with increased number of sweat glands compared to other people, also tend to sweat more.
  • Sometimes people experience increased sweating due to and inherited trait which causes them to sweat more compared to others.

What are the causes of diaphoresis?

While diaphoresis can be a normal encounter in a minority of patients, it also can be a result of an underlying pathology in many others. Diaphoresis can be caused by several conditions ranging from sleep apnoea or anxiousness to malaria and sepsis. Since diaphoresis is a symptoms that is caused by several conditions, your health care provider should be able to determine the underlying cause to decide on the management of this condition.

The following are some of the most common causes of diaphoresis.

Pregnancy

Pregnancy is a state where the mother’s body undergo so many hormonal changes. Pregnancy increases the hormone levels in one persons body. The metabolism also increases as a result of these hormonal changes that take place during pregnancy and as a consequence of this there is a rise in the body temperature. Hence during pregnancy, they have a tendency to sweat more in comparison to other people. Another reason that may increase the chance of sweating in a pregnant woman is that during pregnancy, you gain weight and as a result of the weight gain also, the body temperature rises and thus the chance of you sweating more. Because of these two main reasons, pregnancy can result in diaphoresis.

However, this is a normal scenario for most pregnant women and this is normal only IF you do not have any other associated symptoms such as fever, body aches and pains or vomiting. As long as you do not experience these other symptoms, increased sweating during pregnancy is not a concern.

Menopause

Menopause is the cessation of the menstrual cycles for more than 12 months. This is a normal condition that all women face at some point in their life time, most commonly between the ages of 45 to 50 years. During menopause, a woman experiences several symptoms in addition to the loss of menstrual periods. Out of the many symptoms they might experience, hot flashes and sweating which is particularly seen at night is something that most patients complain of.

The reason behind this is that during menopause, there are several hormonal changes that take place and there are fluctuating hormonal levels during this period. One important hormone is oestrogen. With these fluctuating levels of hormones, false signals are sent to the brain saying that the body is overheated. As a result, patients often experience excessive sweating and hot flushes.

If you feel that the symptoms are getting worse, it is best to consult your health care provider and they will prescribe you a low dose of a hormonal therapy pill which will provide some symptoms relief for a short period of time.

Diabetes mellitus

Diabetes is a common comorbid condition that is experienced by so many people of different age groups. Excessive sweating can also be caused in patients with diabetes mellitus. However, they do not experience this symptom all the time. They experience these symptoms when their blood sugar levels drop less than the normal values, a condition known as hypoglycemia or an hypoglycemic attack. This type of situations is commonly experienced by diabetic patients due to their inability to maintain normal blood sugar level. Other signs and symptoms of diabetes mellitus include:

  • Tremors and shakiness
  • Dizziness
  • Anxiety
  • Intense hunger
  • Blurred vision
  • Slurred speech

It is very important that all diabetic patients are capable to identify such an episode because in such cases, the blood sugar levels should be quickly restored as soon as possible to avoid serious consequences as a result of hypoglycaemia such as coma and sometimes death.

Hyperthyroidism or thyrotoxicosis

Hyperthyroidism or thyrotoxicosis is a condition where the thyroid gland becomes overactive and starts to produce more and more thyroxine. As you know thyroxine is an important hormone that is necessary for all the metabolic reactions within our body to take place. Therefore when there is excessive amounts of thyroxine produced within the body, the metabolic reactions speed and as a result a patient will experience a wide range of symptoms. Out of the many symptoms, one common symptom that many of these patients experience is increased sweating which is out of proportion to their level of activity or outside environmental temperature.

Other signs and symptoms that  a patient with hyperthyroidism may experience include:

  • Tremors
  • Increased heart rate
  • Heart palpitations
  • Anxiety
  • Difficulty in sleeping
  • Loss of weight despite a good appetite
  • Heat intolerance

Although hyperthyroidism is not a medical emergency, it is important that you seek medical treatment if you have been experiencing any of these signs and symptoms. This is because, hyperthyroidism or thyrotoxicosis for a long period of time can lead to many complications especially that of the heart such as atrial fibrillation and eventually heart failure. Therefore get medication if you have hyperthyroidism. If you have hyperthyroidism, your health care provider will start you on anti-thyroid medication such as carbimazole and also on oral propranolol to reduce the symptoms.

Alcohol consumption

Alcohol is a central nervous system depressant. It also affects the cardiovascular system and every part of your body in addition to the central nervous system. Therefore consuming alcohol can make your heart beat a lot faster and dilatation of the peripheral blood vessels. When these blood vessels are dilated, you will sweat a lot than usual and you may experience this in the form of night sweats.

Night sweats may also occur during the withdrawal phase of alcohol but this is only temporary.

Alcohol withdrawal

Alcohol withdrawal is a phase that a person may go through a few hours or few weeks after their last alcohol drink. It may last from a few days to a few weeks.

Night sweats in alcohol withdrawal is usually associated with other symptoms like nausea, loss of appetite, headache, body aches and pains, muscle aches and pains and fever.  Severe symptoms of alcohol withdrawal include vomiting, increased heart rate, palpitations, raised blood pressure, tremors and confusion.

Drugs

Medicines like antidepressants, hypoglycemic agents and hormonal therapy can also cause diaphoresis. Other drugs that may cause diaphoresis include:

  1. Pain medications such as naproxen and Celebrex
  2. Antibiotics such as ciprofloxacin and antiviral medications such as ribavirin
  3. Chemotherapeutic drugs such as tamoxifen and leuprolide
  4. Other hormonal medications such as levothyroxine

Cancer

Diaphoresis can also be caused by certain types of cancer such as:

  1. Lymphoma
  2. Liver cell cancer
  3. Bone cancer
  4. Leukemia
  5. Carcinoid tumours

The diaphoresis can be due to the cancer itself, its treatment or due to an infection.

Anaphylaxis

Anaphylaxis is a severe allergic reaction and it is a medical emergency. It usually occurs minutes after being exposed to something you are allergic to be it a drug or a particular food item. The other symptoms of anaphylaxis include:

  1. Swelling of the face and lips
  2. Redness of the skin
  3. Itchiness of the skin
  4. Hives
  5. Rapid drop in the blood pressure
  6. Difficulty in breathing
  7. Loss of consciousness

If you experience any of these symptoms, immediately come to a hospital as this is a lifer threatening emergency, immediate medical attention is required.
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When should you seek medical care for diaphoresis?

If you have diaphoresis, it is important that you seek medical care because this could be as a result of an underlying condition which could be easily treated. However, there are cases where you need to seek immediate attention if you have profuse sweating. You have to call your health care provider or seek immediate treatment if you have any of the following signs and symptoms associated with increased sweating of the body:

  • Loss of consciousness
  • Nausea or vomiting
  • Cold skin or cold peripheries
  • Pale skin colour
  • Difficulty in breathing and sudden rapid swelling of the face and lips
  • Chest pain
  • Heart palpitations

What is the treatment for diaphoresis?

The treatment of diaphoresis depends on the underlying condition. Before your doctor plans your treatment, he or she will first have to find the underlying cause for your excessive sweating and make a diagnosis.  For this, they will first start by taking a detailed history including your signs and symptoms you are currently experiencing plus your past medical history and family history. After taking the history, your doctor will then investigate you thoroughly to come to an accurate diagnosis. Once a diagnosis is made, he or she will then plan your management. The treatment will vary depending on the underlying condition.

If your diaphoresis is because of menopause, then your doctor will start you on hormonal therapy which may help to relieve the symptoms.

If the underlying cause for your excessive sweating is an infection, then your doctor will prescribe you antibiotic, antiviral or antifungal medication.

If cancer is found to be the underlying cause, then your doctor may recommend chemotherapeutic drug therapy along with other treatments or surgery.

If diaphoresis is occurring as a side effect of the drugs your taking, then your doctor may recommend on either stopping that particular drug or will prescribe you alternative drugs.

If alcohol abuse, drug abuse or caffeine consumption is the underlying cause for your excessive sweating, then your doctor will advise you to limit or reduce the intake of these substances. Sometimes they may prescribe your certain drugs that will help you to get over such addictions.

Simple measures like wearing light clothes, sleeping without a blanket or opening a window in your bedroom or air conditioning your room may help to reduce the profuse sweating as well.

How can you prevent night sweats?

Prevention of diaphoresis also depends on the underlying cause. Some underlying causes of diaphoresis can be prevented. The following tips may help you to reduce the frequency of experiencing diaphoresis.

  • Limit or stop the use of alcohol intake and caffeine.
  • Stop using drugs and try to get out of such addictions.
  • Avoid tobacco smoking.
  • If your bedroom temperature is really warm at night, then open a window in the room to cool down the room. Maintain a cooler temperature in your bed room at night to help you sleep better throughout the night.
  • Do not eat any spicy foods, exercise or drink any warm drinks just before bed time.
  • If you suspect that you have an underlying condition such as an infection, then visit your health care professional for prompt treatment.
  • Avoid wearing tight clothes, especially at night. Instead, wear some loose, comfortable clothes. Anything that will help you sleep comfortably at night.
  • If you are under stress for some reason, find something to calm you down and make you more relaxed such as yoga and meditation. Even some relaxing music will help you.

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Thilini Gunawardane
About Thilini Gunawardane 28 Articles
I am a final year medical student and I'm currently doing my clinical rotations in a private hospital. A huge people-person, an open minded who spent several years in the field of Medicine. I am at my final year on Medicine and clinical rotations at a Hospital (Dr Neville Fernando Teaching Hospital (NFTH). My long term run is to be a consultant one day and serve everyone in need. This has always been in my bucket list and I myself as a go-getter, will make my promisses and prove it to my self. Every-day I wake up knowing how little I know and I work for it. I learn, I use all my sources I have. Working online, I have gained so much experience and learned many things that a person should have in a working environment, time/project management, satisfying the client, meeting deadlines on time.

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