Hyperhidrosis - sweat excessively? What you need to know.
Excessive sweating is called hyperhidrosis. It's more than what you would class as 'normal' sweating. People with hyperhidrosis sweat excessively even when they're not doing the things that would normally make you sweat, like exercise or being in hot or stressful conditions. This excessive sweating can occur in many parts of the body, including the hands, feet, armpits and face. While most can deal with it, for those with significant issues, it can impact their quality of life. From not wanting to shake hands, not being able to hold a pen in their hand, to having drenched clothes. All cause discomfort, embarrassment and then, sometimes, isolation.
Two main types of hyperhidrosis:
Primary hyperhidrosis: This is the most common type and may start in childhood; affects 0-5-1% of people. It's not linked with a medical condition and may run in families; affects the palms, soles, underarms and face.
Secondary hyperhidrosis: This type is usually because of a medical condition or from taking a medicine. It can occur suddenly and can affect more parts of the body. Some causes might be from the thyroid, hormones, diabetes, some medicine or infections.
How do you treat it?
Botox/Dysport injections, (botulinum toxin) can be given to help block the nerves that make the sweat glands work. Most often used for underarm sweating but also for other areas, like the hands. These injections have become the mainstay for people with more severe. symptoms. Because they are well tolerated, results can be seen in about a week. Often they will last for an average of six months.
Drying agents – aluminium salts can be used in the area. These seem to help stop the sweat glands but may cause irritation for some. Lasts up to 48 hours.
Topical antiperspirants: prescription antiperspirants that have aluminium chloride in them can be used. These help to temporarily block the sweat glands.
Oral medicines, like anticholinergics – can help reduce sweating. But have many have side effects and are not well tolerated.
Surgery – there is surgery like thoracoscopic sympathectomy (cutting or clamping of the sympathetic nerves that cause the sweating). However, as with any procedure, there are risks. But some people do choose this as a more permanent option. Normally for those where other treatments do not work.
Lifestyle changes – avoiding things that make you sweat, like spicy foods, caffeine and alcohol can help some people with their sweating; especially if caused by hormones. For example, for women in menopause. Wearing clothing made from natural fibres, like cotton, may help.
It's important to see a medical professional to find out what will be best for you. They can help with what type of hyperhidrosis you have and then recommend what's best for you.
Is Raynaud's disease the cause of cold, throbbing fingers?
Raynaud's disease affects the blood vessels, particularly the small arteries in the extremities, such as fingers and toes. It is characterised by episodes of vasospasm, where the blood vessels constrict, leading to reduced blood flow to the affected areas. This can result in colour changes in the skin, usually causing the fingers or toes to turn white, then blue and finally red when blood flow returns.
Patients have difficulty holding objects and describe a throbbing sensation as their fingers and or toes return to normal. Sometimes returning to normal may be in patches where parts of the fingers or toes are white and others look normal.
What causes Raynaud's disease?
The exact cause of Raynaud's disease is unknown but it is believed to involve an exaggerated response of the blood vessels to cold temperatures or emotional stress. It can occur on its own, known as primary Raynaud's disease, or as a secondary condition, known as secondary Raynaud’s disease or Raynaud’s Syndrome, linked with other underlying medical conditions such as autoimmune diseases (eg, lupus, scleroderma as part of CREST syndrome), vascular diseases or with some medications.
Treatment for Raynaud's disease aims to reduce the frequency and severity of attacks, relieve symptoms and prevent complications. Patients may go long periods without flare ups.
What are some common treatments?
Common approaches include:
- Lifestyle modifications: Avoiding triggers such as cold temperatures and stress is important. Keep the body warm by wearing layered clothing. Hand warmers or heated gloves may be useful and avoiding exposure to cold water can all help.
- Medications: Medications may help improve blood flow and reduce vasospasm. Examples include calcium channel blockers (eg, Nifedipine), oral vasodilators (eg, Pentoxyfilline and Sildenafil aka Viagra), intravenous prostaglandins (eg, Iloprost) and alpha-blockers.
- Biofeedback: This technique helps individuals learn to control their body temperature and blood flow by providing real-time feedback. It can be useful for some people with Raynaud's disease.
- Avoiding vasoconstrictive substances: Certain substances, such as nicotine in tobacco, can worsen symptoms. Avoiding smoking and exposure to secondhand smoke is beneficial.
- Stress management: Learning how to reduce stress, such as relaxation exercises and meditation, may help prevent or minimise attacks that result from stress.
- Surgery: In severe cases or when complications such as ulcer and gangrene arise, surgical intervention may be considered. Sympathetic nerve surgery aims to disrupt the nerve signals that trigger vasospasm. They may be benefit those with severe secondary Raynaud’s Syndrome.
It is important to consult a medical professional for an accurate diagnosis. They will describe the most appropriate treatment plan based on individual circumstances.
Kidney stones - are they the cause of your pain?
Kidney stones, also known as renal calculi, are hard deposits that form in the kidneys and can cause significant pain and discomfort. The symptoms and treatments for kidney stones can vary depending on the size, location and number of stones present. Read on for an overview:
Symptoms of kidney stones
Symptoms include:
- Severe pain: The most common symptom is intense pain in the side or back, below the ribs. The pain can radiate to the lower abdomen and groin.
- Hematuria: Blood in the urine, often visible as pink, red or brown discoloration.
- Frequent urination: The urge to urinate more frequently than usual, accompanied by minimal urine production.
- Cloudy or foul-smelling urine.
- Nausea and vomiting.
- Fever and chills (if you have an infection).
And, so what are the treatments?
Treatment depends on how bad your stones are and whether you have had them diagnosed, including:
- Drinking plenty of fluids: Increasing fluid intake, especially water, helps flush out small kidney stones. You should aim to drink at least two to three litres of water per day.
- Pain management: Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can help alleviate pain. Stronger prescription pain medications may be necessary for severe pain.
- Medical therapy: Dending on the type of kidney stone, medications can be prescribed to help dissolve or prevent the formation of stones in the first place. More commonly used for certain types of stones like uric acid stones.
- Extracorporeal shock wave lithotripsy (ESWL): Sound waves are used in this non-invasive procedure, where kidney stones are broken into smaller pieces that can be passed more easily in the urine.
- Ureteroscopy: A thin tube inserted through the urethra and bladder to reach the stone in the ureter or kidney. The stone can then be removed or broken into smaller pieces using laser or ultrasound.
- Percutaneous nephrolithotomy (PCNL): Surgical procedure for larger stones or when other treatments are not feasible. A small cut is made in the back and a tube is inserted to remove or break up the stone or stones.
- Natural passage: Small stones (usually less than 5mm) may pass naturally through the urinary tract with increased fluid intake and pain management. This process can take from several days to a few weeks.
It is important to consult with a healthcare professional if you suspect you have kidney stones. They can evaluate your symptoms, order diagnostic tests such as imaging or urine analysis and recommend appropriate treatment based on the size and location of the stones.
Kidney Disease Causes and Treatments
The kidneys play a key role in maintaining our overall health. Kidney disease is a common and serious condition that affects millions of people worldwide.
Understanding kidney disease
Kidney disease, also known as renal disease, refers to the gradual loss of kidney function over time. The kidneys have essential functions, such as filtering waste products and excess fluids from the blood. They regulate blood pressure, produce hormones and balance electrolyte levels. When the kidneys are damaged, they cannot do these functions as well, leading to a build up of toxins and waste in the body.
Causes
- Diabetes: Diabetes is one of the leading causes of kidney disease. High blood sugar levels can damage the blood vessels in the kidneys, making it hard for them to filter waste and fluids.
- High Blood Pressure: Uncontrolled or poorly managed high blood pressure can also damage the blood vessels in the kidneys, affecting their ability to filter waste and fluids effectively.
- Chronic Glomerulonephritis: This is a group of kidney diseases characterised by inflammation and damage to the tiny filters in the kidneys.
- Polycystic Kidney Disease (PKD): PKD is a genetic disorder that causes cysts to develop in the kidneys, which leads to kidney damage.
- Urinary Tract Infections (UTIs): Recurrent or untreated UTIs can spread to the kidneys and cause infections that may cause kidney damage.
Symptoms
Following on from this, early on the symptoms may not be that noticeable. However, as the condition progresses, people may have the following signs and symptoms:
- Fatigue and weakness.
- Swelling in the legs, ankles, feet or on the face.
- Decreased urine output or changes in patterns.
- Blood in urine or foamy urine.
- Persistent itching.
- Loss of appetite and unintended weight loss.
- Nausea and vomiting.
- Difficulty concentrating and mental fog.
-Muscle cramps and twitches.
Treatment options
Treatment does depend on the cause and the stage the patient is at. Following on from this, here are some common approaches:
- Medications: Medications may manage conditions, such as diabetes and high blood pressure.
- Lifestyle Changes: Adopting a healthy lifestyle can help slow progression of the disease. This includes maintaining a balanced diet, limiting salt intake, giving up smoking, exercising regularly and managing stress.
- Dialysis: Dialysis may be needed in the later stages of this disease. This is when the kidneys cannot function properly. Dialysis removes waste products and excess fluid from the blood using a machine.
- Kidney Transplant: In cases of end-stage kidney disease, a kidney transplant may be the best option. This involves surgically replacing a damaged kidney with a healthy one from a donor.
- Supportive Care: Managing symptoms and complications, such as anaemia, bone disease and cardiovascular issues, is essential in providing care for people with kidney disease.
Kidney disease is a serious condition that can significantly impact a person's health and quality of life. Understanding its causes, recognising the symptoms and seeking medical advice are crucial steps. By addressing underlying causes, making lifestyle changes and following the recommended treatment options, people can slow the progression of the disease and improve their overall wellbeing. If you suspect kidney disease or experience some of the symptoms above, it is important to talk to a healthcare professional, such as a vascular surgeon.
Lipoedema in Men
Lipoedema in Men: Causes, Symptoms and Treatment Options
Abnormal accumulation of fat in the legs and thighs characterises lipoedema. While more common in women, this chronic condition is increasingly also being seen in men.
What are the symptoms?
Lipoedema typically presents as symmetric swelling and enlargement of the legs, often accompanied by a feeling of heaviness and discomfort. As well, characteristic ‘orange peel’ appearance on the skin may be due to the presence of fibrous tissue. Abnormal accumulation of lymphatic fluid in the tissues characterises lymphoedema, which often accompanies the condition.
While exact causes of lipoedema are not well documented, it is thought to be related to hormonal and genetic factors. Often underdiagnosed and misdiagnosed as obesity, it can have a significant impact on a person’s quality of life.
What are the treatment options for lipoedema in men?
Treatment for lipoedema typically involves a combination of approaches, including compression therapy, manual lymphatic drainage, and liposuction. Compression therapy involves the use of special compression stockings or compression garments to help reduce swelling and improve circulation. Manual lymphatic drainage is a massage technique that helps to reduce the accumulation of lymphatic fluid in the tissues. Liposuction is a surgical procedure that removes excess fat from the affected areas.
Seeing a health professional is the first step
Lastly, men being aware that lipoedema is not just a women’s issue is a good first step. If you have symptoms of lipoedema, it is important to see a healthcare professional who can properly diagnose and treat the condition. With the right treatment, it is possible to reduce the symptoms of lipoedema and improve quality of life.
For more information see our earlier blog: Is fat in the legs lipoedema or obesity? where we talk about how misdiagnosis of lipoedema for obesity, oedema or lymphoedema is common. And as a result of this, sufferers may embark on an incorrect treatment pathway, such as weight loss surgery. While all of these conditions may be present at the same time to differing degrees, it is recognised as a distinct condition, with its own set of specific treatments.
Varicose veins can cause skin eczema
Varicose veins are a common condition that can cause a variety of symptoms, including skin eczema. Eczema is a skin condition characterised by red, itchy and scaly patches of skin. It can occur in individuals who have varicose veins due to a number of different factors.
Why varicose veins can cause skin eczema
Increased pressure on the blood vessels in the legs is one of the main reasons varicose veins can cause eczema. When the valves in the veins become weak or damaged, blood can pool in the legs. This puts extra pressure on the surrounding skin. This increased pressure can cause inflammation and irritation, leading to eczema.
Lymphatic fluid in the legs a contributing factor
Another factor that can contribute to eczema is the accumulation of lymphatic fluid in the legs. Lymphatic fluid is a clear, fluid normally transported through the lymphatic vessels. It helps to remove waste products from the body. When the lymphatic vessels become blocked, lymphatic fluid can accumulate in the legs, causing swelling and inflammation.
Stress can also contribute
In addition, varicose veins can also cause eczema because of the psychological stress and anxiety that can accompany the condition. People with varicose veins may experience feelings of self-consciousness or embarrassment about the appearance of their legs. This can lead to stress and anxiety. This psychological stress can then manifest as eczema.
What are the treatment options?
To treat eczema caused by varicose veins, it is important to address the underlying condition thereby treating the varicose veins. An ultrasound scan can diagnose varicose veins. Self-care measures, such as wearing compression stockings, elevating the legs and exercising regularly can help. Minimally invasive procedures like sclerotherapy or Venaseal can help treat varicose veins. Additionally, using a therapeutic moisturiser, such as fatty cream, and avoiding irritants that can worsen eczema, symptoms can be helpful.
Varicose veins bleeding?
Varicose veins are a common condition affecting the legs and feet. Weakened valves in the veins that allow blood to flow backwards and pool in the legs are the main cause of varicose veins. This can lead to the veins becoming enlarged and twisted, resulting in a condition known as varicose veins. One concerning symptom is varicose veins bleeding.
Varicose vein bleeding can occur for a number of reasons
Varicose vein bleeding can occur for a number of reasons, including:
- Trauma: because varicose veins are located near the surface of the skin they are easily damaged. This means that any kind of trauma to the legs or feet, such as a bump or cut, can cause these veins to bleed.
- Ulceration: Varicose veins can cause blood to pool in the legs, leading to a build-up of pressure in the veins and, over time, this can cause the skin to break down and form ulcers. These ulcers may bleed, especially if they become infected.
- Clotting disorders: Varicose veins can increase the risk of deep vein thrombosis (DVT) or blood clots forming in the legs. If a clot forms in a varicose vein, it can cause bleeding.
- Inflammation: Varicose veins can become inflamed, thrombophlebitis, which can cause them to bleed.
Evaluation by a medical specialist is necessary
Varicose vein bleeding needs evaluation by a medical specialist as soon as possible. They may recommend wearing compression stockings or socks to help protect the legs and to prevent further bleeding. Treatment of varicose veins is also recommended to help prevent future bleeding and improve overall vein health. Firstly, the specialist will book an ultrasound scan to determine the cause of the bleeding, then discuss treatment options that include VenaSeal, a medical adhesive that offers a minimally invasive procedure, with less down time than many other treatments.
Varicose veins in pregnancy
Why Varicose Veins Develop in Pregnancy and How to Manage Them
Pregnancy is an exciting time for many women but it can also come with a host of physical changes and discomforts. A common issue that women experience during pregnancy is the development of varicose veins. These may appear on the legs and are caused by a variety of factors.
One of the main reasons that pregnancy causes varicose veins is due to the increased pressure on the veins in the legs. As the uterus expands during pregnancy, it puts pressure on the veins in the pelvis and legs, making it harder for blood to flow back to the heart. This can cause the veins to dilate and become varicose.
Is it because of hormonal changes?
Another reason that pregnancy causes varicose veins is because of hormonal changes. During pregnancy, a woman’s body produces a high amount of progesterone, which relaxes the walls of the veins. This makes it easier for the veins to expand and become varicose.
Genetics also cause varicose veins. If a woman has a family history of varicose veins, she is more likely to develop them during pregnancy, too.
Will they improve when baby is born
It is important to note that varicose veins at this time are generally harmless and will improve after the baby is born. But if pain is severe, with swelling or redness, medical attention should be sought.
What can you do to prevent them?
Preventative measures taken to help reduce the risk include regular exercise, maintaining a healthy weight, and avoiding prolonged standing or sitting.
Wearing compression stockings can also help to improve circulation in the legs and reduce the risk of varicose veins.
Modern treatments are available
Many women report that their varicose veins are still there after pregnancy. This may mean medical treatment is necessary. Modern treatment such as VenaSeal provide safe, quick and effective relief of varicose veins with minimal downtime, allowing women to return to their normal activities faster.
An ultrasound scan will determine whether treatment is necessary.
What are perforator veins?
What Are Perforator Veins? Function, Health, and Treatments
Perforator veins connect the deep leg veins to the surface veins. Their purpose is to equalise the pressure between the inside and the surface of the legs. This is when the leg muscles are contracting and relaxing during walking and running. Blood flow within perforators normally goes from the skin surface to the deep veins.
What’s the problem with perforator veins?
In about 20% of people suffering from varicose veins, the perforator veins are also abnormal. That is, they are bigger than normal and blood flows from the deep veins out to the skin surface under pressure. People with more varicose veins, have more abnormal perforators. The pressure caused by abnormal perforators can affect the skin causing thickening, discolouration, eczema and ulceration.
Usually, if a person’s varicose veins have been thoroughly treated, abnormal perforators do not need further treatment and they often return to normal function. Occasionally, perforators remain abnormal, causing varicose veins to return or surrounding skin to deteriorate or form leg ulcers. These types of perforators need treatment.
What are the treatments?
The good news is that for most people, when the surrounding varicose veins have been treated, abnormal perforators do not need additional treatment.
When perforators are causing serious skin problems, such as ulcers, non-heating vein treatments like VenaSeal, appear to be superior. This is because VenaSeal allows safe treatment all the way to the ankle with a low the risk of nerve damage.
Sometimes, a single or several persistent perforators need further treatment. In this situation, a heating treatment usually performed under local anaesthetic using RFA (radiofrequency ablation) can reliably close the perforator, with a low risk of nerve damage.
MALS – Median Arcuate Ligament Syndrome
MALS (Median Arcuate Ligament Syndrome): Symptoms & Treatment
What is MALS?
MALS is a condition where a diaphragm ligament (median arcuate ligament) narrows the main artery to the stomach, liver, spleen and pancreas. This is called the coeliac artery. It mostly will affect young women who have stomach pain after eating or exercise. They might also have nausea, vomiting and weight loss.
Some narrowing of the coeliac artery will be found in about 1:30 people who have no symptoms at all.
It is not well known. People with MALS have a wide range of symptoms and diagnosis is hard and treatment results vary.
What causes compression of the coeliac artery?
The diaphragm is a muscle that is important for breathing. Where it joins the spine at the back of the stomach, there is a tough ligament called the median arcuate ligament. The main artery to the stomach passes through this area and can be narrowed by this ligament.
When narrowing has been there for a long time, scarring can occur inside the artery causing a permanent narrowing. Over time, the artery beyond this narrowing can dilate and become an abdominal aortic aneurysm.
What are MALS symptoms?
Most people with MALS have pain in their upper stomach. This may be worse after eating and sometimes after exercise. Nausea and weight loss are also common. Sometimes we can hear turbulence from the narrowing in the artery with a stethoscope. People with MALS are also more likely to suffer from anxiety.
How is MALS diagnosed?
Most people with possible MALS will have already seen a gastroenterologist to rule out the common causes of stomach pain, such as gallstones and stomach problems.
With ultrasound it is possible to see in real time the effect of breathing on the coeliac artery. In MALS, the artery narrows and changes position significantly when breathing out.
CT scan, performed when breathing in and out, is also very useful to show the area of narrowing affecting the coeliac artery. It has a ‘hook’ shape. CT scan will also give a lot of information about other arteries and organs. MR scan and sometimes an artery X-ray, called angiography, are also useful.
Some other causes
Surrounding the coeliac artery is a cluster of nerves. Some will send pain signals from the stomach to the brain. Pressure on these nerves from the ligament will likely be another important factor in the pain caused by MALS.
What treatment is available?
Once a diagnosis of MALS seems likely, the aim of treatment is to relieve the pressure on the coeliac artery. We do this by dividing the ligament. This is typically a minimally invasive procedure and, as well, the nerves around the artery will most likely be taken out at the same time.
If there is still a narrowing in the coeliac artery after treatment, a stent may be needed to open up the artery to a normal size.
And the results?
Most patients (>80%) get relief of their symptoms straight away after treatment and few will have these return.