Effect of Prolonged Cold Foot and Arm Immersion in the Management of Primary Hyperhidrosis A Randomized controlled Trial

Hyperhidrosis (HH) is a disorder of autonomic nervous system, characterized by excessive sweating that is brought on by an overactive sympathetic nervous system. HH is classified as either focal or general based on the distribution of the affected tissues. The scalp, the axilla, the genitalia, the palmar region of the hands, and the plantar surface of the feet are the regions most frequently impacted by this disorder because they have the highest density of eccrine and apoeccrine sweat glands. Hyperhidrosis is classified as Primary and Secondary. Primary hyperhidrosis, average age of onset is 25 years. The earliest average onset of palmar and axillary hyperhidrosis is 19 years. The mainstay of treatment is pharmacological  which includes topical application of aluminium chloride , iontophoresis , antiperspirants , anticholinergics and clonidine or surgical intervention like thoracic sympathetic surgery and botulinum toxin injections , although both are invasive and have a number of negative side effects. Cold foot and arm immersion given for 20 minutes at temperature of 55o - 65o F, on alternate days, weekly thrice for 30 days  reduces perspiration by inhibiting the glandular activity of skin through reflex phenomenon and also decreasing the stimulation of sympathetic nerves. Thus the present study aims at understanding the effect of cold foot and arm immersion for  primary hyperhidrosis depending on the severity and quality of life as it has no side effects compared to other treatment modalities. The Hyperhidrosis Disease Severity Scale, Hyperhidrosis Quality of Life Index, MINOR TEST - (Starch -Iodine) assessments were taken on baseline and after 30 days.