- 1 Diaphoresis Definition
- 2 Diaphoresis Symptoms
- 3 Diaphoresis Micturition
- 4 Diaphoresis ICD-10
- 5 Diaphoresis Treatment
Diaphoresis is simply defined as being the excretion of moisture through the pores of the skin and as such may be correctly used a synonym for the commonly used words,perspiration or sweating. The word sudor is also used for excretion through the skin but, in this case, the actual mechanism and origin of the moisture is not specified meaning that cases where the the sweat glands and pores are not involved are also included. Although the word diaphoresis and diaphoresis meaning may refer to the completely normal process of sweating, it is commonly used in a medical sense to refer to a condition of excessive or inappropriate sweating. Another closely related condition is hyperhydrosis which also refers to excessive moisture secretion but is specifically due to an overactive sympathetic nervous system. The word diaphoresis, like many medical terms, is modern Latin constructed from elements of Greek origin. Dia means “through”, phorein is “carry” and the suffix esis denotes a process so the word literally translates as “process of carrying through”. Diaphoresis meaning is outlined in more detail below.
Normal diaphoresis is primarily a means of thermoregulation with heat energy being removed from the surface of the skin as the moisture evaporates.
The mechanisms involved are complex but the process is largely controlled by thermosensitive neurons in the hypothalamus part of the brain monitoring body core temperature but there is also some input from temperature receptors in the skin. High ambient temperatures or periods of strenuous activity will normally trigger an appropriate diaphoretic response. It should be noted however that sweating commonly occurs in the absence of such trigger conditions. Although sometimes associated with an underlying medical condition, this is by no means always the case and it is advisable to consider other commonly encountered causes of unexplained sweating.
Shock can be a serious condition affecting the functioning of many parts of the body and typically occurs following a traumatic incident such as a motoring accident. Diaphoresis is almost always present in cases of shock and, although of no great medical significance in its own right, can be a useful diagnostic aid. Stress, anxiety and fear also give rise to often profuse sweating and this is commonly localised to the palms, soles, armpits and possibly forehead rather than the whole body. Hormonal changes such as those experienced during puberty, pregnancy and the menopause also frequently cause periods of sweating often accompanied by hot flushes. Even motion sickness or an upset stomach are often accompanied by sweating and individuals vary greatly in their susceptibility to this condition. Men tend to sweat more than women and those with problems of obesity also sweat more due to the greater body mass to be cooled. Withdrawal from drug or alcohol addictions have similar symptoms and should always be supervised by medical professionals. The above examples, although unpleasant, should give no great cause for concern but in some other cases, diaphoresis may be a symptom of a more serious condition. Almost all kinds of infections give rise to an increase in body temperature usually accompanied by some degree of diaphoresis. Serious fevers such as malaria are well known for profuse sweating but many less serious infections also include such symptoms including the common cold.
On a more serious note, diabetes patients should always regard excessive sweating as a possible indicator of hypoglycemia (low blood-sugar level) requiring immediate action and the symptoms of a heart attack also involve diaphoresis along with many other signs indicating a medical emergency. Sepsis, heart failure and various types of cancer also include diaphoresis among their symptoms and exposure to various toxins or even medications can also be a causative factor. Diaphoresis therefore is often the body’s response to external or internal stimuli but in some individuals, there is no obvious cause and it is likely that genetics play a part in determining the levels of diaphoresis. Some people simply have an elevated rate of perspiration of possibly four or five times the average and this may manifest itself throughout the body or, more frequently, be confined to specific areas such as the palms, soles, armpits and forehead. In some rare cases, the problem may be confined to one side of the body suggesting a neurological cause. Diaphoresis with no underlying medical conditions is very common and of no great health significance but can be very distressing involving the need for lifestyle changes. Body odour is frequently encountered due to the proliferation of bacterial growth on the skin.
There have recently been some online warnings regarding diaphoresis and micturition but these simply refer to joke labels applied to water bottles. The labels typically read: DIHYDROGEN MONOXIDE CONTAINMENT UNIT – DANGER MAY CAUSE DIAPHORESIS MICTURITION AND ACUTE TISSUE HYDRATION. As micturition is simply a term meaning urination, and dihydrogen monoxide is of course water, most people should not be too alarmed. Diaphoresis and micturition are not connected in any way and completely different processes are involved.
There is an increasing use of specific codes for medical conditions. The coding system was initiated by the World Health Organisation primarily for statistical purposes and is known as the International Classification of Diseases (or ICD). The codes generated by this system are now widely used in connection with medical insurance claims and billing especially in the US which has its own slightly modified version of ICD. The current version is ICD-10 with the US version also having the suffix CM (Clinical Modification). Diaphoresis is assigned the code R61 under the heading “Generalised Hyperhydrosis”. Prior to 1st October 2015, the earlier ICD-9-CM was in use giving this condition a code of 780.8.
In many cases, diaphoresis is a symptom of another underlying condition rather than a disease in its own right and in such cases, treatment will always centre on the underlying cause such as dealing with any infections and the condition will usually right itself. Cases with no underlying medical condition can be more challenging and such cases are usually referred to under the general title of primary hyperhidrosis. The first steps usually involve lifestyle changes and, when it is known that sweating is triggered by certain events, these should be avoided. This could be as simple as cutting out spicy foods or alcohol. Stress and anxiety may also bring on the condition and, although often difficult to completely eliminate, stressful situations should be avoided as far as possible. The problems of body odour can be lessened by frequent baths or showers and the use of a good antiperspirant. It is important to differentiate between deodorants and antiperspirants. The avoidance of tight clothing can help and natural fibres are preferred to man-made materials such as nylon. Armpit shields are available and careful choice of clothing colours can prevent any visual signs of sweating. Choosing suitable footwear can also help with leather shoes being much better than synthetic materials. Special absorbent insoles or thick socks should be worn and preferably changed twice daily. The shoes themselves are best left to fully air for a day before being worn again. If over-the-counter antiperspirants prove ineffective, a doctor may prescribe a better product such as one containing aluminium chloride which can help to block the sweat glands. Many products also ensure that the conditions on the skin are unsuitable for bacterial growth.
If the above lifestyle changes fail to produce the required improvements, a doctor may consider the use of anticholinergic drugs which work by blocking the acetylcholine which is the substance which normally turns on the activity of the sweat glands. Cases which fail to respond to treatment may be referred to a dermatologist who may consider further more invasive treatments. Iontophoresis is a treatment which has a high success rate and it involves passing a weak electric current over the affected areas. This can be in a water bath or by the use of water soaked pads. This treatment effectively turns off the sweat glands in the area. Initially, the treatment may be needed two to four times weekly but this is usually subsequently extended to longer periods often being as long as a treatment every four weeks. In some cases, localised injections of botulinum toxin may be considered. These injections can stop the operation of the sweat glands and provide relief for several weeks at a time but in some cases, more profuse compensatory sweating may occur in other areas. Surgical intervention is normally regarded as a last resort and is generally not recommended. It is possible to remove the underarm sweat glands by incision or scraping or they can be destroyed in-situ. An even more drastic measure is known as an endoscopic thoracic sympathectomy in which the sympathetic nerve at each side of the spine is clipped from within the thoracic cavity at the point where it exits the spine at vertebra T4. This prevents the nerve signals reaching the sweat glands. This operation is not always successful and carries certain risks. Compensatory sweating often occurs and many people who have undergone this procedure develop gustatory sweating which is when sweating of the face and neck occurs during or shortly after eating. There are other potentially serious side effects meaning that, if offered such treatment, a great deal of thought should be given as to whether to proceed.
In most cases, diaphoresis is a condition which simply has to be lived with. It is not considered a medical emergency and the medical profession do not regard it as being particularly serious other than when it is indicative of a more serious illness. By being aware of the nature of the condition, lifestyle changes can often result in suitable improvements and the ability to manage the symptoms effectively.