Scleroderma is an autoimmune disease that causes hardening and tightening of the skin and connective tissues. It can affect many parts of the body and cause a variety of symptoms. One common symptom that many people with scleroderma experience is excessive sweating (hyperhidrosis).
What causes sweating in scleroderma?
There are a few reasons why scleroderma can lead to increased sweating:
- Damage to sweat glands – The hardening of skin can damage sweat glands, causing them to overproduce sweat
- Nerve damage – Scleroderma can damage nerves that regulate sweat production
- Small blood vessel disease – Vessels that supply sweat glands can be affected, leading to dysfunction
- Medications – Some medications used to treat scleroderma symptoms may cause sweating as a side effect
The areas most commonly affected by excessive sweating include the hands, feet, underarms, and face. The sweating can range from mild to quite severe.
What types of scleroderma lead to increased sweating?
Both major types of scleroderma – localized scleroderma and systemic sclerosis – can cause increased sweating. However, it is more common with diffuse cutaneous systemic sclerosis, the most severe systemic form of the disease. Up to 80% of people with diffuse systemic sclerosis experience hyperhidrosis.
The other subtypes of systemic sclerosis (limited and sine scleroderma) and localized scleroderma have lower rates of hyperhidrosis, but excessive sweating can still occur.
What daily challenges does scleroderma-related sweating cause?
Excessive sweating from scleroderma can negatively impact daily life in many ways, including:
- Difficulty holding objects – Sweaty hands and feet can cause things to slip from grasp
- Damage to materials – Sweat can stain or damage clothing, papers, electronics, furniture, etc.
- Self-consciousness – Sweating can cause embarrassment in social settings
- Skin irritation – Constant moisture can lead to itching, redness, rashes, infections
- Dehydration – Heavy sweating can result in the loss of fluids and electrolytes
- Discomfort – Damp clothing from sweat can be uncomfortable
- Difficulty sleeping – Night sweats wake people up and disrupt sleep
These challenges can severely impact a person’s quality of life. Routine daily activities and social interactions can become difficult. Implementing sweat management techniques is important.
What are the most effective treatments for scleroderma-related sweating?
The excessive sweating of scleroderma is considered secondary hyperhidrosis since it is caused by an underlying medical condition. Treatment focuses on managing the symptoms.
Some of the most effective treatments for hyperhidrosis caused by scleroderma include:
- Antiperspirants – Clinical strength antiperspirants with aluminum chloride can help control mild sweating.
- Iontophoresis – This therapy uses electrical current to treat sweaty hands and feet.
- Anticholinergics – Oral medications that block neurotransmitters involved in sweat production.
- BOTOX – Botulinum toxin injections block nerves that stimulate sweat glands.
- MiraDry – A device uses microwave energy to destroy underarm sweat glands.
- Alternative therapies – Acupuncture, hypnosis, biofeedback can help reduce sweating.
The most effective treatment depends on the location and severity of sweating, along with the person’s medical history and tolerance for side effects. Combining therapies is sometimes necessary for optimal control of scleroderma-related hyperhidrosis.
How does scleroderma sweating change over time?
The sweating caused by scleroderma often correlates with disease activity and severity. During times when scleroderma is progressing rapidly or flaring up, hyperhidrosis tends to worsen. When the condition becomes more stable, excessive sweating may improve to some degree.
However, for many scleroderma patients, the sweating persists long-term and becomes a chronic issue they deal with on a daily basis throughout their lives. The areas affected, amount of sweating, and impact on quality of life can ebb and flow over months or years.
Some people notice their scleroderma-related hyperhidrosis diminishes if their disease improves with treatment. But damage done to sweat glands and nerves may be irreversible, so sweating problems could persist.
When should someone with scleroderma see a doctor about sweating?
It’s a good idea to consult a scleroderma specialist or dermatologist if sweating related to the condition becomes excessive or difficult to manage. They can assess the sweating and determine if specialized treatment is warranted.
See a doctor right away about scleroderma sweating if:
- Sweating disrupts daily activities
- Skin becomes damaged from moisture
- Dehydration results from fluid loss
- Antiperspirants are no longer effective
- You experience night sweats that interrupt sleep
- Sweating causes emotional distress
Prompt medical assessment and treatment can greatly improve a person’s quality of life when scleroderma sweating becomes problematic.
Can children with scleroderma have sweating problems?
Yes, children can develop increased sweating as a symptom of juvenile scleroderma. Their symptoms and disease course are often similar to adult patients. Excessive sweating can occur with both main forms of juvenile scleroderma:
- Localized scleroderma – Circumscribed morphea and linear scleroderma subtypes
- Systemic sclerosis – Includes diffuse, limited and sine systemic subtypes
The location, severity and timing of hyperhidrosis depends on the subtype, area of skin involvement, and disease activity. Proper treatment helps manage the symptoms.
When does scleroderma sweating tend to be worst?
Those with scleroderma tend to notice their excessive sweating worsens at certain times or in specific scenarios:
- At night – Night sweats from scleroderma often disrupt sleep.
- During flares – Disease flares increase inflammation linked to sweating.
- In hot weather – Heat triggers more sweat production.
- When anxious – Stress and anxiety can stimulate sweating.
- While exercising – Physical activity causes people to sweat more.
- In social situations – Embarrassment about sweating can further stimulate it.
Keeping the body cool, managing stress, and proper treatment helps minimize problematic scleroderma-related hyperhidrosis during those vulnerable times.
Can scleroderma occur without sweating problems?
Yes, it’s possible to have scleroderma without excessive sweating. Each person’s symptoms can vary greatly. Not everyone with scleroderma experiences bothersome hyperhidrosis.
Those with very mild and limited disease may have minimal skin involvement that does not affect sweat gland function. The localized form of scleroderma often causes less sweating than systemic scleroderma. Sweating may not develop until later disease stages.
While many people do deal with hyperhidrosis, the location, severity and impact of scleroderma sweating differs among patients. Proper management can help reduce excess sweating.
Does sweating cause scleroderma to spread?
No, there is no evidence that sweating itself impacts the course or progression of scleroderma. The immune system dysfunction that leads to scleroderma is not affected by the amount a person sweats.
However, the skin damage that contributes to excess sweating is caused by the spreading fibrotic process seen in systemic sclerosis. And profuse sweating can further irritate affected skin areas.
While sweating does not directly accelerate scleroderma advancement, some patients notice their disease seems more active when their hyperhidrosis is at its worst.
Can sweating be helpful for scleroderma?
Increased sweating is primarily viewed as a bothersome symptom to treat in scleroderma. But some benefits of sweating may potentially help certain patients:
- Cooling effect – Sweat evaporating from skin cools the body, providing relief if someone is overheated.
- Stress relief – The act of sweating can result in the release of endorphins and other feel-good hormones.
- Toxin purge – Sweat eliminates waste products and toxins from the body through the skin.
- Infection prevention – The moisture and antimicrobial properties of sweat may help prevent some skin infections.
- Exercise – Sweating during physical activity has cardiovascular benefits and may aid mobility in scleroderma.
However, these potential benefits are typically outweighed by the challenges excessive scleroderma-related sweating presents in most patients’ lives.
What is the outlook for scleroderma patients with heavy sweating?
The prognosis for those with problematic hyperhidrosis ultimately depends on the severity of someone’s scleroderma and how well the condition responds to treatment.
If the sweating is controlled with antiperspirants, medications, iontophoresis, etc., quality of life greatly improves. However, sweat management becomes lifelong treatment.
When excessive sweating persists despite therapy, it can contribute to emotional and social difficulties. Skin infections may also develop.
But with a comprehensive treatment plan tailored to the individual, most scleroderma patients are able to effectively manage troublesome sweating. The outlook can be very good, allowing those with scleroderma to live full, active lives.
Key Takeaways
- Many people with scleroderma deal with excessive sweating (hyperhidrosis) due to skin and nerve damage.
- Systemic scleroderma often causes more severe sweating than localized disease.
- Excessive sweating can negatively impact quality of life for those with scleroderma.
- Treatment focuses on managing sweating symptoms with antiperspirants, medications, iontophoresis, BOTOX, etc.
- Working closely with healthcare providers allows most patients to successfully control problematic scleroderma-related sweating.