Anhidrosis and Dry Skin: Seeking Expert Dermatological Advice

No sweating and dry skin?

Hello, doctor.
I would like to consult you about some skin issues.
First, for several years now, I have hardly ever sweat, regardless of the situation.
During the hot summer months, if I do not stay in an air-conditioned room, I am at risk of heatstroke.
There have only been a few instances where I felt a slight sensation of sweat on my skin, but it was very minimal.
Second, in recent years, my skin has become very dry.
Even though I apply lotion daily and only rinse my skin with lukewarm water without using soap, I still experience dryness and cracking.
I wonder what your thoughts are on this? Yesterday, I visited the dermatology department at Taipei Medical University, and the doctor, who said it was the first time encountering such a case, speculated that it might be a sympathetic nerve issue caused by a tumor and atrophy of the sebaceous glands.
However, no further tests or referrals were arranged, and I was only advised to return for a follow-up if I experience additional symptoms.
I am wondering if there are any dermatologists in Taipei who are more knowledgeable about these conditions.
Could you please provide a recommendation? Thank you.

Tes, 20~29 year old female. Ask Date: 2005/12/31

Dr. Huang Ruiyun reply Dermatology

In that case, please visit the Dermatology Department at National Taiwan University Hospital and describe all the details mentioned in your previous email to the attending physician.

Reply Date: 2005/12/31

More Info

Anhidrosis, or the inability to sweat, combined with persistent dry skin, can be a challenging condition to manage. Your experience of not sweating regardless of environmental conditions, even during hot weather, raises concerns about your body's ability to regulate temperature effectively. This can lead to overheating and heat-related illnesses, especially in warmer climates.
The symptoms you describe, including dry and cracked skin despite regular moisturizing, suggest that your skin barrier may be compromised. The skin barrier is essential for retaining moisture and protecting against environmental irritants. When this barrier is disrupted, it can lead to conditions such as xerosis (dry skin) and potentially exacerbate issues like eczema or dermatitis.

The dermatologist's initial assessment linking your symptoms to sympathetic nervous system issues and sebaceous gland atrophy is noteworthy. The sympathetic nervous system plays a crucial role in regulating sweat production. If there is a dysfunction, it could explain your anhidrosis. Additionally, sebaceous glands produce sebum, which helps maintain skin hydration. If these glands are not functioning properly, it could contribute to your dry skin condition.

In terms of management, here are some recommendations:
1. Moisturizing Routine: Continue to apply a high-quality moisturizer regularly. Look for products containing ingredients like ceramides, hyaluronic acid, or glycerin, which can help restore the skin barrier and retain moisture. Applying moisturizer immediately after bathing can help lock in moisture.

2. Avoid Irritants: Since you mentioned using only water for washing, ensure that the water temperature is lukewarm, as hot water can strip the skin of its natural oils. Avoid harsh soaps and detergents that can further irritate your skin.

3. Hydration: Ensure you are adequately hydrated by drinking plenty of water. This can help improve your skin's overall hydration from the inside out.

4. Environmental Factors: Consider using a humidifier in your living space, especially during dry seasons, to add moisture to the air and help prevent your skin from drying out.

5. Medical Evaluation: Given the complexity of your symptoms, it may be beneficial to seek a second opinion from a dermatologist who specializes in skin disorders related to the nervous system or an endocrinologist if there are concerns about hormonal or glandular issues. They may recommend further testing, such as sweat tests or skin biopsies, to better understand the underlying causes of your symptoms.

6. Monitoring Symptoms: Keep a detailed record of your symptoms, including any triggers or changes in your condition. This information can be invaluable for healthcare providers in diagnosing and managing your condition effectively.

7. Avoiding Overheating: Since you are prone to overheating, it is crucial to take precautions in hot weather. Stay in cool environments, wear breathable clothing, and avoid strenuous activities during peak heat hours.

In summary, managing anhidrosis and dry skin requires a multifaceted approach that includes proper skincare, hydration, and possibly further medical evaluation. It is essential to work closely with healthcare professionals who can provide tailored advice and treatment options based on your specific condition. If you feel that your current dermatologist is not addressing your concerns adequately, seeking a specialist with experience in these areas may provide you with the insights and care you need.

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