Everybody, who usually sweats and don’t need to think about it, is a lucky person. But those who suffer from some perspiration disorder and fight against extreme sweating, body odor, or they don’t sweat at all, can confirm how bothering it can be. Problems with sweating don’t affect only the body, but due to permanent sweat maps in underarms, wet head or hands, it significantly obstructs social life. In this article, we are going to talk about a very rare sweating disorder called Chromhidrosis. People with this health disorder produce colored sweat. Before talking about why this is happening, we will have a look at chromhidrosis definition and symptoms.
Chromhidrosis (sometimes just called colored sweat) is an extremely rare functional disorder when sweat glands produce colored sweat. The term is derived from the Greek words, “chroma” (colored) and “hidros” which means sweat. There is another similar sweat disorder called Pseudochromhidrosis, which is more common than chromhidrosis. The difference is that in pseudochromhidrosis, sweat becomes colored after the secretion. The color is produced when sweat meets skin with chromogenic bacteria, dyes, or certain chemicals. In chromhidrosis, sweat coming on the skin surface is already colored.
Two Types of Chromhidrosis
Human body has two types of sweat glands. While eccrine sweat glands, responsible for thermoregulation, are spread all over the body, apocrine sweat glands are found in the face, armpits, genital, parts of eyes, ears and in breast areola. Apocrine glands start to be active in the puberty, and besides thermal stimuli, they also react to emotional impulses. We recognize two types of chromhidrosis according to the affected sweat glands.
Causes of Chromhidrosis
Apocrine chromhidrosis occurs on the face, axillae and around the breasts. Patients with this diagnosis record smaller amount of sweat, which usually has a yellow, blue, green, black, or brown color. It has been demonstrated that this condition is caused by lipofuscin what is a pigment produced by apocrine glands. This pigment is formed by oxidation of lipids in cells. When the body produces an excessive amount of lipofuscin, colored sweat can occur. The color of sweat depends on the concentration of oxidation states of lipofuscin. Higher oxidation is responsible for darker colors of sweat.
Eccrine chromhidrosis is rarer than apocrine and usually affect palms and feet. Patients can excrete any color of sweat. This type of chromhidrosis occurs due to using of certain dyes, drugs, or chemical contactants. There are also chromogenic bacteria, such as Piedraia or Corynebacterium, or fungal contamination that can cause colored sweat.
The color of sweat is the first element in diagnosis. While the sweat is colored yellow, green or blue, apocrine chromhidrosis is most presumed. A doctor can reveal apocrine chromhidrosis by examination of sweat stains on clothing under a Wood’s lamp. When there are lipofuscins, they start to phosphoresce in the ultraviolet or black light. But, in the case the sweat has a black or brown color, this method is not so useful because highly oxidated lipofuscin doesn’t phosphoresce under the black light.
Knowing of patient’s medical history is the best way on how to diagnose eccrine chromhidrosis. We already know that a foreign dye or pigment that comes to the body is the main culprit. These substances are water-soluble and subsequently excreted by eccrine glands. For example, in one patient, consuming tomato powder affects colored sweat. That’s why a doctor should ask a question about food, chemicals using in work and try to find the substance that results in colored sweat.
The correct distinguishing between the two types of chromhidrosis can still be difficult due to the lack of expert information about these very rare conditions.
Due to the infrequent occurrence of this disease, the treatment possibilities are quite limited. In the case of eccrine chromhidrosis, the solution is relatively easy. The physician and the patient should try to identify the water-soluble chemical causing the colored sweat. When the patient stops using it, the sweat should get to the normal.
In the case of apocrine chromhidrosis, it is more difficult. Experts still don’t know the cause why lipofuscin are building up in the glands, that’s why they don’t know to stop it. But there are few ways how to dramatically mitigate the symptoms of this condition.
The most common treatment of apocrine chromhidrosis is probably typed A botulinum toxin injections (Botox) applied directly to the affected area. This toxin paralyzes the sweat glands and prevents the production of sweat. Botox is also successfully used for the treatment of hyperhidrosis and several different disorders. In patients with chromhidrosis, botox treatment has different results. While some patients experience significant relief from colored sweat and improving the conditions, the others don’t record any improvement.
Another option is capsaicin. It is a derivative of the red pepper plant usually used as a pain killer in the form of a topical cream. Besides other effects, capsaicin is able to slow neurotransmitter that is important in sweat production in apocrine glands. The results vary from person to person.