Hyperhidrosis, or excessive sweating can be generalized, affecting the entire body, or focal, affecting specific areas such as the palms, armpits, soles, or face. (52F)

 

 

Eccrine Sweat Glands

 

Structure & Location: These are simple, coiled, tubular glands found throughout the body, with a high concentration on the soles of the feet. (52F)

 

Innervation & Function: Eccrine glands are stimulated by acetylcholine and the sympathetic nervous system. They receive sympathetic innervation via cholinergic (rather than adrenergic) fibers, which trigger sweating based on changes in core body temperature. (52F)

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Apocrine Sweat Glands

 

Structure & Location: These larger, branched glands are primarily located in the axillary (armpits) and perineal regions (including perianal areas, labia majora, scrotum, prepuce, nipples, and areolar tissue). (52F)

 

Innervation & Function: Apocrine glands are stimulated by norepinephrine, often producing malodorous perspiration. They are linked to emotion-induced sweating (e.g., stress, fear, pain, or sexual arousal). (52F)

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Treatment Options

 

     The main goals in hyperhidrosis treatment are blocking acetylcholine (e.g. botulinum toxin or anticholinergics) and reducing stress responses (e.g. beta blockers).

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Anticholinergics such as Oxybutynin, blocks muscarinic receptors (particularly M1, M3, and M4) on both eccrine and apocrine sweat glands, reducing sweat production. They can produce side effects such as dry mouth, blurred vision from reduced tear production, constipation, and other symptoms due to reduced parasympathetic activity. (53F)

 

Botulinum Toxin A - Inhibits the release of acetylcholine at presynaptic terminals, halting sympathetic neurotransmission in sweat glands and thereby stopping excessive sweating. (54F)

 

Beta-Blockers (e.g., Propranolol) - Commonly prescribed for anxiety and stage fright. They lower heart rate and reduce stress-related symptoms like sweating and tremors. (55F)

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How different terpenes could affect hyperhidrosis

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Alpha-Pinene

 

Mechanism: α-Pinene is an acetylcholinesterase inhibitor. (5C,37E)

 

Effect on Sweating:

 

Worse for Cholinergic Sweating: By inhibiting the enzyme that breaks down acetylcholine, α-pinene could increase ACh levels, potentially increasing cholinergic sweating.

 

Possible Stress Reduction: Acetylcholinesterase inhibitors can induce a parasympathetic response,(65C) and increased parasympathetic tone can counteract some sympathetic-driven processes, α-pinene might also calm stress-related triggers; but it could still worsen sweating through increasing acetylcholine.

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Beta-Myrcene

 

Mechanisms: Mu-Opioid and α2-Adrenoreceptor Modulation (69C)

 

Effect on Sweating:

 

Reduced Sympathetic Tone: Activation of α2 receptors can lowers sympathetic outflow and can increase vagal (parasympathetic) tone. (52F)

 

Stress-Induced Sweating: By diminishing the stress (fight-or-flight) response, myrcene may help reduce sweating tied to anxiety, fear, or emotional triggers.

 

Relaxing Indica Terpene: Myrcene is a well known relaxing Indica terpene. It could help reduce stress-induced sweating by modulating both the mu-opioid and alpha 2-adrenoreceptor.

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Linalool

 

Mechanisms: Inhibits ACh Release at neuromuscular junctions (reducing channel open time), (55C) and a NMDA Receptor Antagonist. (12F,24F)

 

Effect on Sweating:

 

Cholinergic Pathway: By decreasing ACh release, linalool could reduce primary neurotransmitter for eccrine glands.

 

Neuroexcitation: As an NMDA antagonist, it could lower excitatory signaling,(23F,24F) further reducing stress-induced sweating.

 

Overall Impact: Could help both cholinergic and stress-related sweating.

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Terpineol

 

Mechanism: Anticholinergic (11D)

 

Effect on Sweating: Similar to prescription anticholinergics, terpineol could reduce excessive sweating by blocking muscarinic receptors on sweat glands.

 

May produce side effects typical of anticholinergics. Prescription anticholinergics can produce symptoms that include dry mouth rapid heart rate, arrhythmias, urinary retention, blurred vision, constipation, reduced gut motility, hyperthermia, and inhibition of sweating.(35C)

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     A cannabis strain with myrcene, terpineol, and linalool could be a good choice to help with hyperhidrosis. Strains that could make sweating worse would have acetylcholinesterase inhibitors, which include:

 

Limonene IC(50)=390.2 ± 30.0 (37E)

Alpha-Pinene IC(50)=524.5 ± 42.4 (37E)

Beta-Caryophyllene IC(50)=436.0±29.9 (37E)

Beta-Caryophyllene Oxide IC(50)=320.16 ± 13.47 (37E)

Humulene IC(50)=785.3 ± 66.0 (37E)

Delta 3 Carene IC(50) not available (52C)

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     Many strains have some of these ACh inhibitor terpenes with Indica’s that have more beneficial terpenes (myrcene, terpineol, and linalool), and depending on the concentration of each, one effect will take over. For example, Lemon Walker still gives me a lot of anticholinergic effects like dry mouth and eyes from the terpineol even though there is some limonene and a-pinene in it, and this strain does help reduce sweating.