What is hyperhidrosis?

Hyperhidrosis is a disease characterized by prolonged sweating, also called polyhidrosis or sudorrhea. Sweating can affect only one region, or the entire body.

Though not life-threatening, it can be painful and cause psychological distress and embarrassment.

In this post, we’ll look at the causes, signs, diagnosis and hyperhidrosis treatment.

Fast facts on hyperhidrosis

Here are a few key points on hyperhidrosis. The main article provides more descriptions and supporting material.

  • Hyperhidrosis tends to begin during adolescence
  • An estimated 7.8 million Americans have hyperhidrosis
  • Most commonly, the feet, hands, face, and armpits are affected
  • There are a number of remedies that can reduce symptoms

What is hyperhidrosis?

A man sweating
Hyperhidrosis can be psychologically damaging

Due to their relatively high concentration of sweat glands, excessive sweating associated with hyperhidrosis is normally most prominent in the hands, feet, armpits and groin.

  • Focal hyperhidrosis: When the excessive sweating is localized. For example, palmoplantar hyperhidrosis is excessive sweating of the palms and soles.
  • Generalized hyperhidrosis: Excessive sweating affects the entire body.

Hyperhidrosis may occur at birth, or may develop later in life. Most cases of excessive sweating, however, appear to begin during teen years of a child.

The condition can be caused by an underlying health problem, or has no apparent cause:

  • Primary idiopathic hyperhidrosis: “Idiopathic” means “of unknown cause.” In the majority of cases, the hyperhidrosis is localized.
  • Secondary hyperhidrosis: The person sweats too much because of an underlying health condition, such as obesity, gout, menopause, a tumor, mercury poisoning, diabetes mellitus, or hyperthyroidism (overactive thyroid gland).

According to the International Hyperhidrosis Organization, hyperhidrosis affects approximately 2.8 percent of Americans; that’s about 7.8 million people.

For others, the effects of hyperhidrosis are so severe that it is uncomfortable and induces anxiety and pain. It that affect the career choices of the individual, the free time activities, personal relationships, self-image, and emotional well-being.

Luckily there are many treatments that can effectively treat the symptoms. The greatest obstacle in the treatment of hyperhidrosis is the vast number of people who do not seek medical help, either because of shame or because they do not know there is effective treatment.

Symptoms

Hyperhidrosis is described as sweating which interferes with normal activity. Episodes of intense sweating occur for no apparent cause at least once a week and affect social life or day-to-day activities.

A lady sweating
Simple lifestyle changes can sometimes ease hyperhidrosis’ symptoms.

Signs and symptoms of hyperhidrosis may include:

  • Clammy or wet palms of the hands
  • Clammy or wet soles of the feet
  • Frequent sweating
  • Noticeable sweating that soaks through clothing

People with hyperhidrosis might experience the following:

  • Irritating and painful skin problems, such as fungal or bacterial infections
  • Worrying about having stained clothing
  • Reluctant to make physical contact
  • Self-conscious
  • Socially withdrawn, sometimes leading to depression
  • Select employment where physical contact or human interaction is not a job requirement
  • Spend a large amount of time each day dealing with sweat, such as changing clothes, wiping, placing napkins or pads under the arms, washing, wearing bulky, or dark clothes
  • Worry more than other people about body odor

Experts aren’t sure why, but excessive sweating during sleep isn’t normal for people with primary hyperhidrosis (type not associated with any underlying health condition).

Causes

The causes of primary hyperhidrosis are not well understood; secondary hyperhidrosis on the other hand has a long list of known causes.

Causes of primary hyperhidrosis

A young man sweating
Primary hyperhidrosis appears to have a genetic component.

People used to believe that primary hyperhidrosis was related to the mental and emotional state of the patient, that the disorder was neurological and only affected individuals who were depressed, anxious or nervous.

Nevertheless, recent research has shown that individuals with primary hyperhidrosis are no more vulnerable to symptoms of anxiety, nervousness or emotional stress when exposed to the same stimuli as the rest of the population.

In reality, it’s the other way around – because of the constant sweating, the emotional and mental feelings felt by many patients with hyperhidrosis.

Studies have also shown that other genes play a part in hyperhidrosis, which makes it appear more likely to be inherited. Most primary hyperhidrosis patients have a sibling or parent who has the disorder.

Causes of secondary hyperhidrosis

  • Spinal cord injury
  • Alcohol abuse
  • Anxiety
  • Diabetes
  • Gout
  • Heart disease
  • Hyperthyroidism – an overactive thyroid gland
  • Obesity
  • Parkinson’s disease
  • Pregnancy
  • Respiratory failure
  • Shingles
  • Some cancers, such as Hodgkin’s disease
  • Some infections – HIV, malaria, TB (tuberculosis)
  • Some medications, including some antidepressants, anticholinesterases (for Alzheimer’s disease), pilocarpine (for glaucoma), propranolol (for high blood pressure)
  • Substance abuse

Diagnosis

Initially, by ordering blood and urine tests, a doctor can seek to rule out any underlying problems, such as an overactive thyroid (hyperthyroidism) or low blood sugar (hypoglycemia).

Patients will be asked about their sweating habits-which body parts are affected, how frequently sweating episodes occur, and whether sweating occurs during sleep.

A series of questions may be asked to the patient, or a questionnaire about the effects of excessive sweating may be completed; questions may include:

  • Do you carry anything around to deal with episodes of excessive sweating, such as napkins, antiperspirants, towels, or pads?
  • Does hyperhidrosis affect your behavior or mental state when you are in public?
  • Has hyperhidrosis had any effect on your employment?
  • Have you ever lost a friend due to hyperhidrosis?
  • How often do you change your clothing?
  • How often do you wash or have a shower/bath?
  • How often do you think about excessive sweating?

Thermoregulatory sweat test: A moisture-sensitive paste is added to the skin. The powder changes color when heavy sweating occurs at room temperature. In a sweat cabinet, the patient is then exposed to high heat and humidity which triggers sweating throughout the entire body.

When exposed to sun, people who have no hyperhidrosis appear not to sweat excessively in the palms of their hands, but hyperhidrosis patients do. This examination would also assist the doctor in assessing the seriousness of the disease.

Natural remedies

Some alterations in daily activity and lifestyle may help improve symptoms:

  • Antiperspirants – deodorants do not stop sweating, but antiperspirants sprays do. Some prescription antiperspirants include aluminum chloride, which plugs the sweat glands.
  • Armpit shields – pads worn in the armpit to protect a garment from perspiration.
  • Clothing – certain synthetic fibers, such as nylon, may worsen symptoms. Loose clothing is better.
  • Shoes – synthetic materials are more likely to worsen symptoms. Natural materials, such as leather, are recommended.
  • Socks – some socks are better at absorbing moisture, such as thick, soft ones made of natural fibers.

If these measures are not effective, medical treatment may help.

Treatment

A doctor may refer the person to a skin specialist, or dermatologist.

They may recommend:

Iontophoresis – in a tank of water the hands and feet are submerged. The water is moved into a painless electric current. Most patients need two to four 20-30 minute therapies.

Botulinum toxin (Botox injections) – Botox injections block the sweat glands’ nerves. Hyperhidrosis patients can need several injections for successful results.

Anticholinergic drugs – these medications block parasympathetic nerve impulses transmission. Patients usually experience symptom change within around 2 weeks.

ETS (Endoscopic Thoracic Sympathectomy) – this surgical technique is used only in serious cases that have not responded to other therapies. The nerves are cut off which carry messages to the sweat glands.

ETS can be used to treat head, hand, or armpit hyperhidrosis. Due to the risk of permanent sexual dysfunction ETS is not recommended for the treatment of feet hyperhidrosis.

Complications

It can lead to complications if hyperhidrosis is not treated.

  • Nail infections: Especially toenail infections.
  • Warts: Skin growths caused by the HPV (human papillomavirus).
  • Bacterial infections: Especially around hair follicles and between the toes.
  • Heat rash (prickly heat, miliaria): An itchy, red skin rash that often causes a stinging or prickling sensation. Heat rash develops when sweat ducts become blocked and perspiration is trapped under the skin.
  • Psychological impact: Excessive sweating can affect the patient’s self-confidence, job, and relationships. Some individuals may become anxious, emotionally stressed, socially withdrawn, and even depressed.

A person with hyperhidrosis, on average, is seeking medical attention after 9 years of living with the disease. It’s necessary to spread the word that you can effectively treat the symptoms of excessive sweating.

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