Hyperhidrosis (Sweating Excessively)

Hyperhidrosis is the medical term used to describe excessive sweating.

Excessive sweating can occur throughout the body (generalized) or in specific regions. The hands, feet, armpits (axillae), and groin have the highest concentration of sweat glands (eccrine glands) and tend to be the areas of greatest perspiration.

Excessive sweating may be a sign of a medical disorder, such as hyperthyroidism, diabetes, or heart disease. This is more likely if the increase in sweating occurs later in life.

Many people experience hyperhidrosis who are otherwise healthy. This is referred to as “primary hyperhidrosis”. Primary hyperhidrosis usually arises during adolescence and appears to be an inherited trait. People with hyperhidrosis will commonly complain that “I get nervous because I sweat, then sweat more because I get nervous.”

The cause of primary hyperhidrosis is unknown. Anxiety can exacerbate sweating for many people, as can alcohol, caffeine, certain foods, and even some smells.

Axillary Hyperhidrosis (Armpit Sweating)

Armpit sweating is a form of excessive sweating in the axilla,or armpits.It can be associated with generalized hyperhidrosis, palmar hyperhidrosis (hand sweating), or it can be occur on its own.

The armpit area has two types of sweat glands, eccrine and apocrine glands. The eccrine glands are responsible for producing the fluid referred to as "sweat". This is an important bodily function to maintain a stable body temperature. However, excessive sweating can be very bothersome to some.

Hiding embarrassing sweat spots under the armpits limits the sufferers' arm movements and pose. In severe cases, shirts must be changed several times during the day. Additionally, anxiety caused by self-consciousness to the sweating may aggravate the sweating. Some careers present challenges for hyperhidrosis sufferers. For example, employees, such as sales staff, who interact with many new people can be negatively affected by social rejection. The risk of dehydration can limit the ability of some sufferers to function in extremely hot (especially if also humid) conditions.

Palmar Hyperhidrosis (Sweating of the Palms and Fee)

Excessive sweating of the hands and feet can impact a person's life and interfere with their sense of well-being.

Excessive hand sweating is the most common form of excessive sweating. It can interfere with many routine activities, such as securely grasping objects. Some hyperhidrosis sufferers avoid situations where they will come into physical contact with others, such as greeting a person with a handshake.

Some careers present challenges for hyperhidrosis sufferers. For example, careers which require the deft use of a knife may not be safely performed by people with excessive sweating of the hands. Employees, such as sales staff, who interact with many new people can be negatively affected by social rejection. Even the playing of musical instruments can be uncomfortable or difficult because of sweaty hands.

Excessive foot sweating does not usually have the same social impact on the patient as hand sweating but can also be very bothersome. Excessive sweating of the feet makes it harder for patients to wear slide-on or open-toe shoes, as the feet slide around in the shoe because of sweat.

Both foot and hand sweating can be aggravated by emotional stress and anxiety.

Treatment of Hyperhidrosis

Hyperhidrosis can often be very effectively managed.

Your physician will recommend a treatment based in your medical history and personal needs.

Treatment options include:

  • Relaxation and meditation
  • Weight loss
  • Stronger antiperspirants with aluminum chloride. Normal antiperspirants are usually not sufficient to control sweat for hyperhidrosis sufferers. Antiperspirants with higher than normal concentration of aluminum chloride may provide some assistance, but can cause irritation.
  • Botulinum toxin (Botox®). Botulinum toxin injections have been approved by the FDA for the treatment of hyperhidrosis. It disables the sweat glands for 4-9 months depending on the site of injections.
  • Iontophoresis. Iontophoresis uses water to conduct a mild electrical current through the skin’s surface. It’s thought that the electric current and mineral particles in the water work together to microscopically thicken the outer layer of the skin, which blocks the flow of sweat to the skin’s surface. Once this sweat output is blocked or interrupted, sweat production on the palms and soles is, often suddenly and dramatically, "turned off". This treatment is particularly useful for people who’ve tried prescription strength antiperspirants but find that they need a stronger treatment.
  • Anticholinergic medications (Ditropan®). These medications are taken by mouth. They inhibit part of the nervous system that trigger sweat production. However, many people experience only minimal benefit,and side effects, such as fatigue and constipation, are commonly reported.
  • Endoscopic thoracic sympathectomy (ETS). This is a surgical procedure used only for severe cases that require treatment and do not respond to other approaches.

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Last updated: 1/8/2019