Hyperhidrosis, or excessive sweating, is a common disorder which produces a lot of unhappiness. An estimated 2%-3% of Americans suffer from excessive sweating of the underarms (axillary hyperhidrosis) or of the palms and soles of the feet (palmoplantar hyperhidrosis).
Hyperhidrosis treatment usually helps, beginning with prescription-strength antiperspirants. If antiperspirants don’t help, you may need to try different medications and therapies. In severe cases, your doctor may suggest surgery either to remove the sweat glands or to disconnect the nerves responsible for the overproduction of sweat.
Sometimes an underlying cause may be found and treated.
Symptoms:
Most people sweat when they exercise or exert themselves, are in a hot environment, or are anxious or under stress. The excessive sweating experienced with hyperhidrosis far exceeds such normal sweating.
The type of hyperhidrosis that usually affects the hands, feet, underarms or face causes at least one episode a week, during waking hours. And the sweating usually occurs on both sides of the body.
Causes:
Although neurologic, endocrine, infectious, and other systemic diseases can sometimes cause hyperhidrosis, most cases occur in people who are otherwise healthy. Heat and emotions may trigger hyperhidrosis in some, but many who suffer from hyperhidrosis sweat nearly all their waking hours, regardless of their mood or the weather.
Sweating is your body’s mechanism to cool itself. Your nervous system automatically triggers your sweat glands when your body temperature rises. Sweating also normally occurs, especially on your palms, when you’re nervous.
The most common form of hyperhidrosis is called primary focal (essential) hyperhidrosis. With this type, the nerves responsible for signaling your sweat glands become overactive, even though they haven’t been triggered by physical activity or a rise in temperature. With stress or nervousness, the problem becomes even worse. This type usually affects your palms and soles and sometimes your face.
There is no medical cause for this type of hyperhidrosis. It may have a hereditary component, because it sometimes runs in families.
Secondary hyperhidrosis occurs when excess sweating is due to a medical condition. It’s the less common type. It’s more likely to cause sweating all over your body. Conditions that may lead to heavy sweating include:
- Diabetes
- Menopause hot flashes
- Thyroid problems
- Low blood sugar
- Some types of cancer
- Heart attack
- Nervous system disorders
- Infections
Treatment:
Although neurologic, endocrine, infectious, and other systemic diseases can sometimes cause hyperhidrosis, most cases occur in people who are otherwise healthy. Heat and emotions may trigger hyperhidrosis in some, but many who suffer from hyperhidrosis sweat nearly all their waking hours, regardTreatment
If an underlying medical condition is contributing to the problem, that condition will be treated first. If no clear cause can be found, treatment focuses on controlling excessive sweating. Sometimes you may need to try a combination of treatments. And even if your sweating improves after treatment, it may recur.less of their mood or the weather.
Diagnosis:
Lab tests
Your doctor may recommend blood, urine or other lab tests to see if your sweating is caused by another medical condition, such as an overactive thyroid (hyperthyroidism) or low blood sugar (hypoglycemia).
Sweat tests
Thermoregulatory sweat test
Thermoregulatory sweat test
A number of tests are available to pinpoint the areas of sweating and estimate the severity of your condition, including an iodine-starch test, skin conductance and a thermoregulatory sweat test.
Medications:
- Prescription antiperspirant– Your doctor may prescribe an antiperspirant with aluminum chloride (Drysol, Xerac Ac). This product can cause skin and eye irritation. It’s usually applied to the affected skin before you go to bed. Then you wash the product off when you get up, taking care to not get any in your eyes. If your skin becomes irritated, hydrocortisone cream might help.
- Prescription creams – A prescription cream that contains glycopyrrolate may help hyperhidrosis that affects the face and head.
- Nerve-blocking medications – Some oral medications block the chemicals that permit certain nerves to communicate with each other. This can reduce sweating in some people. Possible side effects include dry mouth, blurred vision and bladder problems.
- Antidepressants-Some medications used for depression can also decrease sweating. In addition, they may help decrease the anxiety that worsens the hyperhidrosis.
- Botulinum toxin injections Treatment with botulinum toxin (Botox, Myobloc, others) temporarily blocks the nerves that cause sweating. Your skin will be iced or anesthetized first. Each affected area of your body will need several injections. The effects last six to 12 months, and then the treatment needs to be repeated. This treatment can be painful, and some people experience temporary muscle weakness in the treated area.
