A person with hyperhidrosis sweats excessively in certain areas of the body, such as the palms, soles, armpits, or face. The condition can affect the quality of life and self-esteem of the person suffering from it. Various factors contribute to hyperhidrosis, such as genetics, hormones, nerves, or medications. It can be diagnosed through a physical examination, sweat tests, or blood tests. There are several ways to treat it, including antiperspirants, medications, injections, or surgery.
There are two main types of hyperhidrosis: primary and secondary. The type depends on the origin of the excessive sweating.
Overactivity of sweat glands in specific parts of the body causes primary hyperhidrosis. It usually starts in childhood or adolescence and affects both sides of the body equally. Primary hyperhidrosis has a genetic component, but the exact cause is unknown. It may be triggered by heat, stress, emotions, or exercise.
Medical conditions or medications that affect the entire body can cause secondary hyperhidrosis. Secondary hyperhidrosis usually starts in adulthood and affects different parts of the body unevenly. It may occur at any time, even during sleep. Some possible causes of secondary hyperhidrosis include:
Infections, such as tuberculosis, HIV, or malaria.
Endocrine disorders, such as diabetes, hyperthyroidism, or menopause.
Neurological disorders, such as Parkinson’s disease, stroke, or spinal cord injury.
Cancer, such as lymphoma, leukemia, or carcinoid syndrome.
Medications, such as antidepressants, antihypertensives, or opioids.
The main symptom of hyperhidrosis is excessive sweating in one or more areas of the body. The sweating may be constant or intermittent, and it may vary in severity. The sweating may cause:
Wetness, staining, or odor of the clothes or shoes.
Slippery or clammy hands or feet.
Skin irritation, infection, or maceration.
Social embarrassment, anxiety, or depression.
Difficulty in performing daily activities, such as writing, typing, or shaking hands.
A medical history, a physical examination, and some tests are used to diagnose hyperhidrosis. In addition to any other symptoms, medical conditions, or medications, the doctor will ask about the onset, duration, frequency, severity, and triggers of sweating. In addition to checking for signs of sweating, the doctor will look for redness, wetness, and an odor in the affected areas.
Some of the tests that may be done to diagnose or confirm hyperhidrosis are:
Sweat test, which measures the amount of sweat produced by the sweat glands. It can be done by applying a chemical (iodine-starch) or a device (thermistor) to the skin and observing the color or temperature change.
Blood test, which checks the levels of hormones, glucose, electrolytes, or other substances that may be related to the sweating.
Urine test, which detects the presence of drugs, toxins, or infections that may cause the sweating.
Imaging test, such as ultrasound, X-ray, CT scan, or MRI, which shows the structure and function of the sweat glands, the nerves, or the organs that may be involved in the sweating.
The treatment of hyperhidrosis depends on the type, the cause, and the severity of the condition, as well as the patient's preferences and tolerances. There are several possible treatments that aim to reduce sweating, improve quality of life, and prevent or manage complications.
In antiperspirants, sweat ducts are blocked, preventing sweat from reaching the surface of the skin. You can apply them once or twice daily to the affected areas. Aluminum chloride or other active ingredients may cause skin irritation or allergic reactions to some people.
Medications, which are oral or topical drugs that reduce sweat gland activity or nerve activity. In some people, they can cause side effects, such as dry mouth, blurred vision, or drowsiness. Anticholinergics, beta blockers, and antidepressants, can be taken as needed or on a regular basis.
Injections, which are substances that are injected into the skin to temporarily block the nerves that stimulate the sweat glands. In some people, botulinum toxin (Botox) or local anesthetics may cause pain, bruising, or weakness in the injected area. It is possible to undergo them every few months or as needed.
In surgery, sweat glands or the nerves that supply them are removed, destroyed, or disconnected. This procedure is often used as a last resort when other treatments fail or are not suitable. Excisions, curettage, liposuction, sympathectomy, or endoscopic thoracic sympathectomy are some of the methods used. In some cases, it may result in scarring, infection, bleeding, or compensatory sweating (increased sweating elsewhere).
There is no sure way to prevent hyperhidrosis, as it may have different causes and factors. However, some general measures that may help reduce the risk or the severity of hyperhidrosis are:
Seeking medical advice and treatment for any underlying medical condition or medication that may cause or worsen the sweating.
Avoiding or limiting the exposure to heat, humidity, stress, or spicy foods that may trigger or aggravate the sweating.
Wearing loose, breathable, and light-colored clothing and shoes that can absorb or evaporate the sweat and prevent overheating.
Practicing good hygiene and skin care, such as bathing daily, using antibacterial soap, applying antiperspirant, and changing clothes and socks frequently, to prevent odor, infection, or irritation.
Seeking psychological support or counseling, if the sweating affects the self-esteem, the mood, or the social life of the patient.
