For some people, the body’s cooling mechanism (commonly known as sweating) may be overactive. Some sweat four or five times more than normal. This serious medical condition called hyperhidrosis has become prevalent, severe, and socially debilitating to some.

According to a recent study by Doolittle, et al. (2016), nearly 5% of the American population suffers from severe excessive sweating. This accounts for about 15.3 million people, with the prevalence highest among ages 18-39. Moreover, this population also reported that they experience diminished quality of life.

Despite the prevalence, only 51% of this group has discussed their condition with a healthcare professional due to their belief that hyperhidrosis is not a medical condition. Therefore, there is a need to spread awareness of this condition and the various treatments available.

In this article, let’s explore in detail what hyperhidrosis is,  how it affects people who have this condition, and the treatment options available.

What is hyperhidrosis?

Hyperhidrosis is a disorder of the skin characterized by sweating excessively of what is required to regulate the normal body temperature. Without triggers like elevated temperature or activity levels, people with this condition may find themselves sweating uncontrollably.

This kind of sweating commonly affects certain areas, such as the armpits, palms of the hands, soles of the feet, face, chest, and groin.

Hyperhidrosis causes and symptoms

Normally, when a person’s body is overheated, performing physical activities, or feeling stressed or emotional, the nerves send signals to the brain to activate the sweat glands. People with hyperhidrosis generally sweat from eccrine sweat glands, a certain type of sweat gland that makes up 90% of the up to 4 million sweat glands in a person’s body. These can release up to 3 liters of sweat per hour.

To help clinicians and patients understand their condition more and determine the appropriate treatment, hyperhidrosis is classified into two types:

  • Focal hyperhidrosis happens due to genetic mutations and can be inherited from the family. This often begins during childhood or adolescence.
  • Generalized hyperhidrosis happens due to other medical problems like diabetes, Parkinson’s disease, hyperthyroidism, and pregnancy. Medications that contain naproxen and zinc supplement may also cause excessive sweating as a side effect. It usually starts in adulthood.

There are no guidelines to know whether a person is sweating normally or not, but if you feel you sweat uncontrollably and this condition interferes with your quality of life, then you may have hyperhidrosis. The common symptoms of hyperhidrosis include:

  • You frequently shower and change clothes because you feel you have sweated too much.
  • You avoid physical contact like handshakes because you’re embarrassed with your sweaty hands.
  • You don’t take part in physical activities for the fear that your sweating will be worse.
  • You have difficulty holding objects because you’re palms sweat excessively.

How hyperhidrosis affects quality of life

Hyperhidrosis has negative impacts on various aspects of life. Worldwide, almost a third of hyperhidrosis patients report that they are “frequently or constantly bothered” by their sweating condition. A study conducted by Kamudoni, et al. (2017) indicates that hyperhidrosis affects all aspects of a person’s life—daily activities, social life, professional or school life, and psychological well-being.

Dr. Skelsey of the American Academy of Dermatology Association notes that hyperhidrosis affects both the lives of children and adults. For example, children may experience people avoiding holding their hands or not being able to participate well in class because their pencils or crayons get wet when they hold them, even after a short period. For adults, hyperhidrosis sometimes dictates their career and dating choices. They often avoid interactions that involve shaking or holding hands, intending to avoid embarrassment.

Beyond all these issues, excessive sweating also leads to further medical consequences. Too much sweating results in constant wetness of the skin and skin macerations. This increases the risk of getting other skin conditions like athlete’s foot and bacterial infections or pitted keratolysis. Studies show that patients with hyperhidrosis have an almost 30% greater risk of skin infections.

Hyperhidrosis diagnosis

During the doctor’s appointment, you may be asked for your medical history and the symptoms you experience. Factors such as the age of onset, sweating episodes and duration, areas of occurrence of the excessive sweating, and family’s medical history aid clinicians to diagnose hyperhidrosis. If they see that another medical condition is contributing to your sweating problem, laboratory testing may be necessary. However, there is no specific method to quantify hyperhidrosis’ severity.

Hyperhidrosis treatment

There are different ways to tackle hyperhidrosis. If another medical condition is causing your excessive sweating, that condition will be the target of the treatment. On the other hand, if no clear cause is found, the treatment that your doctor may suggest will directly focus on controlling excessive sweating. Certain cases may require combinations of different treatments. Below are some of the hyperhidrosis treatment options:

  • Medications
    • Prescription antiperspirants are often used as the first line of treatment because they are the least invasive and the least expensive. They commonly use metallic salts like aluminum chloride as the primary ingredient. When applied on top of the skin, the antiperspirant is grabbed by the sweat, and this forms temporary plugs that block the flow of sweat for up to 24 hours. Just make sure to follow the instructions carefully as they may cause skin irritation.
    • Prescription creams contain glycopyrrolate, which targets the face and other parts of the head.
    • Nerve-blocking drugs block the chemicals that nerves use to communicate with each other in activating the sweat glands. Just be watchful of some side effects like dry mouth, bladder problems, and blurred vision.
  • Surgical and other procedures
    • Iontophoresis is often recommended for people who didn’t have any improvement after using antiperspirants. This type of treatment primarily targets sweating on the hands and/or the feet. During the treatment, a medical device is used to pass a mild electrical current through the skin’s surface, with water as the medium.
    • Botulinum toxin injections block the nerves that trigger sweating for up to 12 months by injecting directly into the target area of the body. In addition to being painful, the procedure may also lead to temporary muscle weakness near the treated area.
    • Underarm surgeries are an ideal option for those experiencing excessive sweating in the underarms. The techniques employed may include excision, curettage, and liposuction, which either injure or remove the sweat glands.
    • Sympathectomy (nerve surgery) involves cutting, burning, or clamping the spinal nerves responsible for controlling sweat in your hands. This procedure should be verified by the surgeon because it may lead to compensatory sweating or trigger excessive sweating in other body areas.
  • Home remedies
    • Use of non-prescription antiperspirants
    • Applying astringents
    • Bathing daily
    • Changing socks often
    • Airing feet
    • Practicing relaxation techniques

If you think you are suffering from hyperhidrosis, contact Buckeye Dermatology to request an initial appointment. Its medical dermatologists will help you explore treatment options based on your diagnosis.