What is Hyperhidrosis?

It is a condition in which a person sweats excessively and unpredictably. People with hyperhidrosis may sweat even when the temperature is cool or when they are at rest.

Causes 

Sweating helps the body stay cool. In most cases, it is perfectly natural. People sweat more in hot temperatures, when exercising, or in response to situations that make them feel nervous, angry, embarrassed, or afraid.

Excessive sweating occurs without these triggers. People with hyperhidrosis appear to have overactive sweat glands. Uncontrollable sweating can lead to significant discomfort, both physical and emotional.

When excessive sweating affects the hands, feet, and armpits, it is called primary or focal hyperhidrosis. In most cases, the cause cannot be found. It seems to be hereditary. If the sweating occurs as a result of another medical condition, it is called secondary hyperhidrosis. Sweating can occur all over the body or just in one area. Conditions that cause secondary hyperhidrosis include:

  • Acromegaly
  • anxiety conditions
  • Cancer
  • carcinoid syndrome
  • Some drug and substance abuse
  • Glucose control disorders
  • heart disease
  • hyperthyroidism
  • Lung disease
  • Menopause
  • Parkinson’s disease
  • Pheochromocytoma
  • spinal cord injury
  • Stroke attack
  • Tuberculosis or other infections

Symptoms 

The main symptom of hyperhidrosis is dampness.

Tests and exams 

Visible signs of sweating can be noticed during a visit to the doctor. Tests may also be used to diagnose excessive sweating, including:

  • Starch and iodine test: An iodine solution is applied to the area that is sweating. After drying, starch is spread over said area. The combination of iodine and starch turns any part of your body that has excess sweat a dark blue color.
  • Paper test: A special paper is placed on the affected area to absorb sweat, and then it is weighed. The more weight you have, the more sweat will have been absorbed.
  • Blood tests: These may be ordered if problems with the thyroid gland or other conditions are suspected.

You may also be asked about sweating details, such as:

  • Location: Does it occur on the face, palms, or armpits, or all over the body?
  • Weather pattern: Does it happen at night? Does it start suddenly?
  • Triggers: Does the sweating happen when you are reminded of something that bothers you (like a traumatic event)?

Other symptoms: Weight loss, pounding heartbeats, clammy or cold hands, fever, loss of appetite.

Treatment 

Antiperspirants: Excessive sweating can be controlled with strong antiperspirants, which clog the sweat ducts. Products containing 10 to 20% aluminum chloride hexahydrate are the first treatment for underarm sweating. Some people may be prescribed a product containing higher doses of aluminum chloride, which is applied at night to the affected area. These products can cause skin irritation, and large doses can damage clothing. Note: Deodorants do not prevent sweating, but they do help reduce body odor.

Medicines: Certain medicines can prevent the stimulation of the sweat glands. These are prescribed for certain types of hyperhidrosis such as excessive sweating on the face. Medicines have side effects and are not right for everyone.

Iontophoresis: This procedure uses electricity to temporarily deactivate sweat glands. It is most effective for sweaty hands and feet. The hands or feet are immersed in water, and then a mild electrical current is passed through it. The electricity is gradually increased until the patient feels a slight tingling sensation. The therapy lasts approximately 10 to 20 minutes and several sessions are necessary. Although side effects are rare, they include cracking of the skin and blisters.

Botox: Botulinum toxin type A (Botox) is used to treat severe underarm sweating. This condition is called primary axillary hyperhidrosis. Botulinum toxin is injected into the armpit to temporarily block the nerves that stimulate sweating. Side effects include soreness at the injection site and flu-like symptoms. Botox used for sweaty palms can cause mild but temporary weakness and severe pain.

Endoscopic thoracic sympathectomy (ET): In some severe cases, a minimally invasive surgical procedure called a sympathectomy may be recommended if other treatments have not worked. During the procedure, a nerve is cut, which turns off the signal that tells the body to sweat excessively. This procedure is usually performed on patients whose palms sweat excessively. It can also be used to treat extreme sweating of the face. STE does not work as well for those with excessive underarm sweating.

Armpit surgery: This is surgery to remove the sweat glands in the armpits. Methods used include laser, curettage (scraping), excision (cutting), or liposuction. These procedures are performed using local anesthesia.