Hyperhidrosis

What is hyperhidrosis?

Hyperhidrosis is a medical condition of excessive sweating. Sweat normally helps cool the body, but a person with hyperhidrosis sweats even when the temperature is cool or when the person is resting.

When someone has hyperhidrosis, he or she might sweat four to five times more than necessary or normal -- so much that the sweat soaks through clothes and interferes with everyday activities.

Types of hyperhidrosis

There are two types of hyperhidrosis: primary focal and secondary generalized.

Secondary generalized hyperhidrosis is caused by another medical condition, and it might occur all over the body. There are numerous possibilities, such as:

• Acromegaly, a hormonal disorder in which the pituitary gland produces too much growth hormone
• Anxiety conditions
• Cancer
• Carcinoid syndrome
• Diabetes
• Encephalitis
• Gout
• Heart disease, such as heart attack
• Obesity
• Overactive thyroid
• Lung disease
• Menopause
• Parkinson disease
• Pheochromocytoma (adrenal gland tumor)
• Rheumatoid arthritis
• Spinal cord injury
• Stroke
• Tuberculosis or other infections

On the other hand, primary focal hyperhidrosis is not a side effect, nor is it caused by another condition -- it is its own medical condition. It occurs in specific areas of the body, commonly the hands, feet, underarms and face and/or head. Primary focal hyperhidrosis almost always affects more than one of these areas of the body, and it often begins in childhood or adolescence.

The International Hyperhidrosis Society recommends asking the following criteria to determine which type of hyperhidrosis a person has:

First, have you experienced focal visible excess sweat for at least six months without apparent cause? If so, do you meet at least two of the following criteria?

• Your sweat is bilateral and relatively symmetrical, meaning you sweat the same on both sides of your body.
• Your excess sweat impairs your daily activities.
• You experience at least one episode a week.
• The onset of your excess sweat is earlier than age 25.
• Other members of your family suffer from similar sweating problems.
• You stop sweating when you're sleeping.

If you meet at least two of these criteria, it is likely you have primary focal hyperhidrosis.

It’s advisable to seek medical help if you have primary focal hyperhidrosis, or if you have secondary generalized hyperhidrosis and don’t know the cause.

Diagnosis

Keeping track of the specific circumstances of excessive sweating can help a physician figure out what’s causing it and how to treat it. Keep track of:

• The part or parts of the body where the sweating occurs.
• When it happens.
• Possible triggers (what near the time the sweating starts?).
• Accompanying symptoms (such a fever, a change in appetite, or a fast heartbeat).

Blood tests, imaging tests, or tests to measure the amount or location of excess sweating might be ordered to help find the cause.

Treatment

A variety of treatments ranging from antiperspirants to major surgery have been used to help alleviate hyperhidrosis. Options include:

• Antiperspirants: These block the sweat glands, providing temporary relief. Treatment usually involves a process of starting with gentle over-the-counter antiperspirants; then, if those aren’t effective, trying gradually more powerful prescription-strength products that contain high percentages of aluminum chloride hexahydrate.
• Iontophoresis: The treatment involves putting the hands and/or feet into shallow trays of water. An electric current is passed through the water, causing a slight tingling sensation. The electricity temporarily “turns off” sweat glands. Treatment is given three times a week until results appear. Sessions last 10 to 30 minutes.
• Removal of sweat glands: Lasers; microwaves; or procedures involving cutting, scraping or liposuction under local anesthetic remove or injure glands so they stop producing sweat.
• Botox injections: Primarily used for the underarm, palms and soles of the feet, Botox injections block the nerves that stimulate sweating. A treatment usually lasts four to 12 months.
• Medication: Medicines to alleviate excess sweating typically involve significant side effects.
• Endoscopic thoracic sympathectomy (ETS): This last resort cuts the nerve pathways from the spinal column to the sweat glands. It’s a permanent procedure that involves major surgery. 

Resources

International Hyperhidrosis Society: sweathelp.org