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Hyperhidrosis, also known as excessive sweating, occurs when your body produces more sweat than necessary for temperature regulation. This condition can lead to profuse sweating that saturates your clothing or causes your hands to drip with sweat. Excessive perspiration can disrupt your daily life and contribute to social anxiety and embarrassment.
Sweat is a colorless fluid secreted by your eccrine sweat glands. Its primary role is to help regulate your body temperature and prevent overheating. Eccrine glands are distributed throughout your skin and sweat travels through ducts until it reaches the skin’s surface. Once it reaches the surface, sweat transitions from a liquid to a gas, evaporating to cool down your body.
Treatment for hyperhidrosis typically begins with the use of antiperspirants. If antiperspirants prove ineffective, various medications and therapies may be explored. In severe cases, surgical options may be considered, such as removing sweat glands or disconnecting nerves responsible for excessive sweat production. Occasionally, an underlying medical condition may be identified and treated as the underlying cause of hyperhidrosis.
Hyperhidrosis comes in two main types:
- Primary focal hyperhidrosis: This is the most common form and is usually inherited through genetics. It primarily affects areas like the armpits, hands, feet, and face, typically beginning before the age of 25.
- Secondary generalized hyperhidrosis: This type is triggered by underlying medical conditions or medications. Examples include diabetes, Parkinson’s disease, or certain medications like naproxen, and it can lead to excessive sweating, even during sleep.
Symptoms
The symptoms of hyperhidrosis vary in severity. One can Hyperhidrosis primarily manifests through excessive sweating, which can lead to various discomforts and issues:
- Wetness on skin: You’ll notice your skin feeling consistently wet due to the excess sweat production.
- Damp clothing: Your clothes may become damp and uncomfortable as a result of the excessive perspiration.
- Beads of fluid: Beads of sweat may drip from areas like your cheeks, forehead, or other parts of your body.
As hyperhidrosis persists, it can cause additional problems:
- Skin irritation: The constant moisture can lead to itching and inflammation as sweat irritates your skin.
- Body odor: The combination of sweat and bacteria on your skin can result in body odor.
- Foot issues: Your feet may develop cracked or peeling skin due to excessive sweating, known as plantar hyperhidrosis.
Hyperhidrosis symptoms can vary in severity, ranging from occasional mild discomfort to constant and disruptive symptoms that affect your daily life.
Moreover, hyperhidrosis can have a significant emotional impact. Many individuals with this condition feel embarrassed about their excessive sweating and may avoid social situations. If hyperhidrosis takes a toll on your mental well-being, it’s essential to seek support from healthcare professionals to manage both the physical and emotional aspects of the condition.
Causes
Hyperhidrosis, characterized by excessive sweating, is primarily caused by overactive sweat glands, specifically the eccrine glands. These glands normally produce sweat to cool the body when it’s hot or during physical activity or anxiety. However, in individuals with hyperhidrosis, these glands can activate more frequently, leading to unpredictable sweating episodes unrelated to temperature or emotions. Ongoing research aims to uncover the precise reasons behind this excessive sweat production.
The body naturally sweats to regulate its temperature, triggered by the nervous system when body temperature rises. Nervousness can also induce sweating, particularly on the palms.
Primary hyperhidrosis results from faulty nerve signals that make the eccrine glands excessively active. It commonly affects areas like the palms, soles, underarms, and occasionally the face. It tends to run in families and lacks a clear medical cause.
On the other hand, secondary hyperhidrosis arises due to underlying medical conditions or the use of certain medications, such as pain relievers, antidepressants, diabetes drugs, and hormonal medications. This form of hyperhidrosis can lead to widespread sweating throughout the body and is associated with conditions such as diabetes, menopausal hot flashes, thyroid disorders, some cancers, nervous system disorders, and infections.
Diagnosis
Diagnosing hyperhidrosis typically involves a physical examination and an assessment of your symptoms and medical history. To receive a hyperhidrosis diagnosis, you should have experienced excessive sweating for at least six months and answered positively to at least two of the following criteria:
- Sweating occurs on your underarms, palms, soles, or face.
- You experience symmetric sweating on both sides of your body.
- Sweating does not occur at night or is significantly reduced at night.
- Episodes of excessive sweating last for at least one week.
- There is a family history of hyperhidrosis.
- Sweating interferes with your daily activities.
- You are younger than 25 years old.
To determine the underlying cause of hyperhidrosis, healthcare providers may employ various diagnostic tests, including:
- Starch-iodine test: During this test, your healthcare provider applies an iodine solution to the affected, sweaty area and then sprinkles starch over it. The areas with excess sweating will turn dark blue, indicating the presence of sweat.
- Paper test: Special paper is placed on the sweaty area to absorb the sweat. After a certain period, the paper is weighed to measure the amount of sweat produced.
- Blood or imaging tests: These tests may involve taking a blood sample or using imaging techniques to explore potential underlying causes of your symptoms, such as hormonal or neurological issues.
These diagnostic methods can help healthcare providers identify the cause and severity of your hyperhidrosis, allowing them to develop an appropriate treatment plan tailored to your needs.
Treatment
Hyperhidrosis treatment typically begins with addressing the underlying cause, if known. If no specific cause is identified, the focus shifts to managing excessive sweating. If self-care measures prove ineffective, your healthcare provider may recommend various treatments. It’s important to note that even after treatment, symptoms may return.
Medications
- Prescription antiperspirants: Your healthcare provider may prescribe antiperspirants containing aluminum chloride. Apply these to dry skin before bedtime, and wash them off in the morning. Initially, use daily, then reduce to once or twice a week for maintenance. Be cautious to avoid contact with eyes, as these products can cause irritation. Discuss ways to minimize side effects with your provider.
- Prescription creams and wipes: For hyperhidrosis affecting the face and head, glycopyrrolate-containing creams may be recommended. Wipes soaked in glycopyrronium tosylate can help with hands, feet, and underarms. Possible side effects include mild skin irritation and dry mouth.
- Nerve-blocking medications: Certain oral medications can block nerves that stimulate sweat glands, reducing sweating in some individuals. Potential side effects include dry mouth, blurred vision, and bladder issues.
- Antidepressants: Some depression medications can also reduce sweating and may help alleviate anxiety.
- Botulinum toxin injections: This treatment involves injecting botulinum toxin to block nerve signals to sweat glands. Most people experience minimal pain during the procedure, but numbing options may be available. Results may take a few days to become noticeable and typically require repeat treatments every six months. Temporary muscle weakness at the injection site is a possible side effect.
Surgical and other procedures:
- Iontophoresis: A home-based treatment involving soaking hands or feet in water while a device applies a mild electric current to block nerves triggering sweating. It requires regular sessions initially, with potential adjustments for maintenance. Discuss any side effects with your healthcare provider.
- Microwave therapy (miraDry): This therapy employs microwave energy to eliminate sweat glands in the armpits through two sessions, three months apart. Potential side effects include altered skin sensation and discomfort, with long-term effects remaining unknown.
- Sweat gland removal: If excessive sweating is confined to the armpits, sweat glands can be removed through scraping (curettage), suction (liposuction), or a combination of both (suction curettage).
- Nerve surgery (sympathectomy): This surgical procedure involves removing a portion of spinal nerves controlling hand sweating. However, it may lead to compensatory sweating in other areas. Surgery is generally considered only when other treatments prove ineffective. A variation, sympathotomy, interrupts nerve signals without removing the sympathetic nerve, reducing the risk of compensatory sweating. These procedures can be performed under general anesthesia or with local anesthesia and sedation.
Always consult with your healthcare provider to determine the most suitable treatment option for your specific condition and preferences.
