Excessive Sweating

What is hyperhidrosis?

The body has two types of sweat glands: eccrine and apocrine. Eccrine sweat glands are found all over the body surface and open directly onto the skin. Apocrine glands open into a hair follicle and are prevalent in the groin, scalp, and armpits.

The purpose of sweating is to maintain homeostasis through thermoregulation. When we overheat due to exertion or environmental temperatures our bodies excrete sweat to evaporate off the skin, thereby dissipating heat. Technically, sweat needs to naturally evaporate to be most effective-so toweling off is actually less efficient.

Hyperhidrosis is caused by faulty wiring. Seriously, improper nerve functioning with inappropriate signaling causes sweat glands to be overstimulated leading to excess perspiration. So instead of sweating when appropriate to lower your body temperature, individuals with hyperhydrosis may sweat noticeably at any time.

What causes Hyperhidrosis?

Hyperhidrosis is predominantly hereditary-thank your parents. Genetically correlated hyperhidrosis is considered primary hyperhidrosis. The clinical symptoms of primary hyperhidrosis typically manifest spontaneously in otherwise healthy individuals. Men and women with hyperhidrosis will notice sweating outside of normal stimuli like hot environments and emotional responses.

Individuals may also exhibit signs of hyperhidrosis due to pre-existing medical conditions, such as an overactive thyroid, cancer, mental health concerns, and also due to medications and supplements. It can be beneficial to check with your doctor to determine if any medications may be the underlying cause of excessive sweating.

Hyperhidrosis due to other medical conditions or external factors is considered the secondary form. This form can cause excess sweating over larger areas of the body compared to the primary form.

What are the main concerns related to Hyperhidrosis?

There are two general classifications of hyperhidrosis:

• Primary Focal: This form of hyperhidrosis is inherited. Primary focal hyperhidrosis appears on a specific region of the body, such as the hands, feet, underarms, face, or scalp. It usually presents during childhood or adolescence.
• Secondary Generalized: Secondary hyperhidrosis occurs as a result of an underlying medical condition or the use of a medication or supplement. The sweating can occur diffusely across the body. Secondary generalized hyperhidrosis usually presents only in adults.

Who may wish to seek treatment for Hyperhidrosis?

Signs of primary focal hyperhidrosis tend to develop early in life whereas secondary hyperhidrosis usually develops during adulthood. Any individual can develop hyperhidrosis regardless of their gender, age, or race. The excessive sweating is not only physically frustrating, but can also cause self-consciousness. When over the counter antiperspirants and other topicals are not sufficient, an individual may benefit from consulting a professional provider.

How can someone get help for Hyperhidrosis?

Although there is no cure for hyperhidrosis, several treatment options are available to reduce the excess sweating related to both primary and secondary hyperhidrosis. Given sweating is critical to daily life, several cosmetic and non-cosmetic procedures exist to continue to allow the body to produce sweat-just not so excessively. In some cases, medical providers may require a “sweat test” in order to make a proper diagnosis.

• Botox: (botulinum toxin) While it is primarily known for its anti aging properties, Botox can also be used to treat hyperhidrosis. Injections of botox directly into sweat glands alters their function and diminishes sweat production.
• Antiperspirants: Over-the-counter deodorants and antiperspirants can be very helpful in controlling excess sweating. Your doctor may recommend stronger and more specialized products (like those with aluminum chloride) more specifically tailored to your needs.
• Iontophoresis: Typically used for plantar or palmar hyperhidrosis (feet and hands), electricity is used to alter nerve signaling to sweat glands.
• Sweat Gland Removal Surgery: Also known as ETS or Endoscopic Thoracic Sympathectomy. This is generally used as a last resort when other therapies have failed. It is especially popular for treating cases of primary axillary hyperhidrosis. Keep in mind the body needs to sweat so when glands are removed from one area individuals will notice increased perspiration in other regions of the body.
• Anticholinergics: Prescription oral medications used under the care of a healthcare professional.

For a deeper dive into the treatment options listed above, check out our guide to Excessive Sweating Solutions.