What is Hyperhidrosis?

Hyperhidrosis is a condition characterized by excessive sweating that goes beyond what is needed to regulate body temperature. This sweating can occur even without physical exertion or heat, and it often affects specific areas like the hands, feet, underarms, or face. The condition can interfere with daily life, cause embarrassment, and affect emotional well-being.

What causes Hyperhidrosis?

There are two main types:

Primary (focal) hyperhidrosis

• The most common form
• Usually starts in childhood or adolescence
• Affects specific body areas (palms, soles, underarms, face)
• The exact cause is unknown but may be related to overactivity in the sweat glands and nervous system
• Often runs in families

Secondary (generalized) hyperhidrosis

• Caused by an underlying medical condition or medications
• Usually affects the whole body
• Common causes include:
  • Diabetes
  • Thyroid disorders (hyperthyroidism)
  • Infections
  • Menopause
  • Certain cancers
  • Medications, such as antidepressants or blood pressure drugs

Who is at risk?

• People with a family history of hyperhidrosis
• Those with underlying medical conditions
• Individuals exposed to stress, heat, or certain medications
• Anyone with overactive nerves triggering sweat glands excessively

What are the symptoms of Hyperhidrosis?

• Excessive sweating in one or more areas without obvious triggers
• Sweaty palms, feet, underarms, or face even in cool temperatures
• Clothing soaked with sweat
• Difficulty gripping objects, writing, or using tools
• Skin irritation, infections, or odor due to constant moisture
• Social anxiety or embarrassment related to sweating

In primary hyperhidrosis, symptoms are usually symmetrical (both sides affected equally) and may improve during sleep.

How is Hyperhidrosis diagnosed?

A doctor will typically diagnose hyperhidrosis through:

• Medical history and physical examination
• Starch-iodine test or paper test to detect sweat levels
• Blood tests or imaging if secondary causes are suspected
• Evaluation of symptoms’ pattern, location, and duration

How is Hyperhidrosis treated?

Treatment depends on the severity and type of hyperhidrosis:

Lifestyle changes and non-invasive options

• Antiperspirants with aluminum chloride (over-the-counter or prescription strength)
• Absorbent powders, moisture-wicking clothing, or daily hygiene
• Avoiding known triggers like spicy foods or stress

Medical treatments

• Iontophoresis: electrical stimulation in water baths, commonly used for hands and feet
• Botox injections: blocks the nerves that trigger sweat glands, especially in underarms
• Oral medications: anticholinergics to reduce sweating, though side effects can occur

Surgical options (for severe cases)

• Endoscopic thoracic sympathectomy (ETS): surgery to cut nerves controlling sweat glands
• Removal of sweat glands in localized areas such as the underarms

Treatment effectiveness varies by individual and some may need a combination of therapies.

What are the complications of Hyperhidrosis?

• Skin infections such as fungal or bacterial issues
• Eczema or rashes due to constant moisture
• Emotional distress, low self-esteem, or social withdrawal
• Disruption of daily activities like using electronic devices, writing, or holding tools