Hyperhidrosis: What is it?

Nervous because of excessive sweatiness? Excess sweatiness causing you to be nervous? This is a common catch 22 among those who suffer from a condition called hyperhidrosis, but for a condition that is relatively common, most people are not aware that there are treatments that can address it.

Why do I sweat so much?

A lot of people suffer from excessive sweating-more than what is required to regulate temperature. These people are aware that they sweat more than others, and are often negatively affected by it, in some cases, causing serious social anxiety, or in severe cases, limiting the type of work that they can do. There is a good chance that these people have a condition called hyperhidrosis but they may have never heard of the term. Although hyperhidrosis affects 3 to 5% of the North Americans, most people who are affected simply assume it to be a trait that can't be changed rather than a condition that can be treated.

Hyperhidrosis can cause a person to sweat excessively in a specific area, usually the armpits, palms or the feet due to the high concentration of sweat glands, or the problem can be generalized, affecting the entire body. In some cases, hyperhidrosis is caused by a medical condition like diabetes, but more often it is a condition from birth without any medical cause. This is why most people simply assume that their propensity to sweat isn't a condition that can be treated, but simply an unwanted trait.

How can I treat it?

Although rare, if the cause of the excess sweating is caused by a different primary condition, this needs to be treated. In these cases, treating the primary condition will also end the sweating problem. More commonly, excess sweating isn't a symptom of another problem, and is a problem since infancy. These are called idiopathic hyperhidrosis, meaning that the excess sweating has no (known) cause. In these cases, the sweating needs to be managed as a chronic issue. Generally, the main treatments for hyperhidrosis are:

  • Antiperspirants
  • Tap-Water Iontophoresis (TWI)
  • BOTOX Hyperhidrosis
  • Surgical Sympathectomy

Antiperspirants

Typically, antiperspirants are initially used to control sweating. Aluminum chloride is the most common active ingredient used to contain the sweat. The compound when combined with the electrolytes in the sweat, create a plug that stops sweat at the glands. Many also combine deodorants to control odor. They are available over the counter, and convenient. Antiperspirants are a reasonable solution for those with a mild sweating problem in the armpits. Unfortunately, many people with hyperhidrosis have severe sweating which isn't readily controlled by commercial antiperspirants.

Tap-Water Iontophoresis (TWI)

Tap water iontophoresis is a treatment that is used to treat sweating of the palms and feet. In this treatment, the hands and/or the feet are placed into water baths which is connected to a device that emits an electric current. The exact mechanism of action is unknown, but it is thought that the sweat glands contract and plug up the sweat in the affected area. The devices are available for home use. Daily or weekly treatment is required for it to be effective, and the procedure can be quite painful. More than half of patients using this device find the treatment to improve their condition.

BOTOX Hyperhidrosis

BOTOX is a toxin that has the effect of freezing neuromuscular activities in the treated area, and is often used to treat wrinkles that are caused primarily by muscle movement. Using the same principles, BOTOX can help to prevent nerve impulses which signal the glands to produce sweat in the area. This is a safe procedure, and one that is effective. One drawback is that BOTOX is metabolized by the body over 6 to 8 months. At that point, the sweat will come back unless the area is re-treated.

Sympathectomy

For those with severe sweating, many options are simply not effective. Sympathectomy may be an option for these people. By severing the sympathetic glands that control the signals, this procedure can be a savior for those with a severe sweat problem. This procedure is considered to be controversial by many doctors. One of the common and problematic side-effects is called compensatory sweating-a condition where other areas of the body sweat to compensate for the stopped sweating in the treated area.