Hyperhidrosis – Causes, Symptoms, Diagnosis, And Treatment


What is hyperhidrosis?
Hyperhidrosis is a medical condition characterized by excessive sweating. This condition causes abnormal increase in sweating, which is not related to heat or physical activity. People with hyperhidrosis may sweat even when the temperature is cool or when they are at rest. It is a common disorder, which causes a lot of discomfort, anxiety, and affects a person’s quality of life.

What causes hyperhidrosis?
Sweating is natural, which helps the body stay cool. People sweat more in warm temperatures, when they exercise, or in response to situations that make them nervous, angry, embarrassed, or afraid.

Excessive sweating occurs without such triggers. People with hyperhidrosis appear to have overactive sweat glands.

When excessive sweating affects the hands, feet, and armpits, it is called primary or focal hyperhidrosis. In most cases, no cause can be found. It seems to run in families.

If the sweating occurs as a result of another medical condition, it is called secondary hyperhidrosis. The sweating may be all over the body or it may be in one area.

The following conditions may cause secondary hyperhidrosis:

  • Acromegaly
  • Anxiety conditions
  • Cancer
  • Carcinoid syndrome
  • Certain medicines and substances of abuse
  • Glucose control disorders
  • Heart disease, such as heart attack
  • Overactive thyroid
  • Lung disease
  • Menopause
  • Parkinson disease
  • Pheochromocytoma (adrenal gland tumor)
  • Spinal cord injury
  • Stroke
  • Tuberculosis or other infections

What are the symptoms of hyperhidrosis?
The primary symptom of hyperhidrosis is wetness.  Moist palms of the hands, moist soles of the feet, and sweating that soaks through clothing are the common symptoms.

How is hyperhidrosis diagnosed?
During physical exam, your doctor may notice visible signs of sweating. Your doctor may ask following questions to know more about your sweating:

  • Location. Does it occur on your face, palms, or armpits, or all over the body?
  • Time pattern. Does it occur at night? Did it begin suddenly?
  • Triggers. Does the sweating occur when you are reminded of something that upsets you (such as a traumatic event)?
  • Other symptoms. Weight loss, pounding heartbeat, cold or clammy hands, fever, lack of appetite.

The doctor may also do the following tests to diagnose excessive sweating:

  • Starch-iodine test. An iodine solution is applied to the sweaty area. After it dries, starch is sprinkled on the area. The starch-iodine combination turns a dark blue color wherever there is excess sweat.
  • Paper test. Special paper is placed on the affected area to absorb the sweat, and then weighed. The heavier it weights, the more sweat has accumulated.
  • Blood tests. These may be ordered if thyroid problems or other medical conditions are suspected.
  • Imaging tests may be ordered if a tumor is suspected.

How is hyperhidrosis treated?
A wide range of treatments are available to treat hyperhidrosis. Your doctor may choose to treat you with one or more of the following treatment options:

  • Antiperspirants. Excessive sweating may be controlled with strong antiperspirants, which plug the sweat ducts. Products containing 10% to 20% aluminum chloride hexahydrate are the first line of treatment for underarm sweating. Some people may be prescribed a product containing a higher dose of aluminum chloride, which is applied nightly onto the affected areas. Antiperspirants can cause skin irritation, and large doses of aluminum chloride can damage clothing. Note: Deodorants do not prevent sweating, but are helpful in reducing body odor.
  • Medicines. Medicines may prevent stimulation of sweat glands. These are prescribed for certain types of hyperhidrosis such as excessive sweating of the face. Medicines have side effects and are not right for everyone.
  • Iontophoresis. This procedure uses electricity to temporarily turn off the sweat gland. It is most effective for sweating of the hands and feet. The hands or feet are placed into water, and then a gentle current of electricity is passed through it. The electricity is gradually increased until the person feels a light tingling sensation. The therapy lasts about 10 to 30 minutes and requires several sessions. Side effects, although rare, include skin cracking and blisters.
  • Botox. Botulinum toxin type A (Botox) is used to treat severe underarm, palmar, and plantar sweating. This condition is called primary axillary hyperhidrosis. Botulinum toxin injected into the underarm temporarily blocks the nerves that stimulate sweating. Side effects include injection-site pain and flu-like symptoms. Botox used for sweating of the palms can cause mild, but temporary weakness and intense pain.
  • Endoscopic thoracic sympathectomy (ETS). In severe cases, a minimally-invasive surgical procedure called sympathectomy may be recommended when other treatments do not work. The procedure cuts a nerve, turning off the signal that tells the body to sweat excessively. It is usually done on people whose palms sweat much more heavily than normal. It may also be used to treat extreme sweating of the face. ETS does not work as well for those with excessive armpit sweating.
  • Underarm surgery. This is surgery to remove the sweat glands in the armpits. Methods used include laser, curettage (scraping), excision (cutting), or liposuction. These procedures are done using local anesthesia.

This feature is for informational purposes only and is not intended to substitute the expert guidance of a doctor. We advise seeing a doctor if you have any health concerns.

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