Hyperhidrosis

Hyperhidrosis is a condition that is characterized by excessive sweating. It can happen irrespective of hot weather or heavy physical activity. You may sweat so much that your clothes get soaked in them. Hyperhidrosis itself is not a life-threatening condition, but it can affect your quality of life. You may avoid social gatherings or isolate yourself to lower the chance of public embarrassment. It can also affect your mental health and may cause depression or stress in some people. This condition can be managed with medications and lifestyle adaptations. 

Based on its origin, hyperhidrosis can be of primary or secondary nature. The exact cause of primary hyperhidrosis has not been identified yet. Researches are still ongoing to identify its origin but some state that it may be linked to a genetic factor.

Secondary hyperhidrosis occurs due to a pre-existing medical condition. These conditions include obesity, diabetes, gout, heart disease, liver disease, chronic alcoholism, etc. In some scenarios, these conditions affect the normal thermoregulatory mechanism of your body. As a result, your body releases excessive sweat to maintain core body temperature, even without environmental or physical factors. Females can experience hot flashes or night sweats during menopause. 

Hyperhidrosis is divided into two types based on the areas affected by this condition: focal hyperhidrosis and generalized hyperhidrosis.

Focal hyperhidrosis is the more common type. In this case, the nerves that supply your sweat gland of a particular region become overactive, which results in excessive sweating from that region only. This can be exacerbated by stress or anxiety. Areas affected by focal hyperhidrosis include palms, soles, face, underarms, and the groin region.

Generalized hyperhidrosis is less common. It affects your whole body. Your body will start sweating even without physical activity or a temperature rise. It may cause lightheadedness due to unnecessary water loss and electrolytes through sweat. 

There are no known risk factors for primary hyperhidrosis as its cause is yet to determine. You may develop hyperhidrosis if you have a family member with the same condition. People with obesity, diabetes, heart disease, thyroid issues, gout, etc., are at risk for secondary hyperhidrosis. Alcohol consumption and certain medications can also affect your thermoregulatory mechanism.

Hyperhidrosis affects almost 1% of the entire population. This excludes many cases of secondary hyperhidrosis because people often do not notice it. Hyperhidrosis is more prevalent among adolescents, and it affects both men and women equally.  

The characteristic symptom of hyperhidrosis is excessive sweating in the absence of usual factors like high temperature or heavy exercise. If you have focal hyperhidrosis, you will notice your hands or feet getting sweaty throughout the day. Sweating may be exaggerated if you are anxious or stressed. In case of generalized hyperhidrosis, your whole body will feel drenched, and your clothes will appear soaked. You may also experience a fast heartbeat, clammy hands, fever, lack of appetite, or weight loss. Psychological effects of this condition may also present in the form of social avoidance, isolation, depression, or anxiety.

Hyperhidrosis is usually diagnosed on the basis of history and symptoms. Your doctor will ask if you have a positive family history of this condition. History can also help in distinguishing between focal and generalized hyperhidrosis. If secondary hyperhidrosis is suspected, your doctor will likely recommend further testing to identify the underlying condition. Blood sugar levels and HbA1C tests are done to check diabetes. Thyroid function tests (TFTs) are done if a thyroid issue is suspected. Imaging tests may also be done in some cases. 

Hyperhidrosis should be differentiated from other conditions that may present with similar symptoms. These conditions include burning feet syndrome, thyrotoxicosis, neuropathy, hypoglycemia, pheochromocytoma, lymphoma, alcohol toxicity, and a few neoplastic diseases.

Treatment depends upon the cause of hyperhidrosis. If it is due to a secondary disease, treatment options first focus on curing it. For example, diabetic medications will be given to manage your blood sugar levels. You may need to modify your clothing style to lessen sweating. Wear light, loose-fitting clothes that allow air to pass through. Clothes made from stuff like nylon or wool can increase sweating. If your underarms sweat too much, you can use armpit shields or pads to control it. Shoes and socks made of natural material are preferred if you have to wear them. Otherwise, it is recommended to wear open footwear to allow air. Take a bath whenever it is necessary to avoid skin irritation or infections. Some other techniques involve iontophoresis, botulinum toxin injections, the use of anticholinergic or antidepressant drugs, etc. Surgical options are also available for cases of severe hyperhidrosis.

Antiperspirants available over-the-counter can help to a limited extent. If regular antiperspirants do not control sweating, your doctor may prescribe a strong antiperspirant with aluminum chloride. Spray it on the affected body parts only and keep it away from your eyes. Prescription creams containing glycopyrrolate may also be recommended.

Mild to moderate hyperhidrosis is manageable with changes in lifestyle factors and the use of antiperspirants. Severe hyperhidrosis can be treated by more advanced techniques, but the effectiveness of each treatment may vary for different individuals. 

It is difficult to prevent primary hyperhidrosis as it can develop on its own without any triggering factor. Secondary hyperhidrosis can be prevented by managing your pre-existing medical conditions. Consult with your doctor at an early stage if you notice symptoms of excessive sweating and discuss your condition without any hesitation.

Our clinical experts continually monitor the health and medical content posted on CURA4U, and we update our blogs and articles when new information becomes available. Last reviewed by Dr.Saad Zia on May 21, 2023. 

References

Hyperhidrosis: Diagnosis and treatment (aad.org)

https://www.aad.org/public/diseases/a-z/hyperhidrosis-treatment

Excessive sweating (hyperhydrosis) - NHS (www.nhs.uk)

https://www.nhs.uk/conditions/excessive-sweating-hyperhidrosis/