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Sweat-Soaked: How To Deal With Excessive Sweating

Do you sweat excessively? To the point where it feels like sweat is affecting your daily life? You may have hyperhidrosis… aka excessive sweating. Yes, that’s a real thing. Hyperhidrosis is one of those conditions that many people probably don’t even realize they have. In fact, a 2004 study published in the the Journal of the American Academy of Dermatology found that 38 percent of those suffering hyperhidrosis had never even discussed their condition with a healthcare professional.

Sweating too much can be more than just a minor annoyance. It can cause social anxiety and difficulty in everyday tasks — it can make outdoor situations embarrassing and even tasks as simple as picking up a pen impossible when your hands are drenched in sweat. So what can you do? Let’s take a look.

What is hyperhidrosis?

In a nutshell, hyperhidrosis basically means that someone is sweating beyond what is physiologically required by their body and their environment. People sweat to release heat and moisture from their body — sweating is a normal, and necessary part, of our physiology. But when you sweat more than is necessary, that’s when it’s hyperhidrosis.

There are two types of hyperhidrosis: Primary hyperhidrosis is excessive sweating without an alternative origin, whereas secondary hyperhidrosis is caused by other medical conditions. In this case, excess sweating can be caused by disorders of your bodily systems, such as your metabolism or cardiovascular system. Injuries, stress, diabetes, or infection are some of the other possible reasons someone might have secondary hyperhidrosis.

Primary or hyperhidrosis tends to be focal, meaning it’s localized in one area. It mainly affects one area; either the underarms, soles of the feet, palms of the hands, the face, or the scalp. This type of hyperhidrosis may be caused by overactivity of the nervous system, and generally shows up in childhood or adolescence. This type of hyperhidrosis occurs only when you’re awake (meaning you won’t be drowning in sweat when you sleep) and it occurs in otherwise healthy people. It is, however, strongly linked to genetics — up to 80% of people with this type of hyperhidrosis also have a family member who is affected.

The secondary type of hyperhidrosis usually happens over the entire body, and begins in adulthood, possibly after an accident or the beginning of a medication regime. It can also crop up thanks to an infection, any endocrine problems (such as diabetes or thyroid problems), certain drugs, brain diseases, or heart issues, among many other health problems.

If you sweat a lot while you sleep, you may have secondary hyperhidrosis. Symptoms also include skin that stays wet for a long time, which can then cause whiteness, softness, or peeling. Those with this type of hyperhidrosis typically have visible sweating, even when they’re inactive or sitting down.

The bottom line is, if you’re having trouble working, hanging out with friends or going out in social situations, or enjoying physical activities because you’re sweating too much, you may suffer from hyperhidrosis.

If I have hyperhidrosis, what can I do about it?

The good news is, hyperhidrosis can be diagnosed and treated. Your dermatologist will give you a physical exam and ask questions about the condition to find out exactly what’s causing it and where it’s happening. If an underlying condition is indicated, such as in the case for secondary hyperhidrosis, more testing may be necessary.

Treatment depends on where excessive sweating happens on your body, and the type of hyperhidrosis you have. The other good news is that there are lots of treatment options, both in your doctors office and over the counter options… it could be as simple as a prescription-strength antiperspirant, which plugs the sweat glands.

At-home treatment options for hyperhidrosis

Aside from getting you an RX for prescription-strength deodorant, your doctor can also prescribe a medication to temporarily prevent sweating. These come in the form of an anticholinergic or beta blocker. Anticholinergics — like glycopyrrolate or oxybutynin — are the most commonly used oral medications for primary hyperhidrosis. Most patients are able to tolerate these medications pretty well when described a common dose. They can, however, cause unwanted side effects, including dry mouth and eyes, urinary retention, and confusion when taking in higher doses. Beta blockers can be useful for patients who have sweating that’s brought on by performance anxiety.

In-office treatments for hyperhidrosis

There are lots of treatments that dermatologists and doctors can perform to help patients with sweating concerns.

Image courtesy of sweathelp.co.uk.

Iontophoresis is a form of electronic therapy that shuts down sweat glands, and it’s a relatively common remedy that some doctors have suggested to relieve patients who sweat excessively from their hands and feet. Iontophoresis (pictured above) involves sitting in one place for up to 40 minutes, three times a week, as a medical device passes an electrical current through a pan of water into your skin. This probably sounds scary, but don’t worry — the electrical current isn’t strong enough to cause a shock! Some people say that they feel a slight tingling sensation, but it’s painless besides that! It’s believed that the electrocurrent works by blocking our sweat ducts.

Laser therapy, specifically the type that uses a small device that’s inserted into the skin through small incisions, has also been used to reduce underarm sweating. It focuses heat at specific wavelengths to target and destroy sweat glands. One session of an hour or less can reduce sweat significantly, but this is an expensive option.

Botulinum — OnabotulinumtoxinA, commonly known as Botox — is FDA-approved to be injected in small amounts into different areas in the underarms. These tiny injections of Botox temporarily block a chemical that stimulates sweat, reducing sweat for up to six months.

A microwave-based treatment called miraDry has also shown success in treating underarm sweating. This FDA-approved, non-invasive procedure utilizes a hand-held device to deliver electromagnetic energy into sweat glands to destroy them. Results after one one-hour treatment are generally permanent.

Images courtesy of MiraDry.

In extreme cases and types of hyperhidrosis, surgery may be an option. Three main types — excision (cutting), curettage (scraping), and liposuction (sucking) — are sometimes used to remove underarm sweat glands under local anesthesia.

A last-resort (and an invasive) option, endoscopic thoracic sympathectomy (ETS), has been used to interrupt the transmission of nerve signals — these signals are what “turn on” sweat glands. But this surgery has major side effects, including compensatory sweating in other areas.

Basically, if you suffer from hyperhidrosis, you’ll need to talk to your doctor about which option is right for you. Just know this is a problem with solutions!

Dr. Ashley Steffens, a dermatology resident at Southern Illinois University School of Medicine (SIU), helped contribute to the accuracy of this story.

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  1. I’m in the UK and have secondary hyperhydrosis particularly in the face/scalp which seriously affects me. I already have bad anxiety and this really doesn’t help. However, my GP has told me there’s nothing I can do other than use Dricol (or other prescription strength anti-perspirants) which I have tried on my underarms and it really irritated my underarms so obviously I can’t use these on your face!! I asked her about Botox and she just shrugged and said it’s expensive.

  2. I have fibromyalgia and sweaty hands and feet. I wonder if the two are connected since it has to do with the nervous system? I’ve had sweaty hands and feet my whole life. I’ve been teased about it my whole life and even now adults will comment about it. It’s embarressing and I’d give most anything to not deal with it. At age 55 it’s probably not going to stop. Maybe when I’m dead. Would someone please check at that time? Lol! Hubby doesn’t mind. We still hold hands. It doesn’t bother him. I was told by a man when I was little that no man would ever want to hold my hand. Those words have stuck with me for a long time.

  3. My 12 year old Sophia has been dealing with this uncomfortable hyperhidrosis since she was 8. We went to see her pediatrician to which she prescribed a liquid to put on her hands. She has it on her hands and feet. Her feet peel especially when wearing sandals. She is also quite embarrassed about it when it comes to holding hands and even writing papers. The paper will curl up as she is writing. I feel I’ve run out of options here. I don’t want to consider surgery or Botox.
    She is a very nervous child. Any suggestions on what we can do to make her more comfortable?

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