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.
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.
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.