Many people suffer from excessive sweating. Some sweat on their palms and feet while others are covered in sweat all the time as if they were submerged in water. Excessive sweating which is also known as Hyperhidrosis can affect just one specific area or the whole body. Although not life-threatening, it can be uncomfortable and cause embarrassment and psychological trauma.
Excessive sweating occurs in the hands, feet, armpits, and the groin because of their relatively high concentration of sweat glands.
Palmoplantar hyperhidrosis is excessive sweating of the palms and soles while generalized hyperhidrosis is excessive sweating that affects the entire body. Hyperhidrosis may be present from birth or might develop later in life. However, most cases of excessive sweating tend to start during a person’s teenage years.
The condition can be due to an underlying health condition, or have no apparent cause.
Primary idiopathic hyperhidrosis is of an unknown cause. Secondary hyperhidrosis occurs when a person sweats too much because of an underlying health condition, such as obesity, gout, menopause, a tumor, mercury poisoning, diabetes mellitus, or hyperthyroidism which is an overactive thyroid gland.
For some people, hyperhidrosis symptoms are so severe that it becomes embarrassing, causing discomfort and anxiety. The patient’s career choices, free time activities, personal relationships, self-image, and emotional well-being may be affected. Fortunately, there are several options which can treat symptoms effectively. The biggest challenge in treating hyperhidrosis is the significant number of people who do not seek medical advice, either due to embarrassment or because they do not know that effective treatment exists.
Hyperhidrosis is defined as sweating that disrupts normal activities. Episodes of excessive sweating occur at least once a week for no clear reason and have an effect on social life or daily activities.
Signs and symptoms
These include clammy or wet palms, clammy or wet soles of the feet, frequent sweating and noticeable sweating that soaks through clothing.
People with hyperhidrosis might experience the following:
Irritating and painful skin problems, such as fungal or bacterial infections, worrying about having stained clothing, reluctant to make physical contact and be self-conscious. They also worry more than other people about body odour. They might also be socially withdrawn, sometimes leading to depression, select employment where physical contact or human interaction is not a job requirement and spend a large amount of time each day dealing with sweat, such as changing clothes, wiping, placing napkins or pads under the arms, washing, wearing bulky or dark clothes.
Causes of excessive sweating
The causes of primary hyperhidrosis are not well-understood; on the other hand, secondary hyperhidrosis has a long list of known causes.
Initially, a doctor may try to rule out any underlying conditions, such as an overactive thyroid (hyperthyroidism) or low blood sugar (hypoglycemia) by ordering blood and urine tests. Patients will be asked about the patterns of their sweating––which parts of the body are affected, how often sweating episodes occur, and whether sweating occurs during sleep.
The patient may be asked a series of questions, or have to fill a questionnaire about the impact of excessive sweating; questions may include:
Do you carry anything around to deal with episodes of excessive sweating, such as napkins, antiperspirants, towels, or pads?
Does hyperhidrosis affect your behaviour or mental state when you are in public?
Has hyperhidrosis had any effect on your employment?
Have you ever lost a friend due to hyperhidrosis?
How often do you change your clothing?
How often do you wash or have a shower/bath?
How often do you think about excessive sweating?
Thermoregulatory sweat test
This is a powder which is sensitive to moisture applied to the skin. When excessive sweating occurs at room temperature, the powder changes color. The patient is then exposed to high heat and humidity in a sweat cabinet, which triggers sweating throughout the whole body. When exposed to heat, people who do not have hyperhidrosis tend not to sweat excessively in the palms of their hands, but patients with hyperhidrosis do. This test also helps the doctor determine the severity of the condition.
Some alterations in daily activity and lifestyle may help improve symptoms:
Antiperspirants – deodorants do not stop sweating, but antiperspirants sprays do. Some prescription antiperspirants include aluminum chloride, which plugs the sweat glands.
Armpit shields – pads worn in the armpit to protect a garment from perspiration.
Clothing – certain synthetic fibers, such as nylon, may worsen symptoms. Loose clothing is better.
Shoes – synthetic materials are more likely to worsen symptoms. Natural materials, such as leather, are recommended.
Socks – some socks are better at absorbing moisture, such as thick, soft ones made of natural fibers. If these measures are not effective, medical treatment may help.
A doctor may refer the person to a skin specialist, or dermatologist.
They may recommend:
Iontophoresis: The hands and feet are submerged in a bowl of water. A painless electric current is passed through the water. Most patients need two to four 20-30 minute treatments.
Botox injections: Botox injections block the nerves that trigger the sweat glands. Patients with hyperhidrosis may need several injections for effective results.
Anticholinergic drugs: These medications inhibit the transmission of parasympathetic nerve impulses. Patients generally notice an improvement in symptoms within about 2 weeks.
ETS (Endoscopic thoracic sympathectomy): This surgical intervention is only recommended in severe cases which have not responded to other treatments. The nerves that carry messages to the sweat glands are cut. ETS may be used to treat hyperhidrosis of the face, hands or armpits. ETS is not recommended for treating hyperhidrosis of the feet because of the risk of permanent sexual dysfunction.
If excessive sweating is not treated, it can lead to complications such as nail infections, especially toenail infections. It can also cause warts which are skin growths caused by the HPV (human papillomavirus).
Bacterial infections can also occur especially around hair follicles and between the toes.
Sweating excessively can cause heat rash or prickly heat which is an itchy, red skin rash that often causes a stinging or prickling sensation. Heat rash develops when sweat ducts become blocked and perspiration is trapped under the skin.
The Psychological impact is not left out. Excessive sweating can affect the patient’s self-confidence, job and relationships. Some individuals may become anxious, emotionally stressed, socially withdrawn, and even depressed.
On average, a person with hyperhidrosis seeks medical help after living with the condition for nine years. It is important to spread the word that the symptoms of excessive sweating can be effectively treated