Hyperhidrosis

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Hyperhidrosis

Hyperhidrosis (excessive sweating)

Hyperhidrosis is a common problem faced by many individuals. While this condition is generally physiological, it can sometimes be associated with medical conditions, such as thyroid disorders. Therefore, it is better to seek a consultation if you are facing this problem. If the hyperhidrosis is associated with underlying medical problems, the underlying conditions need to be treated. For the majority of people who are otherwise healthy, the hyperhidrosis can be reduced to achieve a better quality of life.

In milder instances, the condition can be improved by local application of medication. For more severe cases, oral medication or botulinum toxin injections may be useful. However, oral medication may be associated with various side effects, such as palpitations, sedation, blurred vision and dry mouth and should be used only after careful consideration. In recent years, botulinum toxin injections have been used to achieve good control of sweating on the palms and axillae lasting for several months after each treatment.

Symptoms

Most people sweat when they exercise or exert themselves, are in a hot environment, or are anxious or under stress. The excessive sweating experienced with hyperhidrosis far exceeds such normal sweating.

The type of hyperhidrosis that usually affects the hands, feet, underarms or face causes at least one episode a week, during waking hours. And the sweating usually occurs on both sides of the body.

Causes

Sweating is your body’s mechanism to cool itself. Your nervous system automatically triggers your sweat glands when your body temperature rises. Sweating also normally occurs, especially on your palms, when you’re nervous.

The most common form of hyperhidrosis is called primary focal (essential) hyperhidrosis. With this type, the nerves responsible for signaling your sweat glands become overactive, even though they haven’t been triggered by physical activity or a rise in temperature. With stress or nervousness, the problem becomes even worse. This type usually affects your palms and soles and sometimes your face.

There is no medical cause for this type of hyperhidrosis. It may have a hereditary component, because it sometimes runs in families.

Secondary hyperhidrosis occurs when excess sweating is due to a medical condition. It’s the less common type. It’s more likely to cause sweating all over your body. Conditions that may lead to heavy sweating include:

Diabetes
Menopause hot flashes
Thyroid problems
Low blood sugar
Some types of cancer
Heart attack
Nervous system disorders
Infections

Treatment

If an underlying medical condition is contributing to the problem, that condition will be treated first. If no clear cause can be found, treatment focuses on controlling excessive sweating. Sometimes you may need to try a combination of treatments. And even if your sweating improves after treatment, it may recur.

Medications

Drugs used to treat hyperhidrosis include:

Prescription antiperspirant. Your doctor may prescribe an antiperspirant with aluminum chloride (Drysol, Xerac Ac). This product can cause skin and eye irritation. It’s usually applied to the affected skin before you go to bed. Then you wash the product off when you get up, taking care to not get any in your eyes. If your skin becomes irritated, hydrocortisone cream might help.
Prescription creams. A prescription cream that contains glycopyrrolate may help hyperhidrosis that affects the face and head.
Nerve-blocking medications. Some oral medications block the chemicals that permit certain nerves to communicate with each other. This can reduce sweating in some people. Possible side effects include dry mouth, blurred vision and bladder problems.
Antidepressants. Some medications used for depression can also decrease sweating. In addition, they may help decrease the anxiety that worsens the hyperhidrosis.
Botulinum toxin injections. Treatment with botulinum toxin (Botox, Myobloc, others) temporarily blocks the nerves that cause sweating. Your skin will be iced or anesthetized first. Each affected area of your body will need several injections. The effects last six to 12 months, and then the treatment needs to be repeated. This treatment can be painful, and some people experience temporary muscle weakness in the treated area.