Hyperhidrosis – Causes, Symptoms, Treatments and More

Are you frequently able to see sweat beads on the skin or have sweat-soaked clothing while not exerting yourself? 

Sweating interferes with daily activities, whether holding a pen, moving or turning a doorknob. 

There is a high possibility that you have Hyperhidrosis which disrupts the usual activities. Continue reading to know what exactly causes this excessive sweating.

What is Hyperhidrosis? 

Hyperhidrosis is a disease that causes excessive sweating in individuals when the cholinergic receptors on eccrine glands are overstimulated. 

Sweating more than the body needs for homeostatic temperature regulation is a defining feature of this illness. The axillae, palms, soles and face are among the regions with the highest concentration of eccrine glands, making them the areas most frequently associated with Hyperhidrosis. 

NCBI states that according to studies, this disorder affects about 3% of people in the United States. Hyperhidrosis can bring on emotional, psychological and social impairment.

Hyperhidrosis is a condition that causes excessive sweating that is not caused due to heat or exercise. The body perspires to keep itself cool. In Hyperhidrosis, there is excessive sweating, which causes a sweaty body and palms which leads to sweat-soaked clothing. Along with the underarms and face, it primarily affects the extremities. Daily tasks are hampered by the condition, which often causes social anxiety.

Primary and secondary hyperhidrosis disorders are the two different types. The underlying reasons for the latter may include thyroid, Diabetes and heart attacks, whereas the former’s origins are still unknown and frequently linked to genes.

The term “hyperhidrosis” is pronounced “hi-purr-hi-droe-sis” and refers to excessive perspiration (hidrosis).

A person who sweats more than the required is said to be excessively perspiring. By keeping the body cool, sweating keeps us from getting too hot. But hyperhidrosis patients sweat even when their bodies don’t require cooling.

Many patients with Hyperhidrosis only sweat in one or two areas of their bodies. Most frequently, they sweat on their head, underarms, feet or palms. One or two places on the body may flow with sweat while the rest of the body stays dry.

What causes Hyperhidrosis? 

• Hyperactive sweat glands cause Hyperhidrosis.

• The body naturally cools itself through sweating to prevent overheating. When the body temperature rises, such as after an exercise, when it’s warm outside, or when stressed or anxious, the nervous system alerts the body to start sweating. 

• A family history of excessive sweating is one of the risk factors for Hyperhidrosis. If an individual has a medical condition that causes sweating or if perspiration is a side effect of medication taken, this could also develop trigger hyperhidrosis.

• Nearly all febrile diseases can result in Hyperhidrosis. Hyperhidrosis is also linked to Tuberculosis and chronically consuming too much alcohol.

• Segmental or localised Hyperhidrosis rarely occurs. In certain adults, the disease may manifest on the forehead, axilla, palm, foot or forearm. Some post-menopausal women experience mild to severe Hyperhidrosis around their faces and scalps. 

• Unilateral Hyperhidrosis most frequently occurs on the right side of the face or the arm than the left.

Types of Hyperhidrosis 

Hyperhidrosis is a biological function. Human bodies naturally perspire to help a person cool off. The nervous system triggers the sweat glands to produce sweat as soon as the body temperature rises. In stressful circumstances, one may also notice the sweat on the palm. The two types of Hyperhidrosis caused due to various underlying diseases are as follows.

Primary focal Hyperhidrosis 

Primary focal Hyperhidrosis is not caused due to any underlying condition. There is a possibility for the disease to have a hereditary origin. 

The nerves that signal the sweat glands are overactive, which results in this type of Hyperhidrosis. This does not occur as a result of increased body temperature or any sort of physical exercise. Anxiety and stress make the situation worse. In some instances, this results in sweating on the face, soles and palms.

When a person has this type of Hyperhidrosis, they can perspire,

• In one or a few areas of the body – Excessive sweating only affects one or a few body parts. The underarms, hands or feet and forehead are the parts of the body that are most frequently impacted.

• On both sides of the body – If the person has excessive sweating in the underarms, they typically observe it in both underarms. It is the same for the hands and feet.

• After waking up – Sweating may start right after waking up. The person normally does not notice damp bedding or wet clothing unless the room is particularly hot.

• At least once each week – For many, it happens much more frequently.

Secondary Hyperhidrosis 

Secondary Hyperhidrosis develops when there is an underlying medical condition.

It is rare and more likely to impact the entire body. The following are the medical conditions.

• Heart attack
• Diabetes
• Hypoglycaemia
• Thyroid problems
• Nervous system disorders
• Menopausal hot flashes
• Certain cancer types

A person with this kind of Hyperhidrosis might observe,

• The entire body sweats excessively – Occasionally, only certain areas of the body sweat.

• Sweating happens during sleep. If a person experiences excessive sweating while sleeping, consulting a dermatologist is necessary to know the cause.

Symptoms of Hyperhidrosis

Sweating can be caused by strenuous exercise, being in the sun, stress and anxiety. Excessive sweating due to Hyperhidrosis is different from these causes. Hands, feet, face and armpits are the most frequent areas of the body where this occurs.

Some signs and symptoms of Hyperhidrosis include,

• Sweating interfering with regular everyday activities.

• Social withdrawal and emotional distress brought on by excessive perspiration.

• When an individual sweats more than they normally do.

• If a person has night sweats without a known cause.

How is Hyperhidrosis diagnosed? 

The doctor will enquire about the medical history, including diseases an individual already has in order to diagnose Hyperhidrosis. 

Performing a physical exam and lab testing is also commonly a diagnosis process. A urine and blood test are required to check an overactive thyroid or low blood sugar since excessive perspiration may be caused by one of these conditions. 

The areas of the body that sweat excessively may require a sweat test, which the doctor analyses. A physician applies a powder substance to several regions of the skin as part of this test. The powder turns purple as an individual sweats.

Although there is no requirement to visit a dermatologist or a family physician for this problem, one should schedule an appointment if the excessive sweating starts suddenly or if a person notices other symptoms, including chest pains, nausea, lightheadedness or night sweats. Hyperhidrosis may also indicate a major medical condition.

Complications of Hyperhidrosis 

Although hyperhidrosis complications are not considered medically severe, they can be emotionally upsetting. The following are the most frequent complications.

• Social and emotional distress

People who have excessive perspiration often feel uncomfortable in social situations and groups. They make every effort to stay away from these circumstances. Their romantic relationships are also affected.

• Bacterial illnesses

Excessive sweating might result in viral and bacterial skin diseases.

• Skin fungus infections

Skin that sweats excessively is more vulnerable to skin infections than healthy skin. Since fungus thrives and grows in damp conditions, fungal infections like jock itch, athlete’s foot and others may develop.

• Bromhidrosis

Bromhidrosis is a bad odour that emanates from the body when sweating comes into contact with bacteria. This primarily affects the toes, foot, genitalia and underarms.

Treatment for Hyperhidrosis 

The type of Hyperhidrosis and the location of the excessive perspiration on the body will determine the course of treatment. The dermatologist also considers other factors, including the patient’s general health.

Medications 

Antiperspirants 

Antiperspirants are usually the first course of treatment a dermatologist suggests. It is inexpensive. Using it as instructed makes an antiperspirant effective. A dermatologist may suggest an ordinary antiperspirant or one with clinical strength. Some people have been prescribed a stronger antiperspirant when they require one.

• Where to use?

Apply to the hairline, hands, feet or underarms.

• How does it work?

The antiperspirant is applied on top of the skin. The antiperspirant is drawn into the sweat glands while sweating. The sweat glands get blocked by this. The body should stop producing sweat when it detects that its sweat glands are blocked.

• Side effects

A few people experience skin irritation and burning sensation as side effects at places where they use antiperspirants.

Be sure to let the dermatologist know if these happen. One can lessen these negative effects by using the antiperspirant in a different way.

Iontophoresis 

Iontophoresis is a solution if the hands, feet or both are affected by excessive perspiration. The treatment can be used at home. The hands or feet must be immersed in a shallow pan of running water. A low-voltage current is passed through the water while doing this via a medical device.

Many patients get relief through this method. Some people find it annoying that this treatment can take a while.

• Where to use?

Hands and feet

• How it works?

The electric current temporarily disables the treated sweat glands.

Most people require between 6 and 10 treatments to stop sweating. Use the gadget as often as the dermatologist advises to see improvement. Initially, a patient may require two or three weekly treatments. A treatment session usually lasts between 20 and 40 minutes.

On noticing positive results, one can keep up the results by repeating the procedure as necessary. This may be every day, every week or every month.

A dermatologist will explain how to use the device and give a prescription so a patient can purchase one if this treatment is appropriate. Also, some patients are prescribed a medication that needs to be mixed with water.

• Side effects

Some people experience dry skin, irritation and pain while undergoing treatment as side effects.

Inform the dermatologist if any side effects occur. These adverse effects are frequently treated by making simple modifications.

Botulinum toxin injections 

A dermatologist injects a weak version of this bacterium beneath the arms. A patient will require numerous injections of small amounts in various areas of the underarms to address excessive perspiration. Patients experience slight discomfort or suffering when procedures are done correctly.

• Where to use?

Underarm

This underarm treatment has been approved by the Food and Drug Administration (FDA). This treatment might be effective for different body parts. Post-menopausal women who have excessive head sweating might benefit from it. This also works when there is excessive sweating on the hands and feet.

• How it works?

A substance that stimulates sweat glands in the body is temporarily blocked by the injections. After four to five days of treatment, most patients start to see improvements.

There is reduced sweating for about four to six months or longer after this treatment. A person may be retreated if the excessive sweating reappears.

• Side effects

When this is injected into the hands, short-term muscular weakening is the most frequent side effect noticed.

Prescription medicines 

Some patients are given a prescription for a drug that temporarily stops them from sweating. These medications treat the whole body.

• How it works?

These medications stop the sweat glands from producing sweats. Exercising extreme caution is essential when using this treatment if the patient is an athlete, working in a warm environment, or residing in a warm area. It’s possible that the body won’t be able to cool itself.

• Where to use?

These medications can effectively treat sweating across the whole body. This medication is an effective treatment for post-menopausal women who sweat profusely from their heads.

• Side effects

Drugs that stop the sweat glands from producing sweat can have dry mouth, blurred vision, dry eyes and abnormal heartbeat as side effects.

Higher doses carry a greater risk of adverse effects. Before using this medication, one should discuss the specific risks and advantages with a dermatologist.

Surgery 

Surgery is an option when other treatments are not effective in providing relief. Surgery is risky and has a permanent effect. The following surgeries can decrease excessive sweating.

Surgically removing sweat glands.

Sympathectomy

• How it works?

A dermatologist surgically removes sweat glands from the underarms, which can be done in the doctor’s office. The patient is awake throughout the procedure since just the area that needs to be treated is anaesthetised.

To remove sweat glands from the underarms, a dermatologist may employ one or more of the following surgical methods.

Laser surgery – vaporise sweat

Excision – cut off sweat glands

Liposuction – remove with suction. 

Curettage – scrape out.

Another surgery widely used to treat Hyperhidrosis is sympathectomy. A surgeon performs this surgery in an operating room.

The surgeon attempts to stop the nerve signals the body delivers to the sweat glands during a sympathectomy. The surgeon will achieve this by severing or destroying some nerves. 

A small surgical camera is inserted into the patient’s chest right below the underarm by the surgeon to locate these nerves. The surgeon needs to briefly deflate the patient’s lung to cut or remove nerves.

• Where to use?

Surgery usually involves treating the underarm sweat glands.

Sympathectomy is typically performed on the palms.

• Side effects

All procedures come with a certain amount of risk. There is a chance of getting an infection if the sweat glands in the underarm are removed. Bruising and pain are possible in patients. These will disappear over time.

Long-term negative effects are also possible. Scarring and loss of emotion are also potential consequences.

Some risks associated with sympathectomy have been decreased by developments in endoscopic surgery. Yet, adverse side effects are still possible. Compensatory sweating is a disorder that some patients experience. This makes some people sweat more profusely than Hyperhidrosis.

A sympathectomy may also damage the nerves that connect the brain and eyes, causing severe low blood pressure, irregular heartbeat and an inability to withstand heat. The surgery has also been fatal in some individuals.

Glycopyrrolate creams 

These creams are useful for treating head and face Hyperhidrosis.

• Prescription cloth wipes 

USFDA has approved this treatment for those who are 9 years of age or older and experience excessive underarm sweating.

• How it works? 

Glypyrronium tosylate, the active component in these individually wrapped towels, can reduce underarm sweating.

• Usage 

Most people use one wipe a day to treat their underarms.

Possible adverse effects include dry mouth, redness on the skin and stinging or burning where the wipe touched the skin.

When to see a doctor? 

In some circumstances, Hyperhidrosis could signify a significant health condition. Consult a doctor in case of experiencing any of the following. 

• Excessive sweating, followed by nausea, dizziness and pain in the chest.
• Sweating makes daily activities difficult.
• Too much sweat causes emotional problems or social withdrawal.
• Sweating at night for no apparent cause.

Conclusion 

Hyperhidrosis is a common problem in clinical practice, and while there are many treatments available, they are mostly ineffective. Therefore, a multidisciplinary team comprising primary care physicians, nurse specialists, thoracic surgeons and plastic surgeon is ideally best to handle the disease. The aim is to minimise problems while reducing perspiration.

If the cause is unknown, a dermatologist ought to be consulted.

Most topical and nonsurgical treatments are ineffective. Surgery is an option, although relapses are common. Patients need to be informed about all available treatments, including their efficacy and any potential side effects. A multidisciplinary approach can give the best hyperhidrosis care and enhance results.

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