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Hyperhidrosis (Excessive Sweating)

Hyperhidrosis (Excessive Sweating)

What is Hyperhidrosis?

Hyperhidrosis is a medical condition which produces excessive sweating in various parts of the body, primarily in the hands, feet, or under the arms. This sweating can occur under normal circumstances such as in hot weather, during physical exertion, or intense emotional states. However, it can also occur in situations where sweating does not normally occur, such as in cooler weather, air-conditioned areas, or without any trigger at all.

What causes Hyperhidrosis?

There is no one particular cause of hyperhidrosis, however the most common cause is genetic or hereditary factors.

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What are the Symptoms of Hyperhidrosis?

The most commonly observed symptoms of hyperhidrosis are excessively sweaty hands, feet, and underarms. The condition causes heavy sweating which soaks through clothing, and frequent sweating under abnormal circumstances.

Are there different types of Hyperhidrosis?

The most common is called Primary Focal Hyperhidrosis. This form of hyperhidrosis affects about 1% to 3% of the population, and usually starts in childhood or adolescence and affects the palms, soles, and armpits. This type can be further broken down into emotionally induced or localized. Emotionally induced hyperhidrosis typically affects the palms , soles,  and the armpits. Localized hyperhidrosis typically affects the palms, armpits, groin, face, and the area below the breasts.

Secondary hyperhidrosis (also called generalized hyperhidrosis) causes excessive sweating all over the body or in a larger area of the body, and is caused by a medical condition or some medications. Examples of medical conditions causing hyperhidrosis are: fever, metabolic disorders, alcoholism, menopause, Hodgkin's disease, tuberculosis, and various types of cancer. The medications most commonly associated with hyperhidrosis are propranolol, venlafaxine, tricyclic antidepressants, pilocarpine, and physostigmine.

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Who is affected by Hyperhidrosis?

Hyperhidrosis, especially axillary hyperhidrosis, which is excessive sweating under the arms, is more common in the general population than was previously thought. In 2004 about 2.8% of the United States population, or about 7.8 million people, reported having hyperhidrosis. Of this group, slightly more than half had axillary hyperhidrosis. One-third of the latter group, or about 1.3 million people, found that the condition significantly interfered with their daily activities and was barely tolerable. Only 38%, however, had ever discussed their excessive sweating with their doctor. Hyperhidrosis affects both sexes equally and may occur in any age group. People of any race may be affected; however, for some unknown reason, Japanese are affected 20 times more frequently than other ethnic groups.

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Isn’t the Body Supposed to Sweat?

Sweating is the body's natural way of cooling itself and is a normal response to a hot environment or intense exercise. However, excessive sweating unrelated to temperatures or physical exertion, can be a problem for some people.

What is the Impact of Hyperhidrosis?

Those with constantly moist hands may feel uncomfortable or embarrassed shaking hands or touching, while others with sweaty armpits and feet may have to contend with the unpleasant odor laser-mach-2 that results from the bacterial breakdown of sweat and cellular debris (bromhidrosis). People with hyperhidrosis often must change their clothes throughout the day, and their shoes can be ruined by the excess moisture.

Hyperhidrosis may also contribute to such skin diseases as athlete's foot (tinea pedis) and contact dermatitis. In addition to excessive sweat production, the texture and color of the skin itself may be affected by hyperhidrosis. The skin may turn a pink or bluish white.

Severe hyperhidrosis on the soles of the feet may produce cracks, fissures, and scaling of the skin which can lead to infection.

How is Hyperhidrosis Diagnosed?

Hyperhidrosis is diagnosed by patient report and a physical examination. In many cases the physician can directly observe the excessive sweating. The doctor may also perform an iodine starch test, which involves applying a mixture of starch and iodine to the affected areas of the patient's body, causing the areas of the skin producing sweat to turn black. The doctor may also order other laboratory or imaging tests if he suspects the excessive sweating is associated with another disease or disorder.

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How is Hyperhidrosis Treated?

One of the more effective and least obtrusive treatments include injections of botulinum toxin, more commonly known as Xeomin or Botox. When injected just beneath the skin of the problem area the medication works to stop the excessive sweating by preventing the transmission of nerve impulses to the sweat glands.  Adverse events or side effects are extremely rare, and even if they do occur they are only temporary. Another benefit to using botulinum toxin is its longevity, one treatment will usually last 6-12 months. For these reasons the use of botulinum toxin to treat hyperhidrosis works well for most patients.

Other treatments exist but are more arduous, less effective, and can have considerable adverse effects. Prescription medications, such as, 20% aluminum chloride hexahydrate solution, also known as Drysol, is applied by the patient at night to the affected areas, then the area is wrapped in a plastic film until morning. This regiment is ongoing and must be done at least twice a week. Drysol works by physically blocking the sweat pores.

Formaldehyde- and glutaraldehyde-based solutions can also be prescribed; however, formaldehyde may trigger an allergic reaction and glutaraldehyde sometimes stains the skin. Anticholinergic drugs may also be given. These drugs include such medications as propantheline, oxybutynin, and benztropine, which can be effective however the side effects of these drugs can be exhaustive and untenable for many people.

Another treatment option is the use of an electrical device that emits low-voltage microwaves, which, when held against the skin, reduces sweating. This is a daily treatment administered in a doctor’s office for several weeks, then ongoing weekly treatments.

At Optimal Male Performance Center, we use only the most effective and least obtrusive method for treatment. We also recommend wearing clothing made of naturally absorbant fabrics, avoiding high-buttoned collars, maintaining shaved underarms, and the use of talc.

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