Serving all of Southwest Forida. Call today for FREE Medical Exam & Consultation. 239-596-8886

I sweat constantly…and its embarrassing. Can anything be done?

I sweat constantly...and its embarrassing. Can anything be done?

Hello Doctor,
I am a 28 year old female, and I have an embarrassing problem.  I sweat constantly.  At first I thought it was just from exercise, but I now notice that sometimes when I am just sitting at work, my feet, under my arms and chest are sweating, and everyone around me appears to be comfortable.  This is particularly embarrassing when my hands are sweating and I have to greet people.  I also have to be careful what type of blouse I wear because of my under arms sweating. When I go outside, and it is warm, the sweating is even worse.  Can you tell me what is going on? I don’t think this is normal.  Is this something you can help me with?

Susan B.
Bonita Springs, FL.

Thank you for your email Susan.  Your question is timely as we head into another warm, sweaty Florida summer, but as you have already noted, your condition is not weather dependent.

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 temperature or physical exertion can be a problem for a lot of people.

Hyperhidrosis is the term used to describe the medical condition of excessive sweating.  It can occur in various parts of the body but is primarily seen in the palms of the hands, soles of the feet, or the axilla (underarm).  Excessive sweating can occur during common situations such as you described, such as hot weather, physical exertion, or intense emotional states, however, it becomes a more serious problem when it occurs during unusual situations, such as in your case; cooler weather, at rest in an air-conditioned area, or without any physical or emotional trigger.  Any of these situations can be defined as hyperhidrosis.

The most common sign and symptom of hyperhidrosis is excessively sweaty or wet palms, soles, and underarms.  The key feature that distinguishes hyperhidrosis from normal sweating is the frequency and intensity of the sweating which will usually cause it to soak through clothing or the need to continually wipe their palms dry.

There are 2 types of hyperhidrosis.  The first and most common type 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 underarms.  This type can further be broken down into two sub types: emotionally induced or localized.  Emotionally induced hyperhidrosis typically affects the palms, soles, and the underarms.  Localized hyperhidrosis typically affects the palms, underarms, groin, face, and the area below the breasts.  The most common reason for primary focal hyperhidrosis is due to genetic or hereditary factors.  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 and/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.

If you are experiencing Secondary hyperhidrosis, the first thing your doctor should review is your current medications.  Very often our clients have been prescribed a medication by their primary physician which is the cause of the new symptoms.  By identifying these medications and adjusting them, the symptoms may be eliminated.

Primary Focal Hyperhidrosis, especially axillary hyperhidrosis, which is excessive sweating in the underarm, 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, in part because many individuals do not realize that this condition exists and simply chalk up their excessive sweating to the temperature around them.  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 people are affected 20 times more frequently than other ethnic groups.

Like most medical problems, 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 they suspect the excessive sweating is associated with another disease or disorder.

Whether diagnosed with the primary or secondary type, hyperhidrosis can have several detrimental physical and emotional effects on a person.  Those with constantly moist hands may feel uncomfortable or embarrassed shaking hands or touching another person, while others with sweaty armpits and feet may have to contend with the unpleasant odor that results from the bacterial breakdown of sweat and cellular debris known as bromhidrosis.  People with hyperhidrosis will often need to change some of their clothes throughout the day and overtime their shoes can be ruined by the excess moisture.  Hyperhidrosis may also contribute to some skin diseases such as tinea pedis (athlete's foot) and contact dermatitis.  In addition to excessive sweat production, the texture and color of the skin may be affected by hyperhidrosis.  The skin may turn a pink or bluish white.  Severe hyperhidrosis of the soles of the feet may produce cracks, fissures, and scaling of the skin which can lead to further infections.

Fortunately, there are treatment options for hyperhidrosis, and Optimal Male can help you find the one that is right for you! One of the most effective and least obtrusive treatments for hyperhidrosis is botulinum toxin, more commonly known as Xeomin or Botox.  This natural organic compound is commonly used in aesthetics to eliminate wrinkles from the forehead and brow but when it is injected just beneath the skin of the hyperhidrosis problem area the compound works to stop the excessive sweating by preventing the transmission of nerve impulses to the sweat glands.  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 the majority of patients.

Other treatments do 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 treatment 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 can stain the skin.

Anticholinergic drugs may also be given.  These drugs include such medications as propantheline, oxybutynin, and benztropine.  These medications can be effective but due to the numerous side effects they are usually untenable for many people.

No matter what treatment option is chosen, it is always recommended to wear clothing made of naturally absorbent fabrics, avoiding high-buttoned collars, using talc or cornstarch, and keeping the underarms shaved.

If you are having a problem with excessive sweating, I encourage you to schedule your FREE Medical Exam and Consultation with my team and I.  We have the solutions to help you stay cool, dry and to be Optimal!

Richard Freier, M.D.
Medical Director
Optimal Male Performance Center
Office: 239.596.8886

Comments are closed.