Understanding Hyperhidrosis – What are the causes, symptoms, and treatment options?
Understanding Hyperhidrosis
In this guide, we’ll delve into the various aspects of hyperhidrosis, including its symptoms, causes, and potential treatment options.
Hyperhidrosis is a condition characterised by excessive sweating beyond what is necessary for regulating body temperature. It can be so extreme that the sweat soaks through your clothes or drips off your skin.
Although hyperhidrosis affects millions of people worldwide, we understand that it can be a challenging and even distressing condition that can significantly impact your everyday life if it’s something you’re experiencing.
In this guide, we’ll delve into the various aspects of hyperhidrosis, including its symptoms, causes, and potential treatment options.
What is hyperhidrosis?
As we’ve already highlighted, hyperhidrosis is a medical condition characterised by excessive and uncontrollable sweating that’s not always related to heat or exercise. It can occur either locally or throughout the body, often affecting areas such as the palms, soles of the feet, underarms, groin, and face.
While hyperhidrosis doesn’t pose a threat to your physical health, it can cause distress in social situations, and you may find that it is impacting your self-confidence. In some cases, it can even lead to experiencing anxiety and depression, so it’s important that you seek advice, support, and treatment if hyperhidrosis is impacting your life in any way.
It’s always sensible to seek medical advice about hyperhidrosis in case it’s a symptom of another illness, infection, or a side effect of medication for which there’s an alternative.
This condition can be classified into two main types: primary hyperhidrosis and secondary hyperhidrosis.
Primary hyperhidrosis
Primary hyperhidrosis typically begins during childhood and gets worse during puberty. It tends to run in families, suggesting that there’s a genetic component, rather than being the symptom of another illness. It often affects specific areas of the body, such as the palms, soles, underarms, or face.
Primary hyperhidrosis is believed to be caused by faulty nerve signals that trigger eccrine sweat glands to become overactive. Our eccrine sweat glands are found on virtually all skin but are in particularly high concentrations on the palms of your hands, soles of your feet, and on your head. According to Hyperhidrosis UK, primary hyperhidrosis won’t usually be present when you’re asleep. It is typically experienced on both sides of the body.
Secondary hyperhidrosis
Unlike primary hyperhidrosis, secondary hyperhidrosis is usually a symptom of an underlying medical condition or a side effect of certain medications. It can be localised, affect the entire body, or only affect one side of the body and may develop at any age. (This is the type of hyperhidrosis that’s often associated with menopause).
People with secondary hyperhidrosis often sweat while asleep.
What are the symptoms of hyperhidrosis?
The main symptom of hyperhidrosis is excessive sweating that occurs spontaneously and without any triggers such as heat or physical exertion. If you have hyperhidrosis, you may experience:
Persistent sweating that significantly impacts your daily activities and social interactions – you might avoid exercise or dancing because you’re worried it will make your symptoms worse and it may impact your confidence at work
Wet or clammy palms, which can interfere with tasks that require manual dexterity, such as typing or driving – if you have excessively sweaty palms, you may also avoid shaking hands with people
Sweat-soaked clothing, particularly in the underarm area
Skin irritation or fungal infections in areas prone to excessive sweating
Some people with hyperhidrosis experience extreme flushing in the face
It’s common for someone with hyperhidrosis to feel that they need to change their clothes or shower multiple times a day.
Although many of us associate sweating with being too hot, some people find that their hyperhidrosis worsens over the winter and during spells of cold weather. Others experience flare-ups in warmer weather, while others still endure hyperhidrosis all year round.
What causes hyperhidrosis?
The exact cause of primary hyperhidrosis is not fully understood, but it is believed to involve overactivity of the sweat glands due to malfunctioning of the nervous system. As we’ve already mentioned, there seems to be a genetic element at play because it often runs in families. Hormones may play a part too, as primary hyperhidrosis often gets worse during puberty.
Anxiety can exacerbate this condition, creating something of a vicious cycle.
Secondary hyperhidrosis, on the other hand, can be attributed to various underlying factors, including:
Medical conditions: Certain medical conditions such as diabetes, hyperthyroidism, menopause, obesity, and autoimmune diseases can lead to secondary hyperhidrosis. The condition can also be brought on by chronic alcoholism.
Medications: Some medications, including antidepressants, antipsychotics, and medications for high blood pressure, may cause excessive sweating as a side effect.
Hormonal changes: Hormonal fluctuations, particularly during puberty, pregnancy, and menopause, can trigger episodes of excessive sweating.
Neurological disorders: Conditions affecting the nervous system, such as Parkinson's disease and spinal cord injuries, can disrupt the body's ability to regulate sweating, leading to hyperhidrosis.
How is hyperhidrosis diagnosed and when should you seek treatment?
Most people have times when they sweat a lot, but it’s usually in response to the temperature around them or because they’ve exerted themselves in some way.
With hyperhidrosis, there isn’t always an obvious cause to the excessive sweating, and it can become problematic because it impacts your daily activities or confidence.
If you think you have hyperhidrosis, please seek your GP’s advice. This can help to determine whether it’s the symptom of another illness. Night sweats, for example, where your night clothes and bedding are soaking wet, should be investigated.
To diagnose hyperhidrosis, a GP will usually conduct a physical examination and talk with you about your symptoms and medical history, including any family history of the condition. They may also order tests to work out whether the sweating you’re experiencing is excessive – these can include blood and urine tests.
If you’re finding your excessive sweating embarrassing, please know that this condition affects many people and treatments are available. Don’t suffer in silence!
What are the treatment options for hyperhidrosis?
Hyperhidrosis can be challenging to manage because there isn’t a one-size-fits-all solution. If a treatment hasn’t worked for you, don’t give up hope – there are always other options to explore.
For some people, making certain lifestyle changes such as wearing breathable clothing, avoiding spicy foods and caffeine, quitting smoking, practicing stress management techniques, and maintaining good personal hygiene is enough to help manage symptoms of hyperhidrosis. However, further interventions may be necessary to alleviate symptoms and improve your quality of life. These include:
Topical treatments: Over-the-counter or prescription-strength antiperspirants containing aluminium chloride can effectively reduce sweating when applied to affected areas such as the underarms, palms, or feet.
Oral medications: In cases of severe hyperhidrosis, doctors may prescribe oral medications such as anticholinergics (drugs that block and inhibit the activity of the neurotransmitter acetylcholine (ACh) at both central and peripheral nervous system synapses) to help reduce sweating by blocking the stimulation of sweat glands.
Botulinum Toxin injections: Injections containing Botulinum Toxin can temporarily block the nerves responsible for activating sweat glands, providing relief from excessive sweating for several months.
Iontophoresis: This non-invasive procedure involves passing a mild electrical current through water-soaked skin, effectively blocking sweat gland activity. It is particularly useful for treating excessive sweating in the hands and feet.
Surgery: In severe cases of primary hyperhidrosis that do not respond to other treatments, surgical interventions such as sympathectomy (nerve surgery) or sweat gland removal may be considered as a last resort.
Finding support for hyperhidrosis
According to the International Hyperhidrosis Society, people who receive Botulinum Toxin injections have found excessive sweating decreases by 82-87% in the underarm area and 80-90% for the palms of the hands. Dryness can last for four to 12 months, but it is important to note that side effects of the treatment can include pain, swelling and bruising at the injection site.
If you have hyperhidrosis and would like to explore whether Botulinum Toxin injections might be a suitable treatment option, please book a consultation.