What is hyperhidrosis?

Hyperhidrosis (say: “hy-per-hy-droh-siss”) is excessive sweating. While everyone sweats when they’re hot, exercising or feeling stress, people who have hyperhidrosis sweat heavily and sweat most of the time, even without the usual triggers.

What are the symptoms of hyperhidrosis?

If you have hyperhidrosis, you may sweat all over your body, or you may sweat mainly on your hands, feet, armpits, face and genital area. Your clothes may be soaked with sweat. Your skin may become white and wrinkled, or red and irritated from the moisture.

Often, dampness from the sweat is accompanied by odor. Sweat by itself doesn’t usually have an odor. But once it is on your skin, bacteria and other germs begin to break it down. That is why hyperhidrosis can cause body odor.

Hyperhidrosis can have an unpleasant effect on your life. You may feel awkward and uncomfortable in social situations. You may be self-conscious because of dampness and odor. You may also be afraid to touch or shake hands with people or raise your arm to reach for something. You may feel embarrassed about being in public, spending time with your friends and going to work or school. These are very normal reactions to having hyperhidrosis.

Should I see my doctor?

Too often, people suffer with hyperhidrosis without seeking help. Perhaps you may think it is silly or embarrassing. But hyperhidrosis can have a negative impact on your life, causing social isolation, depression and anxiety. Plus, it can be a sign of a serious health problem. You are wise to seek your doctor’s advice. Contact your doctor if:

• You seem to sweat a lot more than normal
• Your sweating doesn’t have a cause, such as exercising or being in hot weather
• You also have chest pain, fever, shortness of breath or the feeling that your heart is pounding
• You are losing weight unintentionally
• Your sweating mostly happens at night or worsens at night

What causes hyperhidrosis?

There are 2 types of hyperhidrosis.

Primary hyperhidrosis (also called focal hyperhidrosis) tends to affect both sides of the body and occurs on the feet, hands, underarms, head and face. Sometimes, it affects larger areas of the body. It seems to run in families, often begins in childhood and occurs during waking hours. It is usually very hard to determine the cause of primary hyperhidrosis.

More often, hyperhidrosis is caused by something else. This is called secondary hyperhidrosis (also called generalized hyperhidrosis). It tends to involve large areas of the body, and may happen both during the day and at night. Secondary hyperhidrosis may be caused by:

• Anxiety
• Hormonal changes (such as menopause)
• Problems with blood sugar control
• An overactive thyroid
• Heart disease
• Cancer
• Certain infections or other conditions
• Caffeine
• Certain medicines, such as aspirin, some blood pressure medicines and antidepressants

What will happen at my doctor’s appointment?

Your doctor will probably ask you questions about your symptoms and medical history. The signs of hyperhidrosis may be obvious to your doctor and no testing may be needed. You may also be checked for other problems that could be causing your symptoms. For example, your doctor may order urine and blood tests to check for conditions such as an overactive thyroid and low blood sugar. If your doctor suggests tests specifically for hyperhidrosis, the tests simply measure the level of moisture on your skin.

What can I do to deal with hyperhidrosis?

A number of things can help you deal with hyperhidrosis day to day.

• If you are bothered by odor, try bathing daily with antibacterial soap. This will help wash away the bacteria and other germs that gather on the skin, which are what can cause odor when you sweat.
• Be sure to dry yourself completely. Bacteria and other germs thrive in damp areas.
• Be sure to let your shoes dry completely before wearing them again. Do not wear the same pair of shoes 2 days in a row.
• Wear cotton socks or socks that pull moisture away from the skin. Change your socks throughout the day if needed.
• Cotton and other natural fibers may help you feel cooler and gives you the sense that your skin can breathe. But when you exercise, special fabrics designed to pull dampness away from your skin might be most comfortable.
• Dress shields, which are pads that you can place under your arms, may be useful and help you feel more confident that you won’t sweat through your shirt or blouse.
• Some people find that keeping an extra shirt or pair of socks on hand helps them feel more secure about being in public. Doing this gives you the option to change if your clothes become damp and you feel uncomfortable.
• Keep up with your laundry. Be sure to wash and dry clothing thoroughly before wearing again.
• Try shaving in bothersome areas, such as under the arms.
• If certain foods or drinks seem to make your sweating worse, avoid them. This might include caffeine, spicy foods and alcohol.
• Relaxation techniques might be helpful (such as yoga and meditation), especially if your sweating is triggered by stress. Even if the sweating isn’t triggered directly by stress, the sweating itself can cause stress, so relaxation techniques can be helpful.

How is hyperhidrosis treated?

Many treatment options are available to help control hyperhidrosis. Below are some examples. Talk to your doctor about what might be right for you.

• Antiperspirants. If regular antiperspirants haven’t helped, you may try a product with a higher level of aluminum chloride hexahydrate (brand names: Certain Dri, Drysol, Hypercare, Xerac).This is the ingredient in antiperspirant that shuts down sweat ducts. You may try a product from the store or you may talk to your doctor about a prescription. They are applied at night to towel-dried skin several times a week. Your doctor may suggest you apply every night or even twice a day for the first week, and then once or twice a week to help keep your sweating under control.
• Prescription medicines for hyperhidrosis. Your doctor may prescribe medicine, such as glycopyrrolate or propantheline bromide, to help stop stimulation of the sweat glands. These drugs may have side effects such as dry mouth, constipation and blurry vision. Taking them over time may lead to more serious problems. Talk to your doctor to see if these medicines might be useful to you.
• Medicine to treat the cause of secondary hyperhidrosis. If you have secondary hyperhidrosis that is caused by another condition, medicine that treats that condition may help control your sweating. For example, if stress is part of what triggers you to sweat heavily, then medicine to treat anxiety may be useful to you.
• Iontophoresis (say: “eye-on-toe-for-ee-sis”). This treatment option involves using a special machine that applies low amount of electricity to shut off the sweat glands. This treatment generally is used for hands and feet.
• Botulinum toxin type A (brand name: Botox). This treatment is typically injected into the armpits to block the nerves that cause sweating. Botulinum toxin can work well, but also can be expensive and painful, and sometimes causes flu-like symptoms. Each treatment is effective for about 4 to 8 months.
• Surgery. If your hyperhidrosis is severe and other treatments haven’t worked, surgery may be an option. A surgeon may remove or cut nerves that activate certain sweat glands, or may remove some sweat glands completely. Typically, surgery is used only as a last resort. Many people who go through surgery have new or worsened sweating (called compensatory sweating) later in life. Surgery also carries the risk of nerve and artery damage.

• What is the likely cause of my hyperhidrosis?
• I’m embarrassed by how much I sweat. Will a prescription antiperspirant help?
• What is the best treatment option for me? Will I need to take medicine?
• Do I need to make any lifestyle changes?
• When can I expect relief from my symptoms?
• Is hyperhidrosis a sign of a more serious health problem?
• Do I need any tests?