Hyperhidrosis

Hyperhidrosis

What is hyperhidrosis?

Hyperhidrosis means excessive sweating. It can be localised or affect the whole face and body.

Sweating is controlled by the brain, which sends signals along nerves called “sympathetic nerves” to the small sweat glands in the skin. These nerves are part of the “autonomic nervous system” which controls many unconscious body functions.

Increased sweating is a normal response to a rise in body temperature, and to emotions such as anxiety.

A treatment which reduces sweating is called an antiperspirant. This is different from a deodorant, which reduces odour, usually through an antibacterial effect. The two are often combined in the same product.

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What does it look like?

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Main body location

All over / widespread, Armpit, Foot, Hand

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Can it appear anywhere?

Yes

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What causes hyperhidrosis?

Localised symmetrical hyperhidrosis (primary hyperhidrosis) isthe most common type of hyperhidrosis, this affects certain body sites (localised), and both sides equally (symmetrical). The palms, soles, under arm skin, face and scalp, or a combination of these, can be affected by excessive sweating. The cause is not known. It usually begins in childhood or adolescence and may improve with age. This type of hyperhidrosis is also called focal or primary hyperhidrosis.

Generalised hyperhidrosis (affecting the whole body) can be caused by some illnesses including infections, and by hormonal conditions including the menopause, diabetes and an overactive thyroid gland. This type of hyperhidrosis is called secondary hyperhidrosis. Some medicines can also cause excessive sweating, including fluoxetine and similar antidepressants. Sometimes no cause can be found.

Disease or irritation of the sympathetic nerves is a rare cause of increased sweating, either generally or in localised areas (typically just on one side of the face or body).

Anxiety can trigger or worsen hyperhidrosis, but this does not necessarily mean that the affected person is unusually anxious or stressed. Sometimes worry about sweating can create a vicious circle making the problem worse.

Is hyperhidrosis hereditary?

Hyperhidrosis is a feature of some rare inherited conditions. There is a trend for the common localised symmetrical type to run in families and up to a third of people with hyperhidrosis may have a family member with the condition.

What are the symptoms of hyperhidrosis?

Visible sweat, wet clothes and clammy palms can be embarrassing and can interfere with work and personal relationships. Some people find hand sweating produces problems such as embarrassment when shaking hands, difficulty when writing on paper, using keyboards, playing musical instruments and playing racquet sports.

Hyperhidrosis affects the water-producing (“eccrine”) sweat glands, and not the “apocrine” sweat glands which produce the more oily type of sweat which causes odour, especially under the arms. Therefore, bad odour is not a direct result of hyperhidrosis; however, if feet excessively sweat overgrowth of harmless skin bacteria can cause an unpleasant smell.

How will it be diagnosed?

Your doctor will assess which kind of hyperhidrosis you have. The doctor may suggest you have tests for an infection, diabetes, thyroid overactivity or other conditions.

Can hyperhidrosis be cured?

When there is an underlying cause, which can be treated, the hyperhidrosis may be cured. Surgical treatment, such as a sympathectomy, can help some people, but is often associated with serious side effects, so is not usually recommended unless other treatments have failed. Otherwise, the aim is to control the condition.

How can it be treated?

Most people with hyperhidrosis will have tried commercial antiperspirants. If these fail, and if the sweating is bad enough to interfere with your work or social activities, you should ask your doctor for advice. The doctor will assess whether there might be an underlying cause and may start treatment. If necessary, you may be referred to a dermatologist.

Localised hyperhidrosis

Self care (What can I do?)

If medical treatment is not possible or is unsuccessful, there are still a number of ways you can help yourself. You should try to avoid situations, which you find trigger your sweating, such as hot places or rushing about. Alcohol and spicy foods can also bring on an episode of hyperhidrosis.

Absorbent underlayers such as cotton T-shirts (wicking fabrics) can help hyperhidrosis of the body. Adhesive absorbent underarm pads for clothing are available on the internet. Loose fitting clothes made of natural fibres and leather shoes/sandals are beneficial. Changes of clothes may be necessary during the day. If your feet are the main problem, you may need to change socks and shoes during the day. You may be able to slip your feet out of your shoes even for short periods. You should have several pairs of daytime shoes so that each pair has a few days to dry out. There are many good, absorbent insoles available that will also help. It is best to avoid soap-based products and to use an emollient as a soap substitute instead. Cotton, silver and copper socks are also helpful for many which may work by helping to reduce sweating or to reduce odour secondary to the excessive sweating.

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This information is provided by the British Association of Dermatologists.


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