Hyperhidrosis

Overview

Hyperhidrosis is a medical condition characterized by excessive sweating that is not always related to heat or exercise. It can disrupt daily routines, cause emotional distress, and lead to social withdrawal. Hyperhidrosis typically begins with antiperspirants and may require different medications or therapies if they are not effective. In severe cases, surgery might be considered to remove sweat glands or disconnect nerves related to excessive sweating. Sometimes, an underlying condition may be found and treated.

Understanding the disease

Symptoms

The main symptom of hyperhidrosis is heavy sweating, which goes beyond the sweating from being in a hot environment, exercising, or feeling anxious or stressed. This type of hyperhidrosis usually affects the hands, feet, underarms, or face and causes at least one episode per week when the person is awake, with sweating occurring on both sides of the body. Other symptoms that may require medical attention include heavy sweating with dizziness, pain in the chest, throat, jaw, arms, shoulders, rapid pulse, or cold skin. These symptoms may indicate a serious condition. If sweating disrupts your daily routine, causes emotional distress or social withdrawal, or if you suddenly begin sweating more than usual or experience night sweats for no apparent reason, you should seek medical advice from your healthcare provider.

Risk Factors

The following are potential risk factors for developing hyperhidrosis:

1. Family history: Hyperhidrosis can run in families, and genetics may play a role in its development.
2. Medical conditions: Certain medical conditions, such as diabetes, thyroid problems, or nervous system disorders, may contribute to hyperhidrosis. Additionally, some types of cancer, infections, and menopause hot flashes can cause excessive sweating.
3. Medications: Certain medications, like pain relievers, antidepressants, and some diabetes and hormonal medications, may cause secondary hyperhidrosis. Consult with your healthcare provider to discuss the potential side effects of your medications. It is important to note that not everyone with these risk factors will develop hyperhidrosis, and some individuals without known risk factors may still experience excessive sweating. If you are concerned about your sweating, consult with a healthcare provider to determine the underlying cause and appropriate treatment options.

Development

Primary hyperhidrosis develops due to faulty nerve signals that trigger eccrine sweat glands to become overactive, usually affecting the palms, soles, underarms, and sometimes the face. It has no known medical cause and can run in families. Secondary hyperhidrosis develops as a result of an underlying medical condition or taking certain medications. Some conditions that may cause secondary hyperhidrosis include diabetes, menopause hot flashes, thyroid problems, some types of cancer, nervous system disorders, infections, and others. In these cases, treating the underlying condition may help manage excessive sweating.

Assessment and Diagnosis

Triage

You should see a doctor if hyperhidrosis is suspected when:

1. You have heavy sweating with symptoms such as dizziness, pain in the chest, throat, jaw, arms, shoulders, or a rapid pulse.
2. Sweating disrupts your daily routine.
3. Sweating causes emotional distress or social withdrawal.
4. You suddenly begin to sweat more than usual.
5. You experience night sweats for no apparent reason. It's important to consult a healthcare provider if you suspect hyperhidrosis, as it may be a sign of an underlying condition that needs to be treated.

Diagnosis

To diagnose hyperhidrosis, your health care provider will likely start by asking about your medical history and symptoms. They may also perform a physical exam or recommend lab tests to rule out other medical conditions that could be causing excessive sweating. Additional diagnostic tests such as an iodine-starch test or a sweat test may be used to pinpoint the areas of sweating and evaluate the severity of the condition.

Management and Treatment

Complications

Complications of hyperhidrosis can include infections, social and emotional effects, and disruptions to daily routine, emotional distress, or social withdrawal. Excessive sweating can also be a sign of a more serious underlying condition, which may require medical attention. Some of these potential underlying conditions include diabetes, menopause hot flashes, and thyroid problems. It is important to consult a healthcare provider if excessive sweating is causing disruptions to daily life or causing emotional distress.

Home Remedies

There is no specific information available at this time regarding home remedies for hyperhidrosis. It is recommended to consult a healthcare provider for proper diagnosis and treatment options. For dyshidrosis, some home remedies mentioned include keeping the affected areas clean and dry, using over-the-counter hydrocortisone cream, and applying cool compresses to help alleviate itching and discomfort. However, it is important to consult a healthcare provider for proper diagnosis and treatment as dyshidrosis may require prescription medication.

Treatment

Treatments for hyperhidrosis typically begin with antiperspirants and may include different medications and therapies. If antiperspirants don't help, your health care provider may suggest other options. These may include:

1. Prescription antiperspirants: Stronger prescription antiperspirants can be effective in controlling excessive sweating. These contain a higher concentration of aluminum chloride, which helps block sweat glands.
2. Medications: Certain medications can be used to treat hyperhidrosis. These may include:
   • Glycopyrrolate: This medication is administered via an injection and can help reduce sweating in the underarms for up to six months.
   • Oxybutynin: This medication, usually taken orally, can help control excessive sweating in the hands and feet.
   • Botulinum toxin injections: Injecting botulinum toxin (Botox) into the armpits can help reduce sweating for several months.
3. Surgical options: In severe cases, surgery may be considered to remove sweat glands or disconnect nerves related to excessive sweating. These procedures are typically reserved for cases where other treatments have been unsuccessful. It's important to consult a health care provider to determine the appropriate treatment for your specific situation.

Preparing for medical consultation

To prepare for an appointment for hyperhidrosis, you can start by seeing your primary care provider. You may then be referred to a specialist in diagnosing and treating conditions of the hair and skin (dermatologist) or a specialist in the nervous system (neurologist) or a surgeon. Before your appointment, it can be helpful to list answers to the following questions:

• Has anyone in your immediate family ever had similar symptoms?
• Does your sweating stop when you're asleep?
• What medications and supplements do you take regularly?
• Have your symptoms caused you to avoid social situations or activities? During the appointment, your healthcare provider may ask about your medical history and symptoms, perform a physical exam, or recommend lab tests to further evaluate the cause of your symptoms. They may also suggest treatments such as prescription antiperspirants, relaxation techniques, or changes in your diet.