Understanding Hyperhidrosis

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In most cases, the cause isn’t known. It may be because of a problem with how the nervous system responds to stress. In some cases, it may be caused by another health condition or a medicine. This is known as secondary hyperhidrosis.

The main symptom of hyperhidrosis is heavy sweating that:

• Can cause problems with daily activities and social events

• Happens during the day but not at night

• May happen with no physical activity

The sweating occurs most often in any or all of these areas:

• Bottoms of the feet

• Palms

• Underarms

In some cases, it may also occur in these areas:

• Face

• Groin

• Scalp

• Under the breasts

Treatment choices include:

• Antiperspirant. An antiperspirant that has 10% to 15% aluminum chloride can block sweat glands and help stop sweating. It comes in creams, sticks, gels, and sprays. You can buy antiperspirant at a drugstore. Or your healthcare provider may give you a stronger prescription antiperspirant that has 20% aluminum chloride. Antiperspirant should be applied to dry skin at night before bed. It needs to be applied every night for a week or two, and then once or twice a week or as needed. This can irritate the skin for some people.

• Botulinum toxin. This is a type of medicine that is injected into the areas with sweat glands. This medicine temporarily blocks a chemical that stimulates the sweat glands. You’ll need to get injections every 4 to 6 months.

• Iontophoresis. This treatment uses electricity to block sweat glands. Moist pads are put on the skin, or your hands or feet are placed in shallow water. Chemicals may be added to the water. An electrical current is sent through fluid. The process is done several times a week until sweating is reduced, and then once a week or as advised.

• Surgery. In severe cases, you may have surgery to remove your sweat glands. Or surgery can be done to cut the nerves that send signals to the sweat glands. Either of these types of surgery can stop sweat permanently.  But this can lead to compensatory hyperhidrosis. This means you will start sweating from another part of your body.

• Electromagnetic energy device. This device uses electromagnetic energy to destroy the sweat glands in the underarm area.

• Treating another health condition, or changing a medicine. A health condition or a medicine can cause secondary hyperhidrosis. This can be managed by treating the health condition or by changing the medicine. Your healthcare provider will talk with you about these options if you have secondary hyperhidrosis.

• Oral medicines. There are medicines that can be taken by mouth that will help reduce sweating.

You may have skin problems in the areas where you sweat. The skin may become moist, pale, swollen, and soft enough to rub away easily. This is known as skin maceration. It can lead to loss of skin, pain, and skin infection. You can help prevent this problem by treating your hyperhidrosis and keeping your skin dry as much as possible.

Hyperhidrosis may be caused by or made worse by emotional stress and heat. It can cause problems with work and social life. You may have stains on your clothes and not want to shake hands with people. It can be upsetting to cope with the problems of excess sweat. Talk with your healthcare provider about the following:

• Support groups

• How to prevent skin maceration

• Other ways to manage your condition long-term

Call your healthcare provider right away if you have any of these:

• Symptoms that don’t get better, or get worse

• New symptoms