Hyperhidrosis - Types, Symptoms, Causes, Diagnosis, and Treatment

What Is Hyperhidrosis?

Hyperhidrosis is when a person sweats excessively, irrespective of the climate or physical exertion. The person can sweat when the weather is cold or without any trigger, sometimes due to menopause or thyroid problems. Such people sweat so much that their clothes might get soaked, and sweat starts dripping from their hands (sweaty palms) and feet. This can cause embarrassment and social anxiety and hinder normal day-to-day activities. For a few individuals, the symptoms are so severe that it makes them anxious. It affects the patient’s career choices, activities, relationships, self-esteem, and emotional health.

Treatment is usually done with strong antiperspirants, and if that does not help, the doctor might suggest various medications or therapies. In extreme cases, the person might need surgery to remove the sweat glands or cut the nerves responsible for excessive sweating. Hyperhidrosis disorder is a condition that results in excessive sweating. Most people do not consult a doctor for excess sweating as they think it is not a condition that can be treated.

What Are the Types of Hyperhidrosis?

Sweating caused by hyperhidrosis occurs mostly in the hands, feet, groin, and armpits, as these parts contain the most sweat glands. The types are:

1. Focal Hyperhidrosis: This is when excessive sweating is localized in a particular body part. For example, sweating in the palms and soles (palmoplantar hyperhidrosis).

2. Generalized Hyperhidrosis: This is the type where the entire body is affected. This condition can be present at birth or develop later on. Most people start experiencing the symptoms during their teenage years. This condition can also be classified based on the cause:

• Primary Idiopathic Hyperhidrosis: The cause is unknown. Most of the cases are of this type.

• Secondary Hyperhidrosis: Sweating is due to an underlying health condition like obesity, menopause, gout, mercury poisoning, hyperthyroidism, diabetes, etc.

What Are the Symptoms Experienced by a Person with Hyperhidrosis?

The signs of hyperhidrosis include:

1. Wet and clammy palms (underside of the hand).

2. Wet and clammy soles (underside of the feet).

3. Profuse sweating.

4. Wet and soaked clothing.

The person might also experience the following symptoms:

• Fungal and bacterial infections.

• Avoid any form of physical contact.

• A constant fear of stained clothing.

• Depression due to social withdrawal.

• Become extremely self-conscious.

• Usually, one gets a job that requires working from home.

• Keep changing clothes and try to deal with all the sweating by keeping napkins under one’s arms and wearing dark clothes.

• Constantly worry about body odor.

What Are the Causes of Hyperhidrosis?

Depending on the type, the causes of hyperhidrosis are:

1. Primary Hyperhidrosis: Primary hyperhidrosis is believed to be due to the person’s emotional state. Stress, anxiety, etc., were believed to trigger this. However, recent studies showed that people with this type of hyperhidrosis are anxious and stressed because of excessive sweating and not the other way around. It also showed that genetics plays a role and that this condition could be inherited. Here, the nervous system triggers the sweat glands, makes them overactive, and makes them secrete sweat even without the rise in body temperature. This condition worsens with stress and nervousness.

2. Secondary Hyperhidrosis -

• Injury to the spinal cord.

• Nervous system disorders.

• Anxiety.

• Diabetes.

• Hyperthyroidism.

• Obesity.

• Infections, such as HIV and malaria.

• Medications, such as antidepressants and antihypertensives.

• Parkinson’s.

• Hypoglycemia (low blood glucose).

• Pregnancy.

• Gout.

• Heart problems.

• Respiratory failure.

• Shingles.

• Alcohol and drug abuse.

How Does the Doctor Diagnose Hyperhidrosis?

If someone feels like they sweat a lot without any apparent reason, they should see a doctor. To determine what causes these sweating episodes, the doctor will question patients about their medical history, symptoms, and other issues during the session. The physician will next advise them to undergo additional tests if necessary:

1. Blood and Urine Tests - These tests are done to rule out all other medical conditions that can result in similar symptoms, such as hyperthyroidism.

2. Thermoregulatory Sweat Test - Here, a moisture-sensitive powder is applied to the skin, and when one sweats, the color of the powder changes. People’s palms and soles, who do not have hyperhidrosis do not sweat when exposed to heat. But hyperhidrosis patients do.

Other tests, such as the iodine-starch and skin conductance tests, are also used.

What Are the Treatment Options for Hyperhidrosis?

The treatment options include:

1) Medications:

• Prescription-Strength Antiperspirant - The doctor might recommend an Aluminum chloride-containing antiperspirant. Use it on the skin that is dry before bed. When waking up, wash the substance away, careful not to get any in the eyes. After using it daily for a few days and starting to show results, one can reduce its use to once or twice a week to keep the effects going.

• Medications to Block Nerves - Certain oral drugs disrupt the neurons that activate the sweat glands. In certain cases, this can lessen perspiration. Urinary tract issues, dry tongue, and blurred vision are possible adverse effects.

• Glycopyrrolate Cream - Glycopyrrolate-containing prescription creams may help treat facial and head hyperhidrosis. Glycopyrronium tosylate-soaked wipes may lessen hand, foot, and underarm symptoms. These products may cause moderate skin irritation and dry mouth as adverse effects.

• Botox Injections -The nerves that cause the sweat glands to activate are blocked by botulinum toxin (Botox) treatment. Most patients are unaware of any pain during the process. However, one might wish to numb the skin in advance. A doctor may use any of the following methods to numb the skin. These include massage (vibration anesthesia), ice, and topical anesthetic. Several injections will be required for each damaged section of the body. Results might only become apparent for a few days. Patients will probably require follow-up treatments every six months to maintain the desired outcome.

• Antidepressants - Certain drugs used to treat depression can also reduce perspiration. They might also aid in lowering anxiety.

2) Other Procedures and Surgery:

• Iontophoresis - This home remedy involves submerging one's feet or hands in a pan of water while a gadget runs a modest electric current through the water. The current blocks the nerves that cause perspiration. The afflicted areas must be submerged for 20 to 40 minutes. Continue the therapy two or three times every week until the symptoms subside.

• Microwave Therapy - This treatment uses microwave energy delivered by a portable device to eliminate sweat glands under the arms. Treatment consists of two sessions, spaced three months apart, lasting 20 to 30 minutes each. An alteration in the feeling of the skin and mild discomfort are possible adverse effects.

• Sweat Gland Removal - If individuals only sweat a lot in their armpits, the physician might advise the excision of those sweat glands. This can be accomplished by suctioning them away (liposuction), rubbing them out (curettage), or with a mix of the two techniques (suction curettage).

• Surgery on Nerves (Sympathectomy) - The surgeon makes a little incision in the spinal nerve that regulates the hands' ability to sweat during this treatment. One potential adverse effect is permanent excessive perspiring in other body parts (compensatory sweating). Generally speaking, isolated head and neck perspiration does not lend itself to surgery. This process is modified to treat the palms. Sympathectomy, which stops nerve signals without destroying the sympathetic nerve, lowers the possibility of compensatory sweating. Nerve surgery is normally reserved for patients who have failed numerous previous treatments due to its potential for complications and negative effects.

Which At-Home Treatments Can Help Lower Sweating?

The following suggestions may help lessen body odor and sweating:

• Apply Antiperspirant: Antiperspirants with 6 to 20 % Aluminum chloride can intermittently block sweat pores.

• Choosing Natural-Fiber Shoes and Socks: Shoes made of leather, which naturally breathes, help prevent feet from being too hot or cold.

• Wear What Is Suitable for the Task: When feasible, dress in natural materials like cotton, silk, and wool.

How to Stop Nervous Sweating?

Suppose sweating is mostly caused by anxiety or nervousness, such as when inside or before a social occasion. In that case, there may be another mental reason for sweating: nervous sweating. It is different from hyperhidrosis. Some ways to stop nervous sweating are -

• Remain calm.

• Meditation and relaxation.

• Recognize the sweat inducers.

• Maintain hydration.

• Equip with a potent deodorant.

• Choose the clothes wisely.

Conclusion:

Hyperhidrosis-related excessive perspiration can be a difficult-to-manage short- or long-term ailment. Individuals' desire to retreat from social situations may stem from a worry about how someone could react to their symptoms, such as shaking their sweaty palms. While there is no known treatment for hyperhidrosis, support is offered. A physician can suggest taking prescription-only antiperspirants or other drugs to reduce the symptoms.