Causes
Sweating helps the body stay cool. In most cases, it is perfectly natural. People sweat more in warm temperatures, when they exercise, or in response to situations that make them nervous, angry, embarrassed, or afraid.
Excessive sweating occurs without such triggers. Persons with hyperhidrosis appear to have overactive sweat glands. The uncontrollable sweating can lead to significant discomfort, both physical and emotional.
When excessive sweating affects the hands, feet, and armpits, it is called primary or focal hyperhidrosis. In most cases, no cause can be found. It seems to run in families.
If the sweating occurs as a result of another medical condition, it is called secondary hyperhidrosis. The sweating may be all over the body or it may be in one area. Conditions that cause second hyperhidrosis include:
- Acromegaly
- Anxiety conditions
- Cancer
- Carcinoid syndrome
- Certain medications and substances of abuse
- Glucose control disorders
- Heart disease
- Hyperthyroidism
- Lung disease
- Menopause
- Parkinson disease
- Pheochromocytoma
- Spinal cord injury
- Stroke
- Tuberculosis or other infections
Symptoms
The primary symptom of hyperhidrosis is wetness.
Treatment
Treatments may include:
- Antiperspirants: Excessive sweating may be controlled with strong anti-perspirants, which plug the sweat ducts. Products containing 10% to 20% aluminum chloride hexahydrate are the first line of treatment for underarm sweating. Some patients may be be prescribed a product containing a higher dose of aluminum chloride, which is applied nightly onto the affected areas. Antiperspirants can cause skin irritation, and large doses of aluminum chloride can damage clothing. Note: Deodorants do not prevent sweating, but are helpful in reducing body odor.
- Medication: Medicines may prevent stimulation of sweat glands. These are prescribed for certain types pf hyperhidrosis such as excessive sweating of the face. Medicines have side effects and are not right for everyone.
- Iontophoresis: This procedure uses electricity to temporarily turn off the sweat gland. It is most effective for sweating of the hands and feet. The hands or feet are placed into water, and then a gentle current of electricity is passed through it. The electricity is gradually increased until the patient feels a light tingling sensation. The therapy lasts about 10 to 20 minutes and requires several sessions. Side effects include skin cracking and blisters, although rare.
- Botox: Botulinum toxin type A (Botox) is used to treat severe underarm sweating. This condition is called primary axillary hyperhidrosis. Botulinum toxin injected into the underarm temporarily block the nerves that stimulate sweating. Side effects include injection-site pain and flu-like symptoms. Botox used for sweating of the palms can cause mild, but temporary weakness and intense pain.
- Endoscopic thoracic sympathectomy (ETS) : In severe cases, a minimally-invasive surgical procedure called sympathectomy may be recommended when other treatments do not work. The procedure cuts a nerve, turning off the signal that tells the body to sweat excessively. It is usually done on patients whose palms sweat much more heavily than normal. It may also be used to treat extreme sweating of the face. ETS does not work as well for those with excessive armpit sweating.
- Underarm surgery: This is surgery to remove the sweat glands in the armpits. Methods used include laser, curettage (scraping), excision (cutting), or liposuction. These procedures are done using local anesthesia.
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