Excessive Sweating: Hyperhidrosis- Is it Normal or a Sign of a Medical Problem?

Everyone sweats. You sweat when you're in a hot temperature, after exercising, or in response to an uncomfortable situation that made you nervous, afraid, angry, or even embarrassed. Sweating is your body's way of staying cool. However, some people sweat less and some more.

The amount that you sweat depends on the number of sweat glands that you have and how active they are. Every person is born with two to four million sweat glands, which become fully active during puberty. Although women have a higher number of sweat glands, men have more active sweat glands than women, so they sweat more.

However, women are more emotionally sensitive to sweating. Women with excessive sweating may try to cover up their problem with perfume and layers of clothes. They may also become withdrawn from social situations, because they are embarrassed of how much they sweat.

But when is excessive sweating just a hassle, and when is it a sign of a serious medical problem?

Excessive sweating after exercising or being in warmer weather is usually not a sign of a problem. However, if you start to sweat for no apparent reason, this may be a sign of something more serious.

You should contact your doctor if your excessive sweating starts to disrupt your regular routine, if you experience night sweats for no reason, and if you are sweating much more than normal.

In some cases, heavy sweating is a warning sign of a thyroid problem, diabetes, and certain infections. Excessive sweating is also a symptom of menopause and hyperhidrosis - a condition in which healthy people sweat excessively and without any apparent reason.

Signs and symptoms of this hyperhidrosis also include:

• Frequent and excessive sweating that soaks through your clothes


• Unusual and heavy perspiration on your head, face, feet, and underarms


• Sweating occurs at least once a week without any reason

Although hyperhidrosis occurs without any triggers, certain things can make the sweating worse, including heat, stress, anxiety and other emotional triggers. Researchers believe that individuals with hyperhidrosis have overactive sweat glands. There is some evidence that the condition runs in families.

There are two types of hyperhidrosis: primary (focal) hyperhidrosis and secondary (general) hyperhidrosis.

Primary (or focal) hyperhidrosis is the most common form. It affects between two to three percent of the population, however 40 percent of people with this condition don't seek medical help for it. The typical onset is in childhood or during the teen years.

It is called "focal" hyperhidrosis because it targets specific areas, including the head, face, hands, feet, underarms, and groin area. Sweating occurs on both sides. Researchers don't know what causes it, but there is some evidence that it may be due to minor malfunctions in your nervous system.

Though not as common as the primary type, secondary (or general) hyperhidrosis is often the more serious of the two. People with this condition sweat all over the body, and they often have excessive sweating at night. This type is called "secondary," because the sweating is being caused by another health condition.

A number of medical conditions can trigger secondary hyperhidrosis, including certain cancers, heart failure, stroke, Parkinson's disease, diabetes, pregnancy, menopause, spinal cord injury, anxiety conditions, stroke, tuberculosis, and other infections.

Unlike with primary hyperhidrosis (which often starts in the teenage years), second hyperhidrosis affects middle aged and older people.

With secondary hyperhidrosis, sweating is sometimes accompanied with other symptoms, including fatigue, insomnia, frequent urination, cough, and increased thirst.

Unfortunately, there is no cure for hyperhidrosis. However, there are treatment options to control the symptoms. Treatment for primary hyperhidrosis includes:

• Strong antiperspirants. You can find them over-the-counter and in prescription sprays. Choose an antiperspirant that contains aluminum chloride hexahydrate for the best result. Antiperspirants plug your sweat ducts, so they will slow down your production of sweat. (Keep in mind that deodorants are not the same as antiperspirants. Deodorants only cover up the smell.)


• Botox injections. Botox has been approved to treat severe underarm sweating. It is injected into the underarm to temporary block the nerves that trigger sweating. Side effects include flu-like symptoms and pain at the injection site. The effects of a single injection may last for a few months.


• Medications. Some medication, such as anticholinergics drugs, can help prevent the stimulation of your sweat glands. Beta-blockers are also available to reduce stress-related sweating.


• Iontophoresis. This is a FDA-approved procedure that uses electricity currents to temporarily turn off your sweat gland. This treatment is most effective for sweating in the hands and feet. Side effects include skin cracking and blisters. Sweating is typically reduced after six or ten sessions.


• ETS surgery. In extreme cases, a surgical procedure called an endoscopic thoracic sympathectomy (ETS) may be performed when all other treatments have failed. In this procedure, the nerves that trigger excessive sweating are cut or destroyed. ETS is usually performed on patients with extreme palm sweating, but it has also been used for excessive facial sweating. Unfortunately, it doesn't work for underarm sweating.

Because secondary hyperhidrosis is often caused by another condition, treatment depends on the condition causing the excessive sweating.





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