Hyperhidrosis

(Excessive Sweating)

How to Say It: Hi-per-hi-dro-sis

Definition

Hyperhidrosis is excessive sweating. Common places are the palms of the hands, soles of the feet, and/or the armpits.

Sweat Gland

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Causes

Primary hyperhidrosis does not have a cause. It may be triggered by:

  • High emotional states, such as intense sadness, fear, anger, or stress
  • Spicy foods
  • Hot climates
  • Certain medicines

Secondary hyperhidrosis is caused by an underlying health problem, such as:

Risk Factors

Things that may raise the risk of secondary hyperhidrosis are having any of the health problems that cause it.

Symptoms

Problems may be:

  • Excessive sweating of palms of the hands and/or soles of the feet
  • Excessive sweating of the armpits, head, and/or face
  • Increased amount of sweating
  • Change in pattern of sweating
  • Change in the sweat odor
  • Stained, wet clothing

This problem can be embarrassing and affect relationships.

Diagnosis

The doctor will ask about your symptoms and health history. A physical exam will be done. This may be enough to make the diagnosis in some people.

Tests may be done to find out what may be causing the problem.

Treatment

The goal is to manage symptoms.

Topical Treatments

Treatments can be applied to ease sweating. These are:

  • Aluminum chloride hexahydrate
  • Aluminum tetrachloride
  • Formalin compresses
  • Glutaraldehyde compresses
  • Iontophoresis (stimulation with electrical current)

Medications

Medicines may be used to treat secondary hyperhidrosis.This is not common due to side effects. They may be:

  • Amitriptyline
  • Clonazepam
  • Beta blockers
  • Calcium channel blockers
  • Gabapentin
  • Oxybutynin
  • Indomethacin

Botulinum A Neurotoxin

Botulinum A neurotoxin injections can ease sweating in certain areas. It is often used on the palms of the hands and armpits. It can last 6 to 8 months.

Surgery

Some people may choose to have surgery. Choices are:

  • Endoscopic thoracic or lumbar sympathectomy to kill the nerves that stimulate sweating
  • Curettage to remove sweat glands with surgical scraping
  • Liposuction techniques to remove sweat glands

Prevention

There are no current guidelines to prevent hyperhidrosis.

RESOURCES:

Family Doctor—American Academy of Family Physicians
https://www.familydoctor.org
International Hyperhidrosis Society
https://www.sweathelp.org

CANADIAN RESOURCES

References:

Hyperhidrosis. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/hyperhidrosis. Accessed October 23, 2020.
McConaghy JR, Fosselman D. Hyperhidrosis: Management Options. Am Fam Physician. 2018 Jun 1;97(11):729-734.
Last reviewed September 2020 by EBSCO Medical Review Board Daniel A. Ostrovsky, MD
Last Updated: 10/23/2020

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