Hyperhidrosis (excessive sweating)
What is hyperhidrosis?
Hyperhidrosis is the condition of excessive sweating. Sweating is your body's normal mechanism to cool itself but some people produce more sweat than is needed for cooling - called hyperhidrosis. This condition affects about one per cent of the population.
Hyperhidrosis causes
There are 2 categories of hyperhidrosis - primary and secondary.
In primary hyperhidrosis, the most common type, the cause of the excessive sweating is not known. It often starts in childhood and tends to be localised to the palms, soles or armpits.
Secondary hyperhidrosis occurs when the excessive sweating is due to an underlying medical condition. It may affect the whole body. Some of the possible causes include diabetes, an overactive thyroid gland, obesity, menopause, infections, some medicines (especially antidepressants) and, rarely, some tumours.
Effects of hyperhidrosis
Excessive sweating can be socially embarrassing. It may stain the clothing. Hyperhidrosis of the soles may not only result in smelly feet, but may also damage footwear. People with hyperhidrosis of the palms are often embarrassed by a cold, wet handshake. They may have trouble using keypads and other electronic equipment.
Excessive sweating can also predipose you to skin and nail infections such as warts and tinea. Certain other skin conditions, including eczema and rashes, occur more often in people with hyperhidrosis.
If you suffer from excessive sweating, you should discuss it with your doctor. He or she can determine whether you need to have any tests for secondary causes, and can also advise you on options for treatment.
Hyperhidrosis treatments
Antiperspirants and lifestyle treatments
Topical antiperspirants containing aluminium salts may help to reduce sweating, and deodorants may help to disguise any unpleasant odour. Lifestyle remedies that may also help to reduce sweating and associated odour include daily bathing, wearing clothing and footwear made of natural materials that breathe, changing socks often, rotating shoes so you do not wear the same pair 2 days in a row, and going barefoot when possible.
Anticholinergic medicines
Oral anticholinergic medicines (e.g. propantheline, brand name Pro-Banthine) may sometimes be prescribed to reduce sweating but may cause side effects such as blurred vision, dry mouth and constipation.
Iontophoresis
Treatment with iontophoresis has been quite useful for hyperhidrosis of the palms or soles. It involves passing a low-voltage current through the skin which temporarily reduces the production of sweat. Therapy takes about 15-20 minutes and initially is required every day, although after a while it is required less often.
Botulinum toxin
Botulinum toxin (Botox) injections have been found to be effective for hyperhidrosis of the armpits and palms. Botulinum toxin stops the sympathetic nerves (which normally control sweating) from stimulating the sweat glands, and the effect may last between 6 and 12 months. Side effects are generally minimal but may include temporary weakness of the hand muscles after injections to the palm.
Surgical treatments
Surgical treatment for hyperhidrosis of the armpits and palms includes surgical sympathectomy. This procedure involves cutting the sympathetic nerve that supplies the sweat glands in the arm.
Another surgical treatment for hyperhidrosis of the armpits is the removal of the skin containing sweat glands in the armpits, which usually also requires skin grafting.
The effect of surgery is complete and non-reversible. However, both types of surgery may have complications, which may be severe, so it is important to discuss the issues carefully with your doctor.
Last Reviewed: 17 November 2010
- 1. MayoClinic.com. Hyperhidrosis (excessive sweating) (30 Jul 2010). http://www.mayoclinic.com/health/hyperhidrosis/DS01082 (accessed Nov 2011).
2. Hyperhidrosis (revised Feb 2009). In: eTG complete. Melbourne: Therapeutic Guidelines Limited; Jul 2011. http://online.tg.org.au/complete (accessed Nov 2011).
3. DermNet NZ. Hyperhidrosis (last updated 28 Jun 2011). New Zealand Dermatological Society. http://www.dermnet.org.nz/hair-nails-sweat/hyperhidrosis.html (accessed Nov 2011).
