Hyperhidrosis is a medical condition in which a person sweats excessively and unpredictably. People with hyperhidrosis may sweat even when the temperature is cool or when they are at rest.
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.
However, excessive sweating occurs without such triggers. Those 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's called primary or focal hyperhidrosis. Primary hyperhidrosis affects 2 - 3% of the population, yet less than 40% of patients with this condition seek medical advice. In the majority of primary hyperhidrosis 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:
The primary symptom of hyperhidrosis is wetness.
Visible signs of sweating may be noted during a doctor's visit. A number of tests may also be used to diagnose excessive sweating. Tests include:
You may be also be asked details about your sweating, such as:
Treatments may include:
Aluminum chloride: Initially a patient may need to use it three to seven times a week. After sweating becomes normal, the person may need to use it only once every one to three weeks. If skin irritation is a problem, a doctor may temporarily prescribe a steroid-based cream.
Botox: Swelling goes away in a few weeks. The effect of a single injection can last up to a few months. Some patients need additional injections.
Iontophoresis: Sweating may be reduced after six to 10 sessions. After that, the person may need treatment once every one to four weeks.
Some of the causes of hyperhidrosis can be serious. Always consult a doctor if you have excessive sweating.
Call your health care provider if you have:
Sweating - excessive; Perspiration - excessive; Diaphoresis
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Reisfeld R, Berliner KI. Evidence-based review of the nonsurgical management of hyperhidrosis. Thorac Surg Clin. 2008 May;18(2):157-66. Review.
Hornberger J, Grimes K et al. Recognition, diagnosis and treatment of primary focal hyperhidrosis. J Am Acad Dermatol 2004; 51: 274-86
Lowe NJ, Glaser DA, Eadie N, et al. J Am Acad Dermatol. 2007 Apr;56(4):604-11. Epub 2007 Feb 15.Botulinum toxin type A in the treatment of primary axillary hyperhidrosis: a 52-week multicenter double-blind, randomized, placebo-controlled study of efficacy and safety.
Solish N, Benohanian A, Kowalski JW. Prospective open-label study of botulinum toxin type A in patients with axillary hyperhidrosis: effects on functional impairment and quality of life. Dermatol Surg. 2005 Apr;31(4):405-13.
Updated by: Kevin Berman, MD, PhD, Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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