Excessive Sweating (Hyperhidrosis)

Sweating is a necessary part of our physiology.  We need to sweat to cool our body and regulate our temperature.  However, millions of people suffer from excessive sweating.  This is called hyperhidrosis. Hyperhidrosis can be so severe that it can interfere with social and occupational functioning, ruin clothing and cause a lot of undue stress.

What Is Hyperhidrosis?

Hyperhidrosis is excessive sweating.   It can occur anywhere on the body, but the most common areas are the palms and soles.  Sweating is a normal human physiological function and some people sweat more than others.  Hyperhidrosis is diagnosed when the sweating becomes a problem with social or occupational activities and avoidance of these activities starts to occur due to the excessive sweating. It is also diagnosed when someone has to change clothing multiple times a day to stay dry.  Often, these people do not wear lighter colored clothing as it stains and gets ruined by the excessive sweating.

How is Hyperhidrosis Diagnosed?

There is no lab test or biopsy that is performed to diagnose hyperhidrosis.  The diagnosis is based on whether the hyperhidrosis is interfering with the social and occupational functioning of the patient, and whether excessive time and money is being spent to replace and change clothing, or dealing with the problem.  It may be normal for a construction worker or landscaper to have to change clothing multiple times a day due to the work that they do.  However, if a school teacher, architect, banker or musician have to change clothing or begin to avoid work due to excessive sweating, then hyperhidrosis would be diagnosed.



Watch out
If too large of an area or too many areas of excessive sweating are treated, then a phenomenon called “compensatory hyperhidrosis” can occur.   Compensatory hyperhidrosis is when other areas of the body sweat more profusely to make up for the areas of excessive sweating that were treated.  Sometimes the compensatory hyperhidrosis is worse than the original problem.



What Can Be Done To Treat Hyperhidrosis?

Most people with hyperhidrosis will begin to treat their hyperhidrosis by buying the strongest antiperspirant that they can find.  Some over the counter antiperspirants advertise “clinical” strength antiperspirants which are a little stronger than normal strength antiperspirants.  If this fails, an appointment with a dermatologist to discuss the extent of the excessive sweating should be done. The dermatologist can prescribe topical antiperspirants (drysol, hypercare) that are much stronger than what can be obtained over the counter.   Also, oral medications (glycopyrrolate) designed to reduce the amount of sweating can be prescribed to help reduce the sweating.  Sometimes these medications either do not work or are not well tolerated.  If this happens, then botulism toxin, or Botox, can be injected into the area of hyperhidrosis to reduce the sweating.  Botulism toxin will reduce sweating for up to 6 months.   For a more permanent solution, there is a new procedure called MiraDry that is an electromagnetic treatment that permanently destroys the sweat glands in the area of excessive sweating.   Finally, clipping the nerves to the area of sweating in a procedure called a sympathectomy, can be done, usually by a neurosurgeon.

Excessive sweating is called hyperhidrosis.  Since everyone sweats different amounts depending on their profession, hyperhidrosis is only diagnosed when the sweating begins to interfere with social and occupational functioning, or an excessive amount of money or time is spent dealing with it.   There are many ways to treat hyperhidrosis.  If over the counter antiperspirants are not working, then making an appointment with a dermatologist may be helpful to discuss prescription medications or procedures that can improve the hyperhidrosis.