HYPERHIDROSIS (EXCESS SWEATING)

Excess sweating affects up to 3% of people, and over 110,000 people suffer from axillary (underarm) hyperhidrosis in Australia alone. Women seem to be more impacted than men, and the condition often establishes itself in childhood or adolescence, although adult onset does also happen.  Not everyone suffering the condition reports it to their doctor, so statistics quoted may be an underestimate of the number of people with hyperhidrosis, with some reports indicating the condition being reported in only 1 case in 3.

The condition is generally described depending on which part or parts of the body are affected.

Axillary Hyperhidrosis

Excessive sweating occurs in the armpits. This is one of the most common types.

Palmar Hyperhidrosis

Excess sweatiness affects the palms of the hands - 'sweaty palms', also common.

Plantar Hyperhidrosis

The condition affects the feet.

Craniofacial

The condition is present on the face or the head.

The condition impacts the quality of life both at work and at home. As well as the social stigma of excess sweating, hyperhidrosis has other disadvantages - sufferers need to clean clothes more frequently or buy new clothes. They may have difficulty operating machinery, or for example, playing an instrument or using touchscreen devices with palmar hyperhidrosis. Although it is regarded as being a benign condition, i.e. of no particular danger to health in itself, it can cause other issues such as infections, both fungal (e.g. candidiasis) and bacterial.

CAUSE

There are no clear indications of what causes the condition. However, it is linked to anxiety or nervousness, and in some cases, it is related to diet or lifestyle, with nicotine and caffeine, for example, implicated in some cases. There may also be a family predisposition to hyperhidrosis. Secondary hyperhidrosis is linked to diabetes, thyroid or pituitary problems, obesity and menopause. It can also be caused by nerve damage from injury or disease.

Where treatment can abate excess sweating in one location, it may increase it at another part of the body. This is referred to as 'compensatory hyperhidrosis'.

TREATMENT

General measures

Avoid the dehydration associated with the condition by drinking water regularly
Taking a shower or a bath every day and drying affected areas carefully (this ensures there is no build-up of bacteria)
Avoiding any food or drink or other factors (e.g. smoking/nicotine) that may trigger excessive sweating
Using antiperspirants AND deodorant to reduce sweating and control odour
Choose natural fibre clothing
Remove shoes and socks where possible, change socks frequently and rotating pairs of shoes so that you do not wear the same pair two days in a row if the hyperhidrosis affects the feet
Consider psychotherapy, hypnosis and behavioural therapy if hyperhidrosis is brought on by nervousness or panic attacks 

Iontophoresis

Iontophoresis involves a mild electric current being passed through water in a tray. Hands (or feet) are placed into the water for between 20-40 minutes, and the treatment temporarily blocks the sweat glands. The technique has been in use since the 1940s and can decrease sweat production considerably. 

Anticholinergic medications

These block nerve signals and so can be used to treat 'generalised hyperhidrosis'.

Botox Injections

Botulinum toxin type A injections are useful for the treatment of axillary hyperhidrosis (underarm) and generally last for 4-6 months.

Destroying of sweat glands in the armpit

Miradry, liposuction, subcutaneous curettage or laser.

Endoscopic Thoracic Sympathectomy (ETS)

This surgical procedure involves cutting a set of nerves called the 'spinal sympathetic nerves' which control sweat glands under the arm and on the palms. This option is generally an option of last resort, where the patient has not responded to other treatment. 

 

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