A man in his 30’s was attending a party. He suddenly started sweating profusely for no apparent reason. His clothes were soaked in his sweat making his shirt stained. His hands turned cold, clammy, and sweaty. He could no longer shake hands with people and was totally embarrassed. He excused himself and left the party immediately. The symptoms experienced by this person indicate that he is suffering from a condition known as hyperhidrosis.
Sweating occurs due to heat, exercising or in stressful conditions. Sweating is body’s natural way to cool itself, but when a person’s sweating is more than normal then the condition is termed as hyperhidrosis.
The body has two types of sweat glands namely eccrine glands and apocrine glands that help in regulating the body’s temperature. The eccrine glands open onto the body’s surface while apocrine glands develop in groin, armpits, scalp and hair follicles.
When the temperature of the body increases, these glands secrete sweat to cool off the body. If hyperhidrosis is occurring in the sole and palms due to emotional stress then it is called as primary or focal hyperhidrosis.
This occurs in age group under 20 years of age and when the person is awake. Focal hyperhidrosis is not caused due to any underlying health problem and it is found to run in the family.
In secondary hyperhidrosis or generalized hyperhidrosis, there may be a underlying reason for excessive sweating.
The sweating occurs over larger areas of the body and the causes can include hot flashes during menopause, medication like aspirin, blood pressure medications and antidepressants; low blood sugar, lymphoma, leukemia, overactive thyroid, heart attack, infectious disease, cancer, lung disease, Parkinson’s disease, spinal cord injury and tuberculosis.
A few symptoms are mentioned below. They are:
These symptoms affect the person’s social life as he or she will feel embarrassed to shake hands to greet people.
The doctor must be consulted if there is abnormally excessive sweating; sweating without any apparent cause; there is unintentional loss of weight; sweating is accompanied by chest pain, shortness of breath and heart beating faster than normal; profuse sweating during night.
The doctor will inquire about the symptoms and family history of hyperhidrosis from the patient.
The doctor may recommend blood tests and urine tests to check if the patient is having low blood sugar or if there is any underlying thyroid problem.
A thermoregulatory sweat test, starch test, and iodine test may be done to measure the amount of moisture due to sweat. From the results of the tests, the doctor can understand the severity of hyperhydrosis in the patient.
The medications for the treatment of hyperhidrosis include glycopyrrolate or propantheline bromide that acts by stopping the stimulation of sweat glands. They may have side effects like blurry vision, dry mouth and constipation.
An antidepressant product with high levels of aluminum chloride hexahydrate helps to curb sweat production. The brand names of this product available in the market are Drysol, Certain Dri, Xerac and Hypercare. These products have to be applied on the skin during night times, once or twice as suggested by the doctor.
In case the sweating is due to underlying condition like stress or anxiety, then the doctor may prescribe anti anxiety medication.
In severe cases that do not show improved through medication, iontophoresis procedure is conducted in which low level of electricity is passed through a machine over the sweat glands to block them temporarily. This is used mainly for hands and feet.
An injection of botulinum toxin type A is injected into the arm pits to block the sweat glands there. This treatment can be painful and is effective for 4 to 8 months.
The last resort of treatment when all other methods of treatment have failed is surgery, in which the doctor removes the sweat glands or cuts the nerves activating them. This may have the risk of artery or nerve damage and the person can have worsened sweating known as compensatory sweating in later life.
Surgery is also performed to treat the axillary hyperhidrosis. Axillary hyperhydrosis is a condition where there is excessive sweating in the underarm region and also related to facial sweating.
Fighting excessive sweat and body odor has been a problem since ancient times. The ancient Egyptians first made their deodorant from cinnamon and other spices to fight underarm odor. Deodorant sticks made from the plant Aloe Vera were supposedly used by Queen Cleopatra of Egypt.