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Hyperhidrosis is the medical term for a condition marked by excessive sweating (perspiration) without triggers such as heat or overexertion due to overactive sweat glands. It can happen in cold temperatures, when resting, or at other random times.
Sweating associated with hyperhidrosis can occur for no reason and can affect any area of the body, including the face, chest, armpits, palms, groin (genitals), soles of the feet, and lower back. It can also impact the entire body at once.
Hyperhidrosis typically affects both sides of the body at the same time. It is not a serious health threat, yet it can adversely affect the quality of life. It may sometimes be uncomfortable and can cause psychological damage, including embarrassment in social situations.
While sweating is beneficial for helping the body regulate temperature, with hyperhidrosis, the body sweats more than is necessary due to overworking sweat glands.
Primary focal hyperhidrosis is the most common type, caused by a genetic mutation resulting in a chronic condition that appears most often before the mid-twenties. The face, armpits, hands, and feet are the most common areas to experience sweating.
Secondary generalized hyperhidrosis occurs in response to a medication or medical condition and can cause sweating while asleep. Parkinson’s disease and diabetes are examples of conditions that can cause this form of hyperhidrosis.
How Do We Sweat?
The human body has approximately two to four million sweat glands used in thermoregulation. Though consisting primarily of water, sweat is also about one part fat and salt.
The autonomic nervous system controls sweat, and it occurs without thought or control. In hot weather, or when the body overheats due to exertion, sweat releases from the glands through skin ducts to moisten the skin’s surface. The moisture cools the body as it evaporates.
Sweating due to hyperhidrosis can cause the following symptoms:
● Damp skin
● Beads of liquid dripping from the head or body
● Damp clothing
● Body odor due to sweat mixing with bacteria
● Peeling or cracked skin of the feet
● Itching of the skin due to sweat irritation
● Embarrassment due to body odor, damp skin, or sweat stains on clothes
Types of sweat glands:
● Eccrine glands
The most abundant type of sweat glands, eccrine glands, fall under the category of merocrine glands, a classification of exocrine glands. Eccrine glands cover most of the body’s surface and release the most sweat. The soles of the feet and the palms of the hand have the highest density of sweat glands on the body.
While exocrine glands are known for secreting various substances, merocrine glands do so without damaging the secretory cells.
Besides sweating from eccrine glands, merocrine glands have many other functions, as they are also comprised of pancreatic and salivary glands. Merocrine glands also play an essential role in hormone balance as enzymes from the salivary and pancreatic glands help with food breakdown and digestive processes necessary for nutrient absorption and physiological functions, including hormone production. Discover more about the functions of merocrine glands.
● Apocrine glands
Hair follicles in the scalp, groin, face, breasts, and armpits are home to apocrine glands that secrete a heavier, fattier, odorous sweat, often called “body odor.” The cause of the odor is the breakdown of sweat mixing with the bacteria on the skin.
Apocrine glands are larger than eccrine glands and typically do not function until puberty. They open into hair follicles rather than on the skin surface. Sweat from apocrine glands contains lipids, ammonia, protein, and sugar.
● Apoeccrine glands
Although they begin as eccrine glands, apoeccrine glands develop in the axillary (armpit) region between ages 8 and 14 (puberty). Although they share eccrine and apocrine gland properties, they empty their salt water secretions onto the skin’s surface.
Unlike eccrine gland sweat, the secretions from the apoeccrine glands do not play a leading role in thermoregulation due to their underarm locations.
What Can Trigger Over Sweating?
Sweating can occur for many reasons – some conscious and others without our knowing why. There can be an underlying medical issue with hyperhidrosis, so it is crucial to speak with your physician, especially if you also experience shortness of breath, chest pain, dizziness, or extended sweating for no reason.
Hyperhidrosis can run in families due to a hereditary genetic mutation.
If you have hyperhidrosis, you might want to keep a journal to help the doctor pinpoint if there is a trigger for your sweating. Jot down the location, time, any other symptoms, and what you were doing or eating when the sweating occurred to see if there is a pattern.
● Stress, anxiety, fear, or nervousness
The body can respond to emotional situations and conditions by increasing sweat in response to increased heart rate and adrenal levels. Stress sweat comes from the apocrine glands, so it does not cool the body like sweat from the eccrine glands.
● Warm temperatures or humidity
Heat and humidity cause the body’s temperature to rise. In response, the sweat glands release sweat to the skin’s surface to help cool the body as the moisture evaporates.
● Exercise or physical activity
Any physical activity can overheat the body and cause sweating to regulate its temperature.
● Menopause and andropause
Changing hormone levels can cause women and men to experience hot flashes or night sweats. Restoring balance to these levels through hormone replacement therapy can help reduce sweating.
● Certain foods and beverages
If you have ever taken a bite of a hot pepper, you know that sweat can form rapidly on your brow. Called gustatory sweating, the body responds to the stimulus of spice, caffeine, and alcohol by increasing sweat. Gustatory sweating can also happen to some people when they think about or eat food.
● Illness and medication
Some illnesses and medications can cause the body to sweat, including but not limited to the following:
▪ Fever
▪ Infection
▪ Cancer
▪ Heart disease or heart attack
▪ Parkinson’s disease
▪ Diabetes
▪ Lung disease
▪ Tuberculosis
▪ Stroke
▪ Acromegaly
▪ Low blood sugar (hypoglycemia)
▪ Overactive thyroid gland (hyperthyroidism)
▪ Spinal cord injury
▪ Complex regional pain syndrome (CRPS) that affects a leg or arm
▪ Fever-reducing medications
▪ Synthetic thyroid hormones
▪ Painkillers, such as morphine
▪ Insulin
▪ Albuterol
▪ Hydrocodone
▪ Naproxen
▪ Bupropion
What Are Treatment Options?
Speaking with a doctor to determine the best treatment option for your situation is vital. Some people turn to their primary care providers, while others contact a dermatologist, especially when the skin’s sweat glands are at fault.
If the problem is just in your armpits, trying an over-the-counter antiperspirant first is the best option. Antiperspirants seal the sweat glands to decrease sweat production. Aluminum-based antiperspirants provide the best results.
● Medications
Aside from prescription-strength antiperspirants, the doctor may prescribe antidepressants if emotions trigger sweating. Beta-blockers, anticholinergic agents, aluminum chloride gel, and medicated wipes may help decrease sweating.
● Hyperhidrosis treatment therapies
If at-home treatments and medications do not help, the doctor may recommend any of the following options:
▪ Botox injections: botulinum toxin injected into an overactive nerve can stop or reduce sweat production for a few months
▪ Iontophoresis: treatments that send electrical currents through water in a shallow tub containing your hands or feet can help block sweat glands
▪ Microwave therapy: a device that emits thermal energy is placed against your skin in an area that contains overactive sweat glands to destroy the glands permanently
● Surgery
As a last resort, two surgical options are possible:
▪ Sweat gland removal: the gland is removed through cutting, lasers, liposuction, or scraping
▪ Endoscopic thoracic sympathectomy (ETS): a less invasive option, a nerve leading to the sweat gland is cut to prevent sweat production signals
Are there any steps to take that are not medical to help minimize sweating?
Yes, although they may not always work for everyone, there are some things you can do to help reduce sweating and improve comfort, including:
● Decrease consumption of alcohol, caffeine, and spicy foods
● Drink more water to hydrate your body
● Use sports drinks to replace electrolytes the body loses through sweating
● Wear layers of light clothing that allow the skin to breathe
● Choose cotton clothes and sheets instead of polyester and other blended fabrics that can trap heat
● Remove or add layers, as needed, based on body temperature and comfort
● Remove sweaty clothing as quickly as possible to reduce bacteria buildup that can lead to infections
● Wash your skin and face to remove dried sweat as soon as possible
● Try different brands of antiperspirant to find the one that works best for you; if necessary, ask your doctor for prescription-strength products
● Bathe or shower more frequently
Conclusion
Hyperhidrosis is an unpleasant condition for approximately 3 percent of the adult population in the US. It is not always preventable and can cause embarrassment and other emotional issues.
While there is no cure, there are treatment options to help make it more manageable. A healthcare professional can help you find the one that works best for you.
Contact your doctor if sweating worsens over time, interferes with sleep, adversely affects your life, or causes you to avoid socialization and activities. Sweating can interfere with work-related tasks, such as typing, holding tools, or playing an instrument.
Seek immediate medical attention if sweating accompanies chest pain, dizziness, or nausea.
