Hyperhidrosis : Causes, Types, Treatment and Symptoms

Hyperhidrosis is a medical illness that causes excessive sweating. It can be primary or focal, affecting only certain areas like the palms and underarms, or secondary, affecting wider areas because of another condition. It can start in childhood and have a big effect on a person’s physical, mental, and social health.

Most Common Hyperhidrosis Symptoms:

• Excessive sweating from underarms, hands, feet, or face, even when the environment is cool or the person is resting
• Visible sweating that soaks through the clothing or forms beads on the skin
• Frequent episodes of sweating that interfere with daily activities, such as shaking hands, holding objects, writing, or operating a desktop.
• Bilaterally sweating
• Emotional or social discomfort due to sweating
• The skin in the affected area may appear pink, white, cracked, scaly, or soft.
• Possible odor due to bacteria and yeast on the moist skin.

Common, Uncommon or Underlying Causes of Hyperhidrosis

Hyperhidrosis can be caused by either primary factors (nerve overstimulation without an underlying disease) or secondary factors (an underlying medical condition or medication); therefore, determining the cause is critical for effective therapy.

Here are some reasons for hyperhidrosis:

• Age
• Heat
• Anxiety
• Humidity
• Nervousness
• Febrile illness
• Physical activity
• Caffeine consumption
• Possible genetic mutation
• Chronic alcohol consumption
• Side effects of certain medications
• Overactivity of specific body areas
• Metabolic disorders like diabetes mellitus, obesity
• Faulty nerve signal overstimulating eccrine glands
• Infections such as bacterial endocarditis and sepsis
• Rare metabolic conditions and neurological disorders
• Endocrine disorders like hyperthyroidism and menopause
• Nervous system problems in cases of asymmetric sweating
• Systemic disorders or several underlying medical conditions
• Neurological disorders like Parkinson’s disease and brain stroke
• Several medical conditions, including rheumatoid arthritis, heart failure, or stroke.

When to Seek a Specialist for Your Hyperhidrosis?

Seeing a healthcare professional may help you determine whether hyperhidrosis is primary or secondary (related to an underlying condition), rule out other reasons, and provide appropriate treatment choices, such as prescription antiperspirants, drugs, or treatments.

Visit your specialist if these hyperhidrosis symptoms are present:

• When it disrupts your daily routine or activities
• When over-the-counter antiperspirants fail to work
• Experience night sweats without a clear cause
• Sweating accompanied by dizziness or chest pain
• Causes emotional distress, social anxiety, or withdrawal symptoms
• Frequent sweating occurs once a week in the palms, feet, underarms, and face
• Interfere with daily chores, such as sweeping, mopping, or holding objects, and writing for a prolonged period of time.

Don’t wait for signs to grow severe. Consult our dermatologist today

Diagnostic Approach for Hyperhidrosis

A specialist-approved diagnostic approach for hyperhidrosis often ensures an accurate diagnosis, rules out underlying causes, and guides the selection of appropriate treatment options.

Here are the specialist-approved diagnostic steps:

• The dermatologist collects information on the onset, duration (6 months or more), frequency, and pattern of sweating episodes.
• A family history of excessive sweating is also noted.
• Observes areas of sweating and performs tests, such as the starch-iodine test, to visualize areas of sweat production.
• To differentiate between primary and secondary hyperhidrosis, the specialist may perform:
  – Complete blood count
  – Basic metabolic panel
  – Thyroid function tests
  – Skin conductance test
  – Thermoregulatory sweat test
  – Blood glucose or HbA1c, inflammatory markers, autoimmune antibody tests,
  – Chest X-ray if infections or malignancies are suspected
• Gravimetric testing to weigh sweat production.
• Evaporimetry to measure skin water vapor loss in research or complex cases.
• If the patient reports scales such as the Hyperhidrosis Disease Severity Scale (HDSS), the specialist may assess the drawback of how the condition affects daily life and psychosocial well-being.
• To determine primary hyperhidrosis, one must have excessive, visible sweating at least once per week; bilateral and symmetric involvement (palms, soles, axillae, face); onset younger than 25 years; no sweating during sleep; and a positive family history.

Types of Hyperhidrosis

Knowing these categories helps with diagnosis and treatment since primary hyperhidrosis is addressed by treating the symptoms, but secondary hyperhidrosis needs to find and treat the underlying medical reason.

Commonly classified types of hyperhidrosis include:

1. Primary focal hyperhidrosis: This condition has an overactive sweat gland with no underlying cause. Begins in childhood or adolescence. Happen at least once a week and do not happen during sleep.
2. Secondary generalized hyperhidrosis: This condition occurs as a result of an underlying condition or side effect of a medication. Begins in childhood, affecting a larger area of the body.
3. Based on the areas affected:

• Palmar hyperhidrosis: Excessive sweating of the hands
• Axillary hyperhidrosis: Excessive sweating of the armpits
• Plantar hyperhidrosis: Excessive sweating of the feet
• Facial hyperhidrosis: Excessive sweating of the face
• Truncal hyperhidrosis: Excessive sweating of the abdomen, back, and chest
• Generalized hyperhidrosis: Excessive sweating over the entire body

How to Treat Hyperhidrosis Symptoms?

Treatment for hyperhidrosis usually follows a step-by-step process that varies depending on its severity and location, and may include a wide range of therapies, from mild to invasive. Treatment for secondary hyperhidrosis, on the other hand, must focus on the underlying cause or medicine.

For underlying causes, treatments & rehabilitative strategies include:

• Iontophoresis: Electrical current treatment for palmar and plantar hyperhidrosis
• Topical treatments: Application of topical 20% aluminum chloride under a doctor’s supervision.
• Botulinum toxin injections: To block nerve signals conducting to sweat glands in cases of axillary, palmar, facial, and plantar hyperhidrosis
• A dermatologist prescribed oral medications
• Microwave therapy
• Local removal of the sweat glands

What if Hyperhidrosis is Left Untreated?

If you don’t address hyperhidrosis, it can cause serious physical, dermatological, and psychological difficulties, such as chronic skin problems, a higher risk of infections, psychosocial concerns, and a big drop in quality of life.

Some possible complications of an untreated hyperhidrosis include:

• Relationship with significant other affected
• Fear of being in public situations or public view
• Feelings of embarrassment and shame
• Feeling unhappy and losing control of everyday life
• Fear of other people’s reaction
• Low self-esteem and self-confidence
• Difficulty holding books or phones, turning doorknobs, and opening jar lids
• Reduced effectiveness at work
• Avoiding savory spicy foods

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