Hyperhidrosis is a medical condition or disorder defined as excessive sweating. Sweating is not the most pleasant topic of discussion, especially when it occurs excessively. The condition is also known as polyhidrosis or sudorrhea. Excessive sweating can be caused by different factors such as genetics, underlying health concerns, or unknown causes. Most people’s sweat glands produce higher amounts of sweat when it is hot, when their bodies are working hard, or even when they are anxious. Those who suffer from hyperhidrosis have sweat glands that produce much more sweat than normal people, sometimes with no cause at all.

This condition affects as many as 2-4.5% of the population, although some suggest that number may even be higher, as the condition often goes unreported. Many people do not realize it is a potentially treatable condition and do not seek treatment until many years after the condition develops.

For many who suffer from hyperhidrosis, this is not just an uncomfortable condition physically but also psychologically. Physical discomfort can present in the form of bacterial infections on often-wet areas, the inability to grasp items well because of sweaty palms, and accompanying effects like sweat stains on clothing. Psychological effects include loss of self-confidence, avoiding people, and even seeking jobs that do not require interaction with people or sustained physical effort.

Thankfully, there is a lot of information available on hyperhidrosis. There are known causes and multiple lines of treatment. For many people, hyperhidrosis no longer has to control their lives. They can live more comfortably with effective treatment of the condition.

Focal hyperhidrosis is excessive sweating concentrated in certain areas, or foci. This may be the palms and soles of the feet, or face, and is often the same on both sides of the body. Typically, this kind is the primary type of hyperhidrosis. Focal hyperhidrosis or primary focal hyperhidrosis occurs without an underlying health cause. The sweat glands become overactive, triggered by the nerves that control them. This triggering happens without the environmental conditions like a rise in temperature or exertion by the body that typically trigger sweating in a person who sweats a normal amount.

Generalized hyperhidrosis is excessive sweating throughout the body, not concentrated in one particular area. Oftentimes, generalized hyperhidrosis falls into the secondary category of causes. This means there is an underlying health condition that may be causing the excessive sweat. In these cases, it is best to first try to deal with the underlying condition rather than just masking the symptom of excessive sweating.

Hyperhidrosis can be caused by many factors. Primary hyperhidrosis can sometimes be genetic, occurring more often in families that have a history of excessive sweating. Secondary hyperhidrosis is most commonly caused by an underlying medical condition. Some of the conditions that can cause secondary hyperhidrosis include:

• Diabetes
• Hot flashes (like those experienced in menopause)
• Heart attack
• Low blood sugar
• Thyroid problems
• Infections
• Lung disease
• Parkinson’s disease
• Anxiety disorders
• Opioid withdrawal
• Medications
• Some kinds of cancer
• Endocrine disorders
• Neurologic disorders (including injury to the nervous system)
• Illnesses like COVID-19

If you are experiencing any of these symptoms along with hyperhidrosis, it is best to speak to Dr. Dima Ali for more health information.

Hyperhidrosis may be more common than the numbers show. There are statistics that say anywhere from 2-4.5% of the population suffers from this condition, but some believe that is a low number. This is because many people do not know that excessive sweating is a treatable health condition, and they continue to live with it for years after it begins. Many who have the condition begin to have symptoms as early as their teenage years, but do not seek medical treatment for an average of 9 years.

There are a number of tools a doctor can use for the diagnosis and treatment of hyperhidrosis. These may include questionnaires about your history (When does it occur? What triggers it? Where on the body does it occur? Do other symptoms accompany the sweating?) or a test made of special powders that react to moisture. Powders, like those in a starch-iodine combination, are placed on areas where hyperhidrosis is suspected. The powder will turn a dark blue color if moisture is present. Often, the patient will be tested both at room temperature and in a heated environment. If the palms, for example, sweat more than other areas of the body, hyperhidrosis is probably at play.

Another diagnosis method for hyperhidrosis is a paper test, where special paper is placed in the suspected area and then weighed to measure the amount of sweat present. If Dr. Dima Ali suspects an underlying health condition is causing you to sweat excessively, she may order blood or imaging tests to check for these.

Hyperhidrosis treatment is multifaceted, and the treatment options can be different depending on the type of hyperhidrosis. Patients can seek out some treatments without a doctor, such as over-the-counter antiperspirants, which may be effective in reducing production from sweat glands. Although some people are concerned that antiperspirants and products containing aluminum chloride have a health risk, The American Academy of Dermatology states there is no evidence that antiperspirants cause an increased chance of breast cancer or Alzheimer's. If this alone is not effective to reduce sweating, Dr. Dima Ali may recommend a prescription antiperspirant containing aluminum chloride hexahydrate.

Other available treatments at WellMedica  to reduce overproduction of sweat glands include:

Antidepressants: Some antidepressant medications can reduce hyperhidrosis directly, and some can reduce anxiety that is causing the condition.

Botulinum Toxin: Injections of botulinum toxin-a, or Botox®, are used to treat axillary hyperhidrosis. First, an area like the hands, feet, or underarm is numbed, so there is less discomfort from the injections. Many tiny injections are then placed by a provider where excessive sweating occurs. The Botox® temporarily blocks the nerves that cause excessive sweating. The sweat glands no longer receive the signal to produce sweat and the sweating may be reduced for months. Because Botox® wears off after 3-4 months, patients need to return to the clinic periodically for repeated treatments.

Radiofrequency Therapy: The most recent solutions for hyperhidrosis are ThermiDry by ThermiTight, which are minimally invasive treatments that help to reduce excessive sweating through radiofrequency technology. These treatments use a device that delivers radiofrequency energy beneath the skin. Radiofrequency energy is typically used for nonsurgical facelifts; however, when used for hyperhidrosis, individuals have experienced incredible results that are long-lasting. Our patients have noticed drastic differences with much of the same results as Botox®, but at a lower cost and less frequent appointments. Results can last for several years as compared to Botox®, which lasts about 3-4 months.