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Excessive Sweating (Hyperhidrosis)

  • Excessive perspiration that can get in the way of daily life and cause skin infections
  • Types include primary hyperhidrosis and secondary hyperhidrosis
  • Treatments range from prescription-strength antiperspirant to medication and in-office procedures
  • Involves Dermatology

Overview

Working up a sweat on hot, muggy days or while exercising is only natural and, in fact, healthy. Sweating is the body’s way of cooling down. But sometimes, the body sweats too much, which is the case for people who have a medical condition called hyperhidrosis.

In people with hyperhidrosis, the body’s 2 to 4 million sweat glands are overactive, causing profuse perspiration at times when others would sweat lightly (if at all). They sweat a lot even when weather or physical activity don’t warrant it. If this is the case for you or a loved one, you might consider talking to a dermatologist about it because there are treatments that can help.

If you find yourself staining your shirts on a daily basis, feeling embarrassed to give a handshake because of dripping palms, sweating in the midst of a winter blizzard or coming home to a puddle of sweat in your sneakers, it may be the time to speak with a board- certified dermatologist for an evaluation. Sometimes the condition is caused by medications or a medical condition, but most of the time there is no underlying cause. 

At Yale Medicine Dermatology, we understand that hyperhidrosis can interfere with your day-to-day life and cause embarrassment. We do a thorough evaluation to determine if there is a cause of sweating and then customize a treatment regimen that fits your lifestyle.

What is hyperhidrosis?

People who sweat excessively find that their perspiration gets in the way of their daily lives. Besides the obvious social stigma and discomfort hyperhidrosis causes, people with this condition may also get skin infections caused by fungi and yeast in places the skin gets too wet, too often.  

Though we know that excessive sweating is triggered by overactivity of the sympathetic nervous system, it’s unusual that a cause can be identified. Sometimes, however, hyperhidrosis can be caused by disorders of the thyroid, menopause or certain medications. The condition affects about 3% of Americans.

There are two types of hyperhidrosis:

Primary hyperhidrosis: Often, people who have this condition sweat excessively from only one or two parts of the body, not all over. Their feet, hands, underarms, foreheads, palms or scalps may get sopped (embarrassingly so), while the rest of their bodies sweat normally. This condition is not associated with a systemic disorder.

Secondary hyperhidrosis: This type of hyperhidrosis can happen in one or two locations on the body, or it can affect the entire body. It results from some medications or from a medical condition. Here are some conditions commonly associated with secondary hyperhidrosis:

  • Overactive thyroid
  • Diabetes
  • Menopause
  • Head injuries
  • Spinal cord injuries
  • Obesity
  • Tumors

Is odor an issue with hyperhidrosis?

There is some good news associated with the condition: Most people don’t have body odor issue from their hyperhidrosis. Even so, you may want to take steps to be sure that you don’t get body odor (bromhidrosis) associated with your excessive sweating. Here are some things you can do:

  • Bathe daily with an antibacterial soap.
  • Change socks and shoes often.
  • Use an antiperspirant or deodorant under the arms.
  • Apply shoe spray for foot odor.
  • Decrease your intake of certain foods like garlic, asparagus and curry that can contribute to body odor. 

Do the antiperspirants or deodorants used to treat excessive sweating cause breast cancer?

While there has been research on the topic, there is no conclusive evidence at this time that regular use of these products is associated with breast cancer development, according to an article in the journal Epidemiology.

There are many natural and clinical-strength formulas to try, and it’s really a matter of personal preference. So find what works best for you.

How is hyperhidrosis diagnosed?

Your dermatologist will take a medical history, and ask questions about your sweating patterns. Sometimes bloodwork is needed to determine if there’s an underlying medical cause for hyperhidrosis.

Who gets hyperhidrosis?

People of all ages can experience excessive sweating. Dermatologists note that:

  • Hyperhidrosis tends to run in families.
  • Some medical conditions (like menopause) may cause sweating.
  • Certain medications can cause excessive sweating.
  • The problem occurs despite the climate.
  • More people probably have hyperhidrosis than are diagnosed.

What are the treatments for hyperhidrosis?

If wearing an antiperspirant to stop wetness isn’t working well enough to control your sweating problem, there are several treatments available:

  • Prescription strength antiperspirants: Your doctor may recommend applying these products overnight and/or under a layer of plastic wrap. This improves their efficacy by helping the formula to penetrate into the skin, where the sweat glands are located.
  • Medications: Your doctor may prescribe medications that help prevent the sweat glands from releasing sweat. This may not be an option for people who live, work or exercise in areas with high temperatures (because sweating cools the body) or who have certain medical conditions. New medications are in the pipeline, too, (from Brickell BioTech and Dermira) that may offer solutions in the future for patients with hyperhidrosis.
  • Iontophoresis: This device works by temporarily turning off the sweat glands via delivery of a low-voltage current to the nerves, while you soak your hands or feet in a shallow pan of water. Follow your dermatologist’s advice on how often to do the treatment.
  • Botulinum toxin injections (like Botox):  Botox injections are FDA-approved for use in the armpit area for people with hyperhidrosis. Given by a dermatologist, the injections are effective for several months after treatment. They work by blocking the release of a chemicals that cause sweating to occur.

Surgery, though not performed at Yale, is another option for hyperhidrosis. 

Why is Yale Medicine dermatology unique in its ability to treat hyperhidrosis?

Yale Medicine dermatologists understand the sensitivity associated with seeing a doctor for hyperhidrosis.

“Hyperhidrosis is common, and probably even more than currently realized because many patients don’t mention the issue. This is often either due to embarrassment, self-consciousness or a lack of knowledge that treatment options exist or which physicians might offer them," says Yale Medicine dermatologist Sara Perkins, MD. “Anyone concerned about their level of perspiration, is wiping sweat from their forehead regardless of temperature or activity level, or avoids raising their arms or shaking hands because of obvious moisture should see a dermatologist to discuss management options. For many patients, finally addressing the issue can be life-changing.”