Hyperhidrosis

The most common type of hyperhidrosis affects certain body sites only. The palms, soles, armpits, face and scalp, or a combination of these are common places. The cause is not known. It usually begins in childhood or teenage years and may improve with age.

Sweating all over can be without a cause or can be caused by some illnesses including infections, and by hormonal conditions including the menopause, diabetes, and an overactive thyroid gland. Some medicines can also cause the problem, including fluoxetine and similar antidepressants.

Rarely, increased sweating can be caused by nerve damage.

Anxiety can worsen sweating, and so worrying about sweating can make the problem worse.

Is hyperhidrosis hereditary?

Hyperhidrosis is a feature of some rare inherited conditions. Up to a third of people with hyperhidrosis may have a family member with the condition.

Visible sweat, wet clothes and clammy palms are common symptoms. People often find this embarrassing and it can affect work and personal relationships. Sweaty hands can cause problems with shaking hands, writing on paper, using keyboards, playing musical instruments, and playing racquet sports.

Hyperhidrosis affects the water-producing (“eccrine”) sweat glands, and not the “apocrine” sweat glands which produce the oilier type of sweat and cause odour, especially under the arms. Therefore, bad odour is not a direct result of hyperhidrosis; however, if your feet sweat excessively, an overgrowth of harmless skin bacteria can cause an unpleasant smell.

Your doctor will assess which kind of hyperhidrosis you have. The doctor may rarely suggest you have tests for an infection, diabetes, thyroid overactivity, or other conditions.

Can hyperhidrosis be cured?

Hyperhidrosis seems to get better with increasing age and is uncommon in the elderly. There are many treatments that help reduce sweating.

Surgical treatment, such as a sympathectomy, can help some people, but is often associated with serious side effects, so is not usually recommended.

How can it be treated?

Most people with hyperhidrosis will have tried commercial antiperspirants. If these fail, and if the sweating is troublesome, you should ask your doctor for advice. The doctor will assess whether there might be an underlying cause and may start treatment. If necessary, you may be referred to a dermatologist.

There are several ways you can help yourself. You should try to avoid situations, which you find trigger your sweating, such as hot places or rushing about. Alcohol and spicy foods can also bring on an episode of hyperhidrosis.

Absorbent underlayers such as cotton T-shirts (wicking fabrics) can help hyperhidrosis of the body. Adhesive absorbent underarm pads for clothing are available. Loose fitting clothes made of natural fibres and leather shoes/sandals are also beneficial. Changes of clothes may be necessary during the day. Some colours show sweat more than others (white and black are better than blue, for example).

If your feet are the main problem, you may need to change socks and shoes during the day. You may be able to slip your feet out of your shoes even for short periods. Avoid tight-fitting shoes such as boots or sports shoes; leather shoes are generally better. You should have several pairs of daytime shoes so that each pair has a few days to dry out. There are many good, absorbent insoles available that will also help. Cotton, silver, and copper socks are also helpful for many, those may work by helping to reduce sweating or to reduce odour secondary to the excessive sweating.

Often anxiety can also play a role; in this case relaxation techniques and counselling can help.