What is Excessive Sweating/Hyperhidrosis?

Sweating is a normal way of keeping your body temperature regulated either in hot weather or during exercise. When this sweating becomes excessive, or occurs even when it is not necessary, it is called hyperhidrosis, and mainly affects the hands, feet and armpits. Excessive sweating can be very embarrassing, and can have psychological as well as physical symptoms, such as a social phobias, anxiousness and depression.

There are two main types of excessive sweating, focal or generalized, and treatments vary according to each type.

Focal hyperhidrosis is when excessive sweating occurs in a particular ‘focal’ place such as the hands, armpits, feet or face. The rest of the body will sweat normally. This usually occurs because the sweat glands in the focal points are overly sensitive and the condition can often run in families indicating a genetic link. Focal sweating usually first begins at puberty and both men and women can be affected. This type of excessive sweating can be reoccurring, and is susceptible to triggers such as anxiety, excitement, fear or even certain types of food. It can be a long-term condition, but many people find that as they get older symptoms may ease and become less frequent.

Generalized hyperhidrosis is when you sweat excessive all over you body. This is less common than focal hyperhidrosis and can be caused by an underlying medical condition such as heart problems, damage to nerves in the spinal cord, and hormone imbalances. It can also be a side effect to certain drugs and if you suffer from this type of generalized hyperhidrosis you should consult your doctor.

Excessive sweating is not a serious condition in itself, but it can be very distressing and cause a negative impact on your social and work interactions. In some cases, especially on the hands and feet your skin can become overly soft through the constant dampness, and therefore prone to cuts and infections, and also excess sweat can encourage bacteria to grow which releases a pungent body odour.

There are many ways you can combat the unpleasant effects of excessive sweating.
- Try to avoid spicy food as this can trigger sweating.
- Combine the use of antiperspirants (which reduce sweating) and deodorants (which masks smells).
- If regular antiperspirants are ineffective, you could try products that include aluminium chloride which works by blocking the opening of the sweat ducts, and these must always be applied to dry, clean skin only, to avoid irritation.
- Wear light, loose natural fibre clothing and try to avoid clothes that show sweat marks easily.
- If you suffer from excessive feet sweating, always wear shoes and socks made from natural materials, and change socks twice a day. Leave shoes to dry out thoroughly before wearing again.
- Iontophoresis – this is a treatment for focal hyperhidrosis that uses electrical stimulation to block the nerves that trigger sweating in affected areas. You will need ongoing treatments to prevent excessive sweating from reoccurring.
- Botulinum toxin injections – this is said to be effective for armpit sweating, and consists of a series of small injections just under the skin, which block the nerves that trigger sweating. This can also be used for hand, foot and face sweating, but can cause weakness in the small muscles around the injected areas. Also this treatment is only temporary and will need to be repeated every 4-8 months.
- There are various medications that can block nerves that stimulate the sweat glands such as propantheline. These medicines are not prescribed very often though as they have some side effects including mouth dryness and blurred vision.

There are also some surgical options for severe cases of excessive sweating. One option for focal sweating under the arms, is to remove the sweat glands in the armpits. This can cause scarring though and a risk of further complications. Another method, which is successful on hand sweating, is a sympathectomy operation, which involves cutting the nerves that control the sweat glands in the hand area. This can be very effective, but some people do report an increase in sweating in other parts of the body (namely the trunk) and also some minor weakness in the hands following the procedure. The sympathectomy is not recommended for foot sweating as there is a significant risk of impairing sexual function.