EXCESSIVE SWEATING

This information explains the different types of excessive sweating, treatment options,costs, and sources of help.

In some people, the body's mechanism for cooling down is overactive-so overactive that they may sweat four to five times more than is necessary, or normal. This extreme sweating can be embarrassing, stressful, uncomfortable and disruptive to a normal lifestyle and can negatively impact on self-confidence. This condition is called hyperhidrosis and affects mainly armpits, hands, feet, and groin. It can start in adolescence and affects men and women equally, occurring in 1-3 % of the population.

If you suffer from excessive sweating, chances are, you suffer every day. You may constantly worry about how much you’re sweating. You may spend hours each day dealing with sweat - changing clothes, "freshening up", wiping, placing napkins or pads under your arms or in your pockets, bathing, and hiding under dark-colored, bulky clothes. You may have lost friends and opportunities because of extremely sweaty palms, feet, face, or armpits. Afraid of what people will think, you may even make excuses to stay home, or choose careers in which you don’t have to interact with people, shake hands, or give presentations. Emotional problems, including depression, social isolation, and decreased confidence, can result.

In addition to psychological troubles, excessive sweating can also cause painful or irritating skin problems, such as bacterial or fungal overgrowth, infections, and disintegration (also called maceration) of the skin. From physical discomfort, to anxiety, embarrassment, and the stress of always hiding your sweat from others, hyperhidrosis can impact nearly all aspects of your life

(The questionnaire below comes from www.sweathelp.org which is a useful source of information)

  • How many times per day do you think or worry about sweating?
  • How many times per day do you change clothes? Bathe?
  • Do you carry “supplies” (such as pads, extra clothes, napkins, powders, antiperspirants, or towels) to help you manage your sweat?
  • How often do you have to purchase new clothing or shoes? Do you find that you make such purchases more frequently than other people?
  • How many minutes or hours per day do you spend “dealing” with sweat?
  • Have you tried any topical solutions (antiperspirants, powders, or deodorants) designed to control sweating? If yes, how many different types?
  • Do you ever change your social plans due to excessive sweating or fear of excessive sweating?
  • Have you ever damaged reading or writing material, artwork, paperwork, a musical instrument, or an electric or metallic device due to sweating?
  • Does excessive sweating affect your work performance or career choices?
  • Have you experienced skin irritation or infections due to excessive sweating or your attempts to manage excessive sweating?
  • Does sweating in public cause you distress?
  • When you are in a situation involving contact with other people, or when you think about such a situation, do you experience sweating?
  • Have you ever lost friends or a job due to excessive sweating?

While it's important to document how excessive sweating impacts the quality of your life, it's also key to understand what type of excessive sweating you have, to decide the best treatment.

There are two types of hyperhidrosis: primary focal and secondary generalized. Understanding the difference is one of the first steps in understanding hyperhidrosis.

Primary focal hyperhidrosis refers to excessive sweating that is not caused by another medical condition, noris it a side effect of medications. The excessive sweating is the medical condition. This type of sweating occurs on very specific areas of the body (described as focal areas) and is usually relatively "symmetric" meaning that both the left and right sides of the body are affected similarly. The most common focal areas are the hands, feet, underarms, and head or face. 

Primary focal hyperhidrosis often begins in childhood or adolescence, especially hyperhidrosis of the hands and feet. Interestingly, although people with primary focal hyperhidrosis have episodes of excessive sweating at least once a week, they usually do not experience excessive sweating while sleeping. It’s also been shown that primary focal hyperhidrosis may be inherited and many members of the same family may suffer from this condition (but sadly many never talk about it with each other because of embarrassment). 

If you meet at least two of the criteria below, chances are you have primary hyperhidrosis:

  • Your sweat is bilateral and relatively symmetrical, meaning you sweat the same amount on both sides of your body.
  • Your excess sweat impairs your daily activities.
  • You experience at least one episode a week.
  • The onset of your excess sweat is earlier than age 25.
  • You have a positive family history. (Meaning that other members of your family suffer from similar sweating problems.)
  • You stop sweating when you're sleeping.

Upwards of 90 percent of people who present with excessive sweating will be diagnosed with primary hyperhidrosis.

Secondary generalized hyperhidrosis. This type of excessive sweating is caused by another medical condition or is a side effect of a medication. That’s why it’s called secondary - it’s secondary to something else. Unlike with primary focal hyperhidrosis, people with secondary hyperhidrosis experience sweating on larger or other areas of the body (described as generalized areas). Another key difference between the two types of hyperhidrosis is that people with secondary generalized hyperhidrosis may often experience their sweating symptoms while sleeping. With secondary hyperhidrosis, excessive sweating usually starts in adulthood, whereas primary hyperhidrosis starts in childhood or adolescence. Finding a potential treatment for secondary excessive sweating often involves first determining what (if any) underlying medical condition or medication may be the root of the problem. In the case of secondary hyperhidrosis, you don't want to eliminate an important symptom of an underlying cause.

If you think you suffer from secondary hyperhidrosis, we've compiled a list of medications that can cause excessive sweating as a side effect, and a list of diseases and conditions that can cause excessive sweating as a symptom. Of course, not everyone who takes one of these medications or who suffers from one of these conditions will experience sweating. The lists are provided as a starting point for a discussion with a physician. Only a knowledgeable physician can diagnosis and treat hyperhidrosis. 

Drugs/Medications Known to Cause Hyperhidrosis as a Side Effect: This list contains numerous medications that can cause excessive sweating: http://www.sweathelp.org/images/pdf/drugs_2009.pdf

Diseases & Conditions that May Cause Hyperhidrosis are numerous. The commonest ones are thyroid disorders, menopause, heart disease, acute infections, and diabetes. The following list shows more causes of excessive sweating: http://www.sweathelp.org/pdf/Diseases_2009.pdf

The commonest treatments for excessive sweating are antiperspirants, especially those containing aluminium chloride. Follow the instructions carefully as they can irritate the skin.

Another option is Iontophoresis, where a home medical device is used to pass a mild electrical current through water (usually utilising shallow pans big enough for your hands or feet) and through the skin's surface. This is a safe treatment, which needs to be kept up long-term to maintain results, but is not suitable for underarm sweating.

A further option is to attend our Resident Doctor at Faceworks for a consultation to see if you are suitable for underarm injections of a prescription medicine. This refers to a treatment with a purified protein, injected with tiny needles under the arms. This treatment can last 4-12 months and is priced at €595 women and €645 men, for both underarms.This cost is tax-allowable at 20%, at the year end, using a Med 1 form from Revenue.

Aesthetic clinics are governed by the HPRA, The Health Products Regulatory Authority (formerly the Irish Medicines Board), which prohibits the use of brand names like Botox ®, Vistabel ®, and Azzalure®. Dr Brenner is very experienced in underarm injections, but she does not treat hyperhidrosis of the palms or feet with these injections-she can refer you to another doctor for these treatments if necessary, after assessment.

Good sources of information on line are : www.sweathelp.org and www.hyperhidrosisuk.org


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