Sweating is the normal response to an increase in body temperature. The skin produces sweat to cool the body after vigorous exercise or extended periods in a hot environment. Some people, however, sweat excessively. They produce more sweat than is needed to cool the body, and sweat even when body temperature is normal. While certain conditions can cause excessive sweating such as night sweats or menopausal hot flashes, some people experience it without any particular cause. This form of excessive sweating is called primary hyperhidrosis, and it can cause serious social, professional, and psychological problems.
Excessive and uncontrollable sweating is the main symptom of hyperhidrosis. People may sweat from certain body regions such as the armpits, palms, and/or soles of the feet, or they may simply sweat from various places. The sweating usually occurs equally on both sides of the body and occurs usually at least once per week.
Primary hyperhidrosis tends to run in families, so most people with the condition have at least one family member who also suffers from excessive sweating. While hyperhidrosis can begin at nearly any age, most cases start before a person is 25 years old.
Hyperhidrosis is not life threatening, but it can cause severe social problems. People who have excessive sweating in their armpits often stained their clothes and have noticeable wet marks that they feel they must hide from others. When hyperhidrosis occurs in the palms, people avoid shaking hands, which can be taken as a sign of disrespect in social and professional settings. Indeed, sweating of the palms can be so severe that it interferes with the ability to perform some tasks require a dry grip, such as using hand tools. Excessive sweating can lead other conditions in the affected area such as eczema, warts, and fungal infections.
It is not clear why some people develop primary hyperhidrosis. The sweat glands themselves appear to be normal— the nerves that control the sweat glands appear to be the problem. Hyperhidrosis seems to be triggered by emotional stress, though it is not a psychological condition.
Antiperspirants are usually the first treatment for hyperhidrosis. An antiperspirant is a substance that absorbs excess sweat. Prescription antiperspirants can also plug sweat ducts. As you may expect, antiperspirants are most helpful for people with mild hyperhidrosis.
Botulinum toxin is a more definitive treatment for excessive sweating and can be used in mild, moderate, and severe cases of hyperhidrosis. Agents such as Botox, Dysport, or Xeomin are injected into the affected area to block the nerves that cause sweating.
Other treatments are used in cases where botulinum toxin fails to reduce excessive sweating. Other treatments include
None of these additional treatments are ideal since they are either not fully effective and/or can cause serious side effects.