Health A to Z

Hyperhidrosis

Feel like you could break a sweat in the middle of a Canadian blizzard? You may have hyperhidrosis (HH), which is excessive sweating that occurs frequently or constantly.

This post was originally posted in July 2014 and has been updated.

The condition affects about 800,000 Canadians. While sweating is a perfectly natural way for the body to cool us down, some people sweat far more than is needed. HH can be a great source of embarrassment but there are helpful treatments.

Hyperhidrosis causes With focal hyperhidrosis, which affects the palms, soles of the feet and possibly the underarms, the condition occurs as an excessive response to an emotional situation. It may be hereditary. Generalized hyperhidrosis affects large areas of the body and may have an underlying cause such as medication, menopause (hot flashes), thyroid disease, heart attack or infectious disease. Treating the root cause or switching medications may help resolve generalized hyperhidrosis.

Hyperhidrosis symptoms With HH, sufferers usually have sweaty hands, armpits and feet. If you have the condition, you frequently experience excessive sweating that can even soak your clothes. You may notice that your skin is clammy or dripping with sweat. And while most people sweat during exercise, when it’s hot or they’re nervous, HH happens far more frequently; usually at least weekly without any obvious cause. If you ever experience a cold sweat, which can accompany chest or stomach pains, and may indicate a bigger medical problem, such as a heart attack, get medical help immediately.

Hyperhidrosis diagnosis/tests If perspiration is putting a damper on your daily routine or you suddenly begin to sweat more or experience night sweats, see your physician who may refer you to a dermatologist for treatment.  She’ll ask you about your symptoms and conduct a medical examination. She may order blood tests to see if your sweating is due to another medical condition, such as an overactive thyroid, or conduct a thermoregulatory sweat test. During the test, a powder that is moisture sensitive is put on the skin and it changes colour to reveal which body parts sweat at room temperature, high heat and humidity. The findings from the test will help the doctor diagnose you and determine the best treatment.

Hyperhidrosis treatment Fortunately, several options are available to treat excessive sweating:

Clinical-strength antiperspirant Good for moderate to excessive sweating, these products contain a higher concentration of aluminum chlorohydrate (20%) that is applied to the armpits at night to form sweat plugs. The antiperspirant effect lasts the entire next day or as long as a week, even after showering.

Topical anticholinergic solutions Aluminum chloride hexahydrate (Drysol) products, are one example of these solutions, which are applied at night to the areas where you sweat. They’re available behind the counter at pharmacies without a prescription. In the morning, wash off the antiperspirant to prevent skin irritation. Symptoms often improve within a week but some skin irritation may occur.

Medications Anticholinergic drug, such as glycopyrrolate (Robinul, Robinul Forte), block acetylcholine, a chemical messenger in the body that helps to stimulate the sweat glands. However, the side effects of these medications, including dry mouth, constipation and dizziness, may be worse than the sweating itself.

Botox injections Not just for wrinkle smoothing! Botox shots are used to treat severe hyperhidrosis by blocking the nerves that trigger the sweat gland. You may need several injections to get the results you want and it will only last for several months.

Surgery In severe cases, surgery can be effective for HH. For example, if excessive sweating happens just in your armpits, removing the sweat glands may help.

Hyperhidrosis prevention It may be possible to stay a little dryer (and keep odour in check) with a few hygiene and lifestyle changes:

Your routine Bathe daily, dry your feet after the bath and apply foot powder. Use an antiperspirant  on your hands, feet and underarms.

Your clothes Wear socks that absorb moisture and change them frequently. Wear natural fabrics, such as cotton, wool and silk that allow your skin to breathe. Rotate your shoes to give the sweat a chance to dry out and try inserts to absorb sweat.

Stress control Try relaxation techniques, such as meditation to help you cope with the stress that makes you sweat.

More resources:
Hyperhidrosis: Excessive Sweating
International Hyperhidrosis Society