Category Archives: Hyperhidrosis

The Impact of Hyperhidrosis

Life’s worries

Sweat is something that most people hardly think about.  It’s just something that happens when it’s hot, when your working out, or sometimes when feeling a strong emotion. But for people suffering from hyperhidrosis, there is a constant worry about sweat. It pervades all aspects of their lives, to a degree that may seem shocking to those not afflicted with the condition. 

Here are some of the many ways that hyperhidrosis can impact one’s quality of life.

Difficulty accomplishing simple tasks

Hyperhidrosis, especially in the palms, can make day-to-day activities more difficult. When your hands are slippery with sweat, keeping a grip on anything is challenging. Ditto for navigating touch screens and turning doorknobs. It can even be dangerous for jobs that require tools, such as handling hot pans and knives for cooks and hospital staff, using sharp and heavy equipment for technicians and engineers, conducting fine laboratory work for those in the science and medical fields, handling paper and money for office workers, among others.

People who sweat from their head can also find it difficult to see from time to time as the sweat drips down their forehead into their eyes. They need to constantly wipe away the sweat, or else wear something that will absorb the moisture. These distractions can make driving dangerous.

Those that suffer from armpit sweating (or axillary hyperhidrosis) often find it very embarrassing and constantly fear inadvertently putting up their arms up in case someone sees their sweat marks.  They often report needing to be very choosy about the clothes they wear and activities they partake in.

Physical discomfort and inconvenience

With hyperhidrosis, even mild physical activity can cause one to sweat as if they’ve run a marathon. Arriving to work or school sticky and wet after a commute is uncomfortable and embarrassing. Many lug around spare clothes, towels, handkerchiefs, antiperspirants, and deodorants to make the rest of the day more bearable. 

Accumulation of moisture in the armpits or in the groin area can lead to chafing, pain, and irritation to the skin. It is also a predisposing factor for bacterial growths that cause unpleasant odours at best and inflammation at worst. To prevent this from happening, many people who suffer from hyperhidrosis need to think of workarounds. These take time and resources, which lowers their quality of life considerably.

Limitations on lifestyle

Studies on the effect of hyperhidrosis on patients show that the condition dictates many aspects of their lifestyle.

This is particularly obvious in choosing what they wear. People with hyperhidrosis gravitate towards darker colours that help make sweat marks less obvious. They would rather opt for breathable fabrics and fits. People who sweat from their feet do not wear flip flops or sandals to avoid slipping out of them. Those who perspire from their head will avoid wearing make-up because it slides off. This hampers their self-confidence and ability to express themselves.

Hyperhidrosis can also affect the activities patients choose to engage in. Since heat and physical exercise can trigger sweating, those with hyperhidrosis tend to minimise working out or going outdoors, especially when it involves other people. It is also a factor to consider when choosing a career, with some hyperhidrosis patients opting for office jobs in air-conditioned rooms just so they can avoid physical excursions.

Fear of touch-related social interactions

Touching is a normal part of building relationships, but it is something that hyperhidrosis patients dread. This fear usually stems from previous social interactions when they have been on the receiving end of awkwardness and disgust for their sweat. People with palmar sweating avoid shaking hands and giving high fives, while those with generalised sweating shy away from hugs and crowded places. Fear of other people seeing their perspiration leads many to avoid social gatherings altogether, affecting interpersonal relationships with both family and friends. This is particularly an issue when attempting to build romantic relationships, as intimate physical contact is expected.

Unhealthy levels of stress

People with hyperhidrosis worry all the time about their condition. It’s the little things, like stressing about the smell of their socks when they take off their shoes in public, handing sweat-soaked money when paying for purchase, leaving noticeable sweat marks on surfaces. These small worries add up over time and drastically affect their self-esteem. This can have a pervasive effect on everything from social life to career opportunities.

In addition, a good number of people who have hyperhidrosis do not know that treatment is available. There is not much attention given to the condition even among healthcare providers. This can lead to a feeling of hopelessness at the situation, and resignation to spend the rest of their life sweating excessively and suffering for it.  However, modern medical treatments can improve the lives of sufferers of hyperhidrosis drastically, and in most cases, back to normal levels of sweating. 

Conclusion

Hyperhidrosis can have a negative impact on patients’ lives. However, seeking care from a dermatologist to learn about options for treatments is the first step to overcoming this otherwise troubling condition.  Seeking therapy for mental health impacts may also be appropriate for some. This can help lessen the anxiety they feel about sweating. 

If you are experiencing any mental health concerns, please see your GP or mental health professional.  

 

Purpose of this information

The information presented on this website and in this article is for general information and example purposes only, does not contain health advice specific for users and must not be relied on for that purpose.  Please see your GP, dermatologist or other health care professional for specific advice.

 

 

References

 

Kamudoni, P., Mueller, B., Halford, J. et al. The impact of hyperhidrosis on patients’ daily life and quality of life: a qualitative investigation. Health Qual Life Outcomes 15, 121 (2017). https://doi.org/10.1186/s12955-017-0693-x

 

Strutton, D. R., Kowalski, J. W., Glaser, D. A., & Stang, P. E. (2004). US prevalence of hyperhidrosis and impact on individuals with axillary hyperhidrosis: results from a national survey. Journal of the American Academy of Dermatology, 51(2), 241–248. https://doi.org/10.1016/j.jaad.2003.12.040

 

Botox injections hyperhidrosis

Botulinum Toxin for Hyperhidrosis

One of the many uses of botulinum toxin

 

Botulinum toxins may have a scary-sounding name, but it’s just the umbrella term for the famous anti-wrinkle treatment. This injection has long been used by the rich and famous to slow down the passage of time. But there are many other uses for botulinum toxins, and one of them is hyperhidrosis. 

 

So if you’re suffering from excessive sweating, this is one treatment for consideration.

What is botulinum toxin?

Botulinum toxin is a substance produced by Clostridium botulinum. When this bacteria enters the body through contaminated food, through an open wound, or through inhalation, the toxin it produces attacks the nervous system, leading to a disease called botulism. This is characterised by paralysis of muscles and even organs. It does not take a high amount of toxins to cause morbidity and mortality.

 

It is a testament to humankind’s ingenuity to use this dangerous substance as a treatment for various conditions. In extremely diluted amounts and with processing, botulinum toxins can be used to control conditions that result in involuntary muscle contractions, repetitive eye movements, and neuromuscular dysfunction. But perhaps botulinum toxin is best known for its ability to achieve tight, wrinkle-free, youthful-looking skin. 

 

There are two TGA-approved botulinum toxin formulations, both of which exert their effects through blocking the release of an important neurotransmitter, acetylcholine. The binding of acetylcholine to nerve receptors is crucial for many processes, including muscle movement and glandular secretions. 

How does botulinum toxin help with hyperhidrosis?

We have two kinds of sweat glands. Eccrine sweat glands are the most numerous and are found all over the body. Their primary function is to regulate temperature. When the body feels like it’s getting a little too hot, the nervous system produces acetylcholine, which in turn is the chemical trigger for eccrine glands to start producing sweat. 

 

On the other hand, we have apocrine sweat glands. These are much fewer in number, and are concentrated in the axillary (armpits), groin area, and breast area. Instead of responding to acetylcholine, they are triggered by noradrenaline. Noradrenaline is produced when the body feels strong emotions such as distress, fear, pain, and sexual stimulation. The sweat they produce is more viscous, and has a tendency to smell when in contact with bacteria.

 

What are the advantages and disadvantages of using botulinum toxin for hyperhidrosis?

Botulinum toxin has been used as a treatment for hyperhidrosis for over 25 years. Its safety and efficacy have long been established through numerous studies. Patients have consistently reported a significant decrease in sweat production and an increase in quality of life within 2 weeks of treatment.

 

Though botulinum toxin injections are more expensive than topical antiperspirants, the first line of treatment against hyperhidrosis, they are much more convenient. The effect of a single session can last from 3-9 months, whereas topical antiperspirants will require at least weekly, if not daily application. 

 

Botulinum toxin is particularly effective for focal hyperhidrosis, or excessive sweating in select parts of the body. Patients with profuse perspiration in the armpits, palms of the hands, soles of the feet, and face or head area stand to benefit the most from this treatment.

 

Using botulinum toxin may have side effects, although studies show that it occurs in a minority of patients. When used for axillary hyperhidrosis, there may be temporary itchiness or bruising. When used for palmar hyperhidrosis, there may be temporary weakening of the hand-grip.

How is botulinum toxin used for hyperhidrosis?

Botulinum toxin can only be administered by a licensed medical professional. Always consult your doctor before pushing through with this treatment, as some medical conditions may contraindicate its use, even at such a miniscule amount. 

 

When injected by dermatologists, there is a Medicare subsidy that applies making the treatment more affordable.  Certain criteria need to be met however, so its best to make an appointment to check your suitability.

 

The area is first cleansed and then marked appropriately.  Various pain-reduction techniques are used at Melbourne Skin & Dermatology to ensure a comfortable treatment.  Multiple injections are then applied to the treatment area.  The markings are then washed off and the patient is good to go back immediately to unrestricted activities.

 

Purpose of this information

The information presented on this website and in this article is for general information and example purposes only, does not contain health advice specific for users and must not be relied on for that purpose.  Please see your GP, dermatologist or other health care professional for specific advice.

 

References

 

de Almeida, A. R., & Montagner, S. (2014). Botulinum toxin for axillary hyperhidrosis. Dermatologic clinics, 32(4), 495–504. https://doi.org/10.1016/j.det.2014.06.013

 

Doft, M. A., Hardy, K. L., & Ascherman, J. A. (2012). Treatment of hyperhidrosis with botulinum toxin. Aesthetic surgery journal, 32(2), 238–244. https://doi.org/10.1177/1090820X11434506

 

Hodge BD, Sanvictores T, Brodell RT. Anatomy, Skin Sweat Glands. [Updated 2021 Aug 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482278/

 

Nigam, P. K., & Nigam, A. (2010). Botulinum toxin. Indian journal of dermatology, 55(1), 8–14. https://doi.org/10.4103/0019-5154.60343

 

https://dermnetnz.org/topics/hyperhidrosis#:~:text=Botulinum%20toxin%20injections%20are%20approved,other%20sites%20such%20as%20palms.

 

Excessive Sweating image

Why am I sweating so much?

The 101 on hyperhidrosis

 

If you are self-conscious about how much you sweat, you could be suffering from a condition called hyperhidrosis. Many people who live with it do not even know that it is a medical phenomenon; they just think it is an unfortunate and frequent occurrence that they need to work around. While hyperhidrosis is not a life-threatening disease, anyone who has it can attest to the fact it is very inconvenient, embarrassing, and can be a great impact on daily school, work and social activities. 

 

So if you’re one of them, you’ll be pleased to know that hyperhidrosis has long been given attention by the medical community. There are options available to help better manage, or, in some cases, completely eliminate this condition.

 

But before you go in search of a cure, it’s important to get a better understanding of hyperhidrosis.

What causes us to sweat?

To understand the causes of excessive sweating, it is first important to consider what causes normal sweating. And at the centre of that conversation is the hypothalamus.

 

The hypothalamus wants to keep our bodies at a constant temperature of 37 degrees Celsius. When the body appears to be getting a little too hot for comfort, temperature sensors in the skin and internal organs send messages to the hypothalamus to do something about it. Among the many ways to cool the body down, releasing sweat through the sweat glands is one of the most effective responses. This is called “thermoregulatory sweat”.

 

However, it’s not just increased heat or exertion that causes us to sweat. Strong emotions and stress can cause us to break out in what is commonly known as “cold sweat”. Whereas thermoregulatory sweat is usually excreted throughout the body, emotional sweat is typically concentrated in the armpits, face, palms, and feet. 

 

It is important to consider that these two general types of sweating are interrelated. It is likely that one process influences the other.

What causes excessive sweating?

There are two general kinds of hyperhidrosis. Usually, it is easy to differentiate the two based on onset of the disease, family history, and symmetry of affected areas, but in some cases, further tests may need to be done to confirm the diagnosis.

 

Primary hyperhidrosis

Primary hyperhidrosis can run in families. Though the exact gene that controls this has not been identified, it appears to be autosomally inherited with incomplete penetrance.  This is a fancy way of saying that it can be passed on to both males and females of the family, and can manifest with different severity and presentation among family members. So if you have primary hyperhidrosis, there’s a good chance you’re not the only sweaty one in the family.

 

This condition usually appears in childhood or puberty, and can continue into adulthood. There are some who report a period of quiescence or remission, but for some, it’s something they live with for most of their adult lives.

 

Primary hyperhidrosis can be focal (meaning only in one area such as the armpits) or generalised (head and trunk). A hallmark of focal primary hyperhidrosis is that it presents symmetrically.  So in these cases, if the right armpit sweats a lot, you can expect the left to do the same. You can have it in one or more areas of the body. For some, they may even present with both focal and generalised primary hyperhidrosis.

Secondary hyperhidrosis

Secondary hyperhidrosis can be caused by hormonal imbalances, neurological or endocrine diseases, or certain types of drugs.  Pregnancy and menopause have been associated with periods of excessive sweating that may extend for months up to years. Some people develop hyperhidrosis as a side effect of conditions that affect the brain, spine, and peripheral nerves, while others start to notice increased perspiration after taking cholinergic drugs, antidepressants, and opioid painkillers.

 

Sudden onset of increased volume and frequency of sweating in people who have no prior history of sweatiness is a potential sign of secondary hyperhidrosis. 

 

Like primary hyperhidrosis, secondary hyperhidrosis can be both focal and generalised. The difference is that when it does manifest focally, it tends to occur on one side. This is usually because of a compensatory mechanism, ie, it is possible that the nerves supplying the right side of the body have been damaged and no longer produce sweat, so the nerves on the left side work extra hard to make up for it. Generalised secondary hyperhidrosis can be difficult to differentiate from generalised primary hyperhidrosis, but that’s what a visit to the dermatologist is for! 

 

For some, it is easy to identify the trigger. But for others, it may not be so clear-cut. Usually, secondary hyperhidrosis is accompanied by other red flags that something is wrong in the endocrine or nervous system. If there are no other signs, doctors will usually prescribe a battery of diagnostic tests in an attempt to find out what’s causing it.

 

Purpose of this information

The information presented on this website and in this article is for general information and example purposes only, does not contain health advice specific for users and must not be relied on for that purpose.  Please see your GP, dermatologist or other health care professional for specific advice.

 

 

References:

 

Rystedt A, Brismar K, Aquilonius SM, Naver H, Swartling C. (2016). Hyperhidrosis – an unknown widespread “silent” disorder. Journal of Neurology and Neuromedicine, 1(4): 25-33.

 

Schlereth, Tanja & Dieterich, Marianne & Birklein, Frank. (2009). Hyperhidrosis-Causes and Treatment of Enhanced Sweating. Deutsches Ärzteblatt international. 106. 32-7. 10.3238/arztebl.2009.0032. 

 

https://dermnetnz.org/topics/hyperhidrosis