Hyperhidrosis

What is hyperhidrosis?

Hyperhidrosis, or excessive sweating, is a relatively rare, non-life-threatening medical condition that occurs in the:

• Hands (palmar hyperhidrosis);

• Armpits (axillary hyperhidrosis); or

• Feet (plantar hyperhidrosis)

Regardless of where it occurs, hyperhidrosis affects a person’s quality of life.

What causes hyperhidrosis?

No clear cause of hyperhidrosis has been identified to date. To better understand why hyperhidrosis occurs, it is important to recognize that sweat is required by the body as a coolant to protect against overheating. Your body has several million sweat glands distributed over it, the bulk of which are eccrine glands that secrete odorless, clear fluid that helps regulate body temperature through evaporative heat loss. Generally, hyperhidrosis involves overactive eccrine glands.

The apocrine glands are the other type of sweat glands, which are found in the armpits and genital area. Apocrine glands produce a thick fluid that produces body odor when it comes in contact with bacteria on the skin’s surface.

Skin

The skin is composed of an epidermal layer from which hair follicles, sweat glands and sebaceous glands descend into the underlying dermis.

Nerves activate both the eccrine and apocrine glands. These nerves (from the autonomic nervous system) become active due to a variety of stimuli, including:

• Heat

• Hormones

• Stress

• Physical activity or exercise

In patients with hyperhidrosis, sweat glands (eccrine glands in particular) overreact to stimuli, producing more sweat than is needed.

Overall, there are two types of hyperhidrosis, both of which may be inherited:

Generalized hyperhidrosis

Localized hyperhidrosis

Generalized hyperhidrosis: Affects large areas of the body with excessive sweating, typically in adults whose sweating occurs during both waking and sleeping hours. Generalized hyperhidrosis may be caused by:

• Heat, humidity, exercise

• Infections, such as tuberculosis

• Malignancies (Hodgkin disease, cancer of the lymphatic system)

• Metabolic diseases and disorders, including hyperthyroidism, diabetes, hypoglycemia, pheochromocytoma (a benign tumor of the sympathetic nervous system), gout, and pituitary disease

• Menopause

• Severe psychological stress

• Some prescription drugs

• Autonomic dysfunction

Localized hyperhidrosis: Specifically affects the palms, soles, armpits and face. Unlike generalized hyperhidrosis, it usually begins in adolescence, but can also manifest in childhood or even in infancy. Localized hyperhidrosis typically does not occur during sleep and is commonly caused by:

• Emotional stress, especially anxiety

• Heat

• Certain odors

• Certain foods, including citric acid, coffee, chocolate, peanut butter and spices

• Spinal cord injury

Who is affected by hyperhidrosis?

People of all ages and genders can be affected by hyperhidrosis. This condition affects millions of people around the world (approximately 3 percent of the population), but because of lack of awareness and understanding that there are treatments for the condition, more than half of these people are never diagnosed or treated for their symptoms.

Is hyperhidrosis serious?

Hyperhidrosis is not a serious or life-threatening condition, although it often interferes with normal, daily activities and affects a person’s quality of life. Severe, chronic sweating may make the affected skin white, wrinkled, and cracked, often causing the area to become red and inflamed. Hyperhidrosis often requires medical care.