By Robert Korst, M.D., Medical Director, Hyperhidrosis Center, The Valley Hospital

Newswise — Hyperhidrosis is excessive sweating that is more than what is needed to regulate body temperature. About 7 million Americans suffer from hyperhidrosis, a disorder that often goes undiagnosed. Hyperhidrosis sufferers often feel a loss of control because the sweating happens independently—without a high body temperature or highly charged emotional situation. The condition may make you avoid social situations, especially when they involve shaking hands. Anxiety can make hyperhidrosis worse. The condition can also be triggered by certain foods and drinks, nicotine, caffeine, and some smells.

Normal Sweating vs. Hyperhidrosis

Normal sweating keeps the body cool and excretes some waste products of the body. Sweating is part of the sympathetic nervous system, a component of the autonomic nervous system. The autonomic nervous system controls involuntary activities in the body, such as the beating of the heart and circulation of blood.

While sweating is a necessary function of the body, excessive sweating can affect a person’s quality of life negatively. Hyperhidrosis can happen all over the body or only in specific parts. The hands, feet, armpits (axilla), and the groin area are the most active regions of perspiration because of the relatively high concentration of sweat glands in these areas. However, any part of the body can be affected by hyperhidrosis. The condition can start during adolescence or even before, and it appears that there is a genetic component to the disorder.

Types of Hyperhidrosis

There are three main types of hyperhidrosis: primary focal hyperhidrosis, generalized idiopathic hyperhidrosis, and secondary generalized hyperhidrosis.

1. Primary focal hyperhidrosis is a medical condition that is not caused by medication or another medical problem. Excessive sweating occurs on specific areas of the body (focal), including the feet, hands, underarms, and face. The sweating may be so severe that sweat drips from the hands, feet, or armpit. If the face is affected, the sweating usually occurs during a social or functional situation and can be accompanied by a reddened facial blush. Primary hyperhidrosis often begins in childhood or adolescence, and it may be inherited. The condition can be difficult to handle psychologically and can lead to anxiety and depression. Physically, primary hyperhidrosis can cause skin irritations and infections. In the armpit area, it can result in a foul-smelling condition called bromhidrosis. There are a number of treatment options for primary focal hyperhidrosis, including medications and surgery.

2. Generalized idiopathic hyperhidrosis occurs when large areas of the body sweat. This condition is usually treated with medications.

3. Secondary generalized hyperhidrosis causes large areas of the body to sweat. It may be caused by a medical condition, such as menopause, diabetes, an overactive thyroid, or stroke. Medications, exercise, and heat also cause secondary generalized hyperhidrosis. The sweating can occur during sleep. This condition should be evaluated by a dermatologist for diagnosis and treatment. Treatment Options

The diagnosis and treatment of excessive sweating depends on the type of hyperhidrosis and the area affected. Most patients with generalized idiopathic hyperhidrosis (which affects large areas of the body) can be treated with oral medications. Those with secondary generalized hyperhidrosis (caused by a medical condition) should be evaluated by a dermatologist.

There are a number of treatment methods used to treat primary focal hyperhidrosis, which occurs on specific areas of the body, including the hands, feet, armpits, and face. Many patients should try conservative therapies (medications or topical agents) first before considering surgery. Your doctor will determine which treatment method is best for you based on the type of hyperhidrosis you suffer from, your age, and your general medical condition.

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