Hyperhidrosis is excessive sweating. It can be an embarrassing and serious problem. It can affect social, professional, and intimate relationships.
The sweating may be in just one area. It is most common in the palms of the hands, soles of the feet, and/or armpits. In some cases the sweating can also affect the entire body. Hyperhidrosis is divided into two categories:
Primary hyperhidrosis—has no known causeSecondary hyperhidrosis—caused by an underlying condition
Primary hyperhidrosis may be triggered by:
High emotional states (such as intense sadness, fear, anger, or stress)Spicy foodsHot climates
Certain medicines:
Fever-lowering medicinesInsulinMeperidineEmetics (vomit-inducing medicines)AlcoholPilocarpine
Secondary hyperhidrosis may be caused by conditions such as:
MenopauseFeverInfection
Cancer, such as
lymphomaThyroid diseaseAcromegaly
or anterior pituitary tumor
Hypothalamic disordersAdrenal tumorParkinsons diseaseNervous system disordersDiabetesTuberculosisDrug withdrawal
Certain medicines:
Fever-lowering medicinesInsulinMeperidineEmetics (vomit-inducing medicines)AlcoholPilocarpineFactors that increase your chance of secondary hyperhidrosis are the conditions that cause it (listed above).
Symptoms include:
Sweaty palms of the hands and/or soles of the feetSweaty armpitsChange in amount of sweatingChange in pattern of sweatingChange in the odor associated with sweatingStained clothingYour doctor will ask about your symptoms and medical history. A physical exam will be done. There are no specific tests for this condition.
A starch-iodine test is often used on armpits. It may be used to determine the areas with the most active sweat glands. Tests may be done if your doctor is concerned that you may have a specific medical condition.
Treatment includes:
To help decrease the uncomfortable feeling and odor associated with sweating, try:
Frequent clothing changesCareful washing
A number of treatments can be applied to decrease sweating in a particular area. These include:
Aluminum chloride hexahydrateAluminum tetrachlorideFormalin compressesGlutaraldehyde compressesIontophoresis (stimulation with electrical current)—needs to be repeated on a daily or weekly basis, eventually tapering off to every 1-2 weeks; may be used if prescription antiperspirants fail
These are very rarely used due to their side effects, but may include:
ScopolaminePhenoxybenzaminePropanthelineThis is the toxin produced by the bacteria that cause botulism. Injections of this toxin can decrease sweating in certain areas. It is often used on the palms of the hands and armpits. The effect of one cycle of injections may last for 6-8 months for most patients.
Endoscopic thoracic sympathectomy—the destruction of nerves that stimulate sweatingCurettage—local removal of sweat glands via surgical scrapingUltrasoundLiposuction techniquesThere are no known ways to prevent hyperhidrosis.
Last reviewed September 2012 by Brian Randall, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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