Understanding Hyperhidrosis

A Comprehensive Guide to Excessive Sweating

Dermatology

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Last updated: Mar 24, 2025

What is Hyperhidrosis?

Hyperhidrosis is a medical condition characterized by excessive sweating beyond what's necessary for normal body temperature regulation. This sweating can occur even when you're not hot or exercising.

Types of Hyperhidrosis

Primary Focal Hyperhidrosis

  • Affects specific body areas (commonly hands, feet, underarms, face)
  • Usually begins in childhood or adolescence
  • Often runs in families
  • Typically occurs on both sides of the body

Secondary Generalized Hyperhidrosis

  • Caused by an underlying medical condition or medication
  • Can affect the entire body
  • Usually develops in adulthood
  • May occur during sleep

Common Symptoms

  • Visible sweating that soaks through clothing
  • Clammy or wet palms and soles
  • Skin problems from constant moisture
  • Social anxiety and embarrassment
  • Difficulty handling objects or performing tasks

Treatment Options

First-Line Treatments

  1. Antiperspirants

    • Over-the-counter or prescription-strength
    • Contains aluminum chloride
    • Apply at night to dry skin
  2. Iontophoresis

    • Passes mild electrical current through water
    • Particularly effective for hands and feet

Advanced Treatments

  1. Botulinum Toxin (Botox) Injections

    • Blocks nerve signals
    • Results last 4-12 months
  2. Oral Medications

    • Anticholinergics
    • Beta-blockers
    • Antidepressants
  3. Surgical Options

    • Sympathectomy (nerve surgery)
    • Local sweat gland removal

Living with Hyperhidrosis

  • Choose moisture-wicking clothing
  • Use absorbent insoles
  • Change socks and clothing frequently
  • Avoid trigger foods and situations
  • Keep a change of clothes handy

When to See a Doctor

  • Sudden onset of excessive sweating
  • Night sweats without obvious cause
  • Sweating interferes with daily activities
  • Signs of infection (odor, redness, fever)

Prognosis

While hyperhidrosis is a chronic condition, most people can achieve good symptom control with proper treatment and management strategies.

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