Do you feel like you sweat too much and it makes you uncomfortable? You are not alone; most people who suffer from excessive sweating do not dare to talk about it and even less to consult a doctor. However, you should not hesitate to see a specialist in excessive sweating. They can determine if you suffer from a medical condition called hyperhidrosis. There are effective treatments that can help you.

Excessive sweating, a real problem

If you sweat too much, it is possible that you have hyperhidrosis, a real medical problem that can be treated. You probably feel uncomfortable discussing it with a doctor.

According to studies:

• Most people with hyperhidrosis say it affects their self-confidence and harms their personal relationships¹.
• Hyperhidrosis has a significant emotional and physical impact on most affected individuals^1,3.
• One in ten Canadians brings a change of clothes to work and avoids contact because of excessive sweating³.

The definition of hyperhidrosis^4,5

Hyperhidrosis, or excessive sweating, is characterized by sweating that exceeds what is normally necessary to cool the body. The most commonly affected areas are the hands, feet, face, and armpits.

Types of hyperhidrosis⁵

Treatment options depend on the type of hyperhidrosis. There are two types:

1. Primary hyperhidrosis (focal primary hyperhidrosis) affects the armpits, palms, feet, and face. A dysfunction of the sympathetic nervous system causes an over-activation of the sweat glands, which then secrete excessive sweat.
2. Secondary hyperhidrosis (generalized hyperhidrosis) usually affects the whole body. It is caused by medications or another medical condition (menopause, metabolic or neurological disorders, or infections).

Diagnosing hyperhidrosis

A specialist in excessive sweating will help determine the best treatment for you. Once secondary hyperhidrosis is ruled out, a simple and quick way to evaluate primary hyperhidrosis is to measure the intensity of your sweating based on how much it interferes with your daily activities. The Hyperhidrosis Intensity Scale (HIS)⁶ allows you to choose the statement that best reflects how you experience your sweating.

Treatment options

The good news is that a specialist in excessive sweating can find a solution to your problem. There is no single “best” treatment for hyperhidrosis. Here is an overview of possible options^5,7,8:

• Topical antiperspirants temporarily block sweat ducts to prevent sweat release.
• Focal injections of botulinum toxin type A interrupt nerve signals to sweat glands. These injections can be used to treat axillary hyperhidrosis in people over 18 years old.
• Iontophoresis devices may be recommended for hyperhidrosis of the hands or feet. These devices send a low-intensity electric current that disrupts sweat gland function.
• Surgery is generally a last-resort intervention for people with severe hyperhidrosis of the armpits, hands, or head who do not respond to other treatments. Two types of surgery are possible:
• Endoscopic sympathectomy involves cutting or clamping the nerves that cause abnormal sweating. It is often performed on an outpatient basis.
• Surgical excision involves removing the sweat glands from the armpits.

You can get help for excessive sweating

If you, or someone you know, suffers from hyperhidrosis, do not hesitate to contact us. We can provide a full diagnosis and recommend an appropriate treatment.

Dr Elroy Shuker MD CM, CCMF
PRAXIS Family Health Clinic

References

¹ Solish N, Benohanian A, Kowalski JW. Dermatol Surg, April 2005; 31(4):405-413.
² Statistics Canada, 2011 Census data.
³ Léger Marketing, How do Canadian Millennials rate themselves on the sweating scale? 810 Canadian adults aged 18 to 40 surveyed on their sweating profile. Online survey conducted between February 7 and 18, 2011. A random sample of the same size would produce a margin of error of ±3.5%, 19 times out of 20. p. 5-25.
⁴ Mayo Clinic, Hyperhidrosis (excessive sweating). Accessible at: http://www.mayoclinic.com/health/hyperhidrosis/DS01082.
⁵ Canadian Dermatology Association. Hyperhidrosis. Accessible at: https://dermatology.ca/en/patients-and-public/skin/hyperhidrosis/
⁶ Solish N, Bertucci V, Dansereau A, et al. Dermatol Surg, 2007;33:908–923.
⁷ U.S. National Library of Medicine and National Institutes of Health, Medline Plus Medical Encyclopedia. Hyperhidrosis. Accessible at: http://www.nlm.nih.gov/medlineplus/ency/article/007259.htm.
⁸ Sweatmanagement.ca/en/. Treatments for hyperhidrosis. Accessible at: http://www.sweatmanagement.ca/en/treatments.