What is Hyperhidrosis?
Hyperhidrosis is a chronic medical disorder that causes the production of excessive sweat. A recent study determined that the condition – once thought to be rare – actually affects approximately 2.8 percent of the U.S. population, or 7.8 million people. One out of three people surveyed with hyperhidrosis said their sweating was intolerable or barely tolerable. Many sufferers said they were depressed and frustrated with daily activities, and they experienced interference with work and romance and had difficulty meeting people. Hyperhidrosis tends to first occur during the already difficult period of puberty and early adolescence. It causes much of its social, psychological, emotional, and physical impairments because of its conspicuous locations: on the palms, underarms, and soles of the feet. At the same time, the amount of sweat that is produced is often too difficult to conceal.
What treatments are available for Hyperhidrosis?
As treatment options are considered, you to try the least invasive options first, such as antiperspirants and iontophoresis. If, after learning how to most effectively use these treatments you still can’t find relief, consider Botox® injections (keeping in mind that Botox® is only appropriate for treating excessive sweating in certain areas of the body). Due to side effects, oral medications are not recommended as a long-term solution and surgical options, although heavily advertised, are reserved for only certain severe cases of hyperhidrosis that have not responded to all the other treatment options, and the risks of permanent damage is fully discussed.
Antiperspirants are considered the first line of treatment for excessive sweating of the underarms, hands, feet, and sometimes face. They are called the first line of treatment because they are the least invasive and experts recommend that they be tried first, before other more invasive treatments. Antiperspirants are available either over-the-counter, like Secret and Sure, or by prescription, like Drysol from your doctor. Some antiperspirants also contain deodorants. Deodorants, on their own, can’t prevent sweating, but they can reduce odor by limiting odor-causing bacteria.
Iontophoresis uses a simple device to treat excessive sweating of the hands (palmar hyperhidrosis) and feet (plantar hyperhidrosis). It is particularly useful for people who’ve tried prescription strength antiperspirants but find that they need a stronger treatment. During iontophoresis patients sit with hands or feet, or both, immersed in shallow trays filled with water for a short period of time (20 to 40 minutes) while the device sends a mild electrical current through the water. The process is repeated every other day for five to ten days or until sweating is reduced to a comfortable level. Once the desired dryness has been achieved, patients are switched to a maintenance schedule, ranging from once per week to once every four weeks, depending on the individual. To maintain dryness, iontophoresis must be repeated as soon as sweating begins to return.
Botox® Injections: With FDA approval in 2004, the United States joined more than 20 other countries that had already approved the use of BOTOX® for excessive sweating. During the procedure, a very fine needle is used to inject small amounts of botulinum toxin just under the skin near the sweat glands responsible for excessive perspiration. Multiple injections are given based on your doctor's assessment of the area that needs to be treated. Injections into the palms or soles may be painful. To ease discomfort, physicians may use one or more of a number of anesthetic techniques such as pain-killing creams, nerve blocks, ice, or vibrations.There is a possibility that during the procedures some sweat glands may be missed. If this happens it's important to talk to your doctor so that he or she can reevaluate the sweating areas and perhaps "fill in" the gaps with additional injections. Botox® injections do not cure hyperhidrosis; your symptoms will return gradually, requiring follow-up injections at intervals varying from seven to sixteen months to maintain dryness.
Oral Medications: Oral or systemic prescription medications are sometimes considered by physicians for the treatment of hyperhidrosis. Some of the medications that have been tried are anticholinergics, beta blockers, and clonidine hydrochloride (specific drug names include Propantheline, Glycopyrronium bromide, Benztropine, Diazepam, Diltiazem, Indomethacin, Oxybutynin, and Glycopyrrolate/Robinul.) Theoretically, these medicines could help treat excessive sweating because they prevent the stimulation of all sweat glands and thus may limit overall sweating, but long-term use is not recommended because of serious side effects.
Surgical Treatments: After all other treatments have been tried, adjusted for individual circumstances, and still found to be ineffective, surgical treatment for excessive sweating may be an option considered by your physician. There are a number of different types of surgery that are sometimes used to treat hyperhidrosis. These include local surgical procedures that remove the sweat glands and endoscopic thoracic sympathectomy (ETS). ETS, in particular, is considered a last resort because it frequently causes serious, irreversible compensatory sweating. ETS surgery is not usually recommended because of the potentially serious negative side effects of the procedure.
Everyday Solutions: While only a doctor can prescribe or perform certain hyperhidrosis treatments, there are things you can do to help make excessive sweating less of a burden on your everyday life:
Bathe Daily to keep the amount of bacteria on your skin low.Dry yourself thoroughly after you bathe. Bacteria and fungi (which can cause body odor and infections on irritated skin) thrive in damp spaces, like between your toes.
If you have sweaty feet, use powders or absorbent insoles, such as summersoles.
Apply antiperspirants twice per day, morning and evening. Or, if you're only using an antiperspirant once per day, apply it in the evening instead of in the morning. Antiperspirants may be used on hands and feet as well as on underarms.
If you’re using a prescription or high-potency antiperspirant, follow your doctor’s instructions carefully and remember that these products may damage clothing and linens. To limit this damage, wear old pajamas if the antiperspirant is applied at night, before bedtime.
- Choose air-permeable clothing. Wear natural fabrics, such as cotton, wool, and silk, which allow your skin to breathe.
- When you exercise, you might prefer high-tech fabrics that wick moisture away from your skin.
- Dress shields, small pads that go in your armpits to absorb sweat, may be an option for you. You may also want to keep an extra shirt with you for emergencies.
- Launder clothes frequently and/or change your shoes and clothing often.
- Rotate your shoes if you have trouble with sweaty feet. Your shoes may not dry out overnight, so try not to wear the same pair two days in a row. Also, try inserts that help to absorb and dissipate sweat.Wear the right socks. Moisture-wicking athletic socks are a good choice. These may be made of merino wool (which doesn’t itch) or a synthetic blend sometimes called "polypro."
- Change your socks often. Change socks or pantyhose once or twice a day, drying your feet thoroughly each time. Women should try pantyhose with cotton soles. Air your feet. Go barefoot when you can, or at least slip out of your shoes now and then.
- Avoid hot beverages (such as coffee), alcohol, and spices, which can make you sweat. Try relaxation techniques such as yoga, meditation, or biofeedback. These can help you learn to control the stress that can trigger perspiration.
- Change your diet. Make note of any foods or beverages that cause you to sweat more than usual.
- Consider eliminating caffeinated drinks (like coffee and cola) from your diet as well as alcohol, certain “hot” spices, and foods with strong odors, such as garlic and onions.
