Causes and Treatments of Excessive Sweating and Hyperhidrosis
Causes and Treatments of Excessive Sweating and Hyperhidrosis
This content has been reviewed and approved for quality and accuracy by James O'Loan (GPhC: 2084549)
Everyone sweats. Whether it is because of exercise or being out in the sun. sweat is produced in order to cool down the body. In some cases, sweat can be produced more often than normal, and without a reason. This is known as excessive sweating.
Excessive sweating is a condition where sweating occurs more often and more intensely than normal. Sweating on its own can happen at any time, but it is most common after exercising or being in hot conditions. Excessive sweating can affect anyone, either all over the body or in certain parts. Excessive sweating is also known as hyperhidrosis, in cases where it is not triggered by exercise or hot weather.
Excessive sweating can happen with no obvious cause, though it is most likely to be caused by exercise or temperature. If you have hyperhidrosis, then it is because it could be another condition that you have, or because of medication. Hyperhidrosis will most likely not have an underlying medical and is called primary hyperhidrosis. This is most likely to be the result of the sweat glands being overactive and causing more perspiration when it isn’t needed. This is said to be hereditary and can run in families. Hyperhidrosis caused by a medical condition is known as secondary hyperhidrosis. This is more likely to cause sweating all over the body. Causes of secondary hyperhidrosis include:
- Low blood sugar
- A heart attack
- A disorder in the nervous system
- Hot flushes caused by menopause
- An infection
Using some types of medication will also lead to excessive depending on the medication used. Hyperhidrosis can also cause infections.
Excessive sweating and hyperhidrosis can affect anyone, regardless of age. It is estimated that 1-3 in every 100 people are affected. The condition can develop at any time though it will most likely first appear during childhood or early on during puberty.
With excessive sweating, it is most likely to occur during exercise, when the weather is warm when you are stressed, or feeling angry or fearful. With hyperhidrosis, it can occur at any time and can happen for no reason.
Sweating at night, known as night sweats, is a condition that can affect anyone. Sweating at night will be normal if the room is hot but night sweats occur when the temperature is cool but the bedding and clothing are wet. There are known causes of night sweats, which include:
- Menopause - hot flushes in particular
- Alcohol or drugs
- Some types of medication
Hyperhidrosis can also cause night sweats, and the cause can also be unknown. If you are unaware of anything that could cause night sweats, make an appointment with your GP and they can help get a diagnosis.
Night sweating in men can be attributed to low levels of testosterone. Even though as men age, it is normal for the level of testosterone to drop, low testosterone is a condition where it is lower than it should be. This can be caused by a number of reasons, including injury to the testicles, type 2 diabetes, kidney disease, a genetic condition such as Klinefelter syndrome, or chemotherapy.
There is a range of treatments out there that can treat excessive sweating and hyperhidrosis. Choosing the right treatment may take a while, and there is a number of different levels of treatments that differ in severity. There are lifestyle changes that may be able to help with reducing how often you experience the condition, but it will not be a cure for hyperhidrosis. These changes include:
- Avoid eating spicy food and drinking alcohol
- Use an antiperspirant instead of a standard deodorant
- Don’t wear tight-fitting clothing
- Don’t wear clothes made from nylon and other man-made materials
- Wear socks that absorb moisture, and change your socks twice a day
- Wear shoes made from leather, and change your shoes during the day
Choosing the right antiperspirant when suffering from excessive sweating or hyperhidrosis can be tricky. A recommendation is to use an antiperspirant that contains aluminium chloride. Aluminium chloride will block the sweat glands. A side effect of this treatment is the fact that it can often irritate the skin or cause itching or tingling. Using emollients on the skin may help to reduce this.
If this does not work, then you can go to your doctor and potentially be prescribed a medicine that is known as an anticholinergic.
This type of medication works by blocking the chemical that causes the sweat glands to produce sweat, acetylcholine. This is a treatment that is rarely used though as many of the anticholinergics are unlicensed to treat hyperhidrosis.
Your doctor may decide to refer you to a dermatologist where they may recommend a number of different treatments. One of these treatments is iontophoresis.
Iontophoresis works by passing an electric current through the skin, generally the hands or feet, using water or a wet pad. This is said to block the sweat glands. This is not painful but can have the short-term side effect of discomfort and skin irritation. A single iontophoresis session lasts for 20-30 minutes and 2-4 sessions a week is recommended. The amount of time that the treatment will last for is dependent on how quickly the symptoms reduce.
Another treatment that could be offered is botulinum toxin injections. This is a treatment where a toxin is injected into the sweat glands that are causing hyperhidrosis. The toxin works by blocking the brain signal to the glands that tells them to sweat. There are usually 15 or more injections that go into the places where the sweat glands are. The treatment can take up to 45 minutes to complete. There are potential side effects when having these injections, which include:
- Itching, redness, or pain in the areas where the injections were placed
- Sweating in other areas of the body
- Weakened muscles
These side effects should subside soon after the treatment occurs. The botulinum injections are available on the NHS, but availability differs based on location. These injections are available privately as well but the pricing will differ based on where the injections are being placed.
In cases where other forms of treatment do not work, or if the hyperhidrosis is severe, surgery may be recommended to you. There are a number of options available, including endoscopic thoracic sympathectomy (ETS) and gland removal.
ETS is the most common type of surgery for treating excessive sweating and hyperhidrosis. In particular, when it comes to treating the palms or armpits. This surgery is done by making small incisions into the side of the chest and cutting the nerves that control the signals that cause sweating in the glands. It should be pointed out that complications can occur as a result of this operation, and that excessive sweating can happen directly after the procedure. As well as that, it may not always be successful. This is why it is only recommended for those who have severe hyperhidrosis which hasn’t been able to be treated with medication and other products. Potential side effects of ETS include:
- A condition called gustatory sweating occurs in the face and neck and eating
- Chest bleeding during surgery
- Chest pain and breathing difficulties, as a result of air being trapped in the chest
- Damage to the nervous system, causing one upper eyelid to drop
There is another type of surgery that can be used to reduce the effects of excessive sweating. This involves removing or destroying the sweat glands themselves. This is most common for the armpits. The surgery can be done in a number of ways:
- Cutting into the armpit and either scraping away the glands carefully or cutting them out
- Getting a probe and holding it above the skin and emit electromagnetic radiation which destroys the glands - no incisions are needed
- Using a laser device by making a small incision into the skin and using the laser to destroy the glands
These procedures are conducted using a local anaesthetic, so you would be awake while the surgery is taking place. Removing the sweat glands is a permanent solution to excessive sweating but at the moment it is only carried out by a small number of surgeons and its availability on the NHS is limited. It won’t work for everyone and it is quite a recent surgery to be used for this treatment. Therefore, its long-term effectiveness and safety are yet to be determined.