Hyperhidrosis is a condition where a person experiences excessive and abnormal sweating that is unrelated to heat, exercise, exertion, or anxiety. It will usually occur while the individual is awake, will affect the hands, feet, face, or underarms on both sides of the body, and happens at least once a week. This can cause embarrassment and social anxiety as sweat can drench through clothing or drip off the person. Our bodies naturally produce sweat as a mechanism for cooling. When the body temperature increases, the nervous system activates sweat glands.
In the most common type of hyperhidrosis, called primary focal hyperhidrosis, the nerves responsible for triggering the sweat glands are overactive and are unrelated to temperature or a person’s level of exertion. It typically affects the palms of the hands and soles of the feet but may also affect the face. Stress and anxiety only worsen the situation. There is no medical condition that causes this type of hyperhidrosis. It is thought to be hereditary.
Less common is secondary hyperhidrosis, which is excessive sweating caused by a medical condition. This type can affect the entire body, and can be related to diabetes, thyroid issues, menopause, some cancers, low blood sugar, heart attack, infections, or nervous system disorders. Opioid withdrawal and certain medications can also lead to increased amounts of sweat production.
A doctor will want to use urine, blood, or other lab tests to determine if a patient’s issue is caused by an underlying medical condition. If so, that condition will be addressed first before focusing on treatments that help control the amount of sweat produced. These treatments options may include prescription antiperspirant containing aluminum chloride, prescription cream containing glycopyrrolate for head and face sweating, nerve-blocking medications, botulinum toxin injections (Botox) to block nerves, or certain types of antidepressants that decrease sweat production and may also decrease the anxiety that exacerbates the issue. Other procedures that might be considered are microwave therapy used to destroy sweat glands, sweat gland removal, or nerve surgery to cut, burn, or clamp the spinal nerves that control the sweat glands.