Why Do I Sweat Excessively?
It’s getting hot outside! Sweating is our bodies’ natural response to eliminate heat. In response to heat, sweat is released by the eccrine glands in the skin.
Hyperhidrosis is an overproduction of sweat beyond what is necessary for maintaining body temperature. Hyperhidrosis can be PRIMARY, which means there is no underlying cause or SECONDARY which means it is triggered by some external factor such as medication or a medical condition. Although almost all areas of the skin contain eccrine sweat glands, primary hyperhidrosis is most commonly seen on hands, feet, and underarms.
According to the International Hyperhidrosis Society, criteria for Primary Hyperhidrosis includes focal visible excess sweat for at least six months without apparent cause, plus at least two of the following criteria:
- Your sweat is bilateral and relatively symmetrical, meaning you sweat the same on both sides of your body.
- Your excess sweat impairs your daily activities.
- You experience at least one episode a week.
- The onset of your excess sweat is earlier than age 25.
- You have a positive family history. (Meaning that other members of your family suffer from similar sweating problems.)
- You stop sweating when you’re sleeping.
There are a number of common ways to target normal sweating and hyperhidrosis so that it does not interfere with your quality of life.
OTC TOPICAL ANTIPERSPIRANTS – The most common variety of these contain Aluminum as their active ingredient. They are available OTC in regular and “clinical” strength.
RX TOPICAL ANTIPERSPIRANTS- For many years the most common of these was DRYSOL, 20% Aluminum Chloride. The most common side effect of Drysol is irritation of the skin. A newer topical antiperspirant is Qbrexa which works through anticholinergic action. The most common side effect is Dry Mouth and Dry Eyes as the Qbrexa appears to be absorbed into the bloodstream affecting other areas as well.
Beyond these commonly prescribed and easily available treatments, there are a few other options that work to mechanically interfere with or destroy the sweat glands. These procedures include iontophoresis, Miradry, and surgical sympathectomy. One other option that we offer in the office is BOTOX injections.
BOTOX injections – BOTOX is injected in hyperhidrotic areas to reduce the action of the eccrine glands. These injections need to be performed every 4-9 months depending on response and are very expensive and quite uncomfortable. For this reason, we make every effort to achieve success with topical medication prior to suggesting BOTOX injections. Insurance coverage for BOTOX injections is also very limited and requires a significant trial and failure of topical medications.
If you are suffering from Hyperhidrosis, let us know at your upcoming appointment! We can help you better enjoy summer and every day with less sweating!
Stay tuned for our upcoming blog post that will sort through the facts and myths regarding topical antiperspirants.
To learn more about hyperhidrosis we recommend the International Hyperhidrosis Society Website and these handouts.
Diseases and Conditions Known to Cause Secondary Hyperhidrosis – https://www.sweathelp.org/pdf/Diseases_2009.pdf
Medications Known to Cause Secondary Hyperhidrosis – https://www.sweathelp.org/pdf/drugs_2009.pdf
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