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Excessive Sweating (Hyperhidrosis)
Sweating is a normal bodily function that serves to cool the body when water on the skin
surface evaporates. Sweat is composed of a water and salt solution that is excreted by the
microscopic sweat glands deep in the skin. This solution comes to the surface through small
tubules called sweat gland ducts. The number of sweat glands per square centimeter of skin
varies widely. The palms of the hand, the soles of the feet, the face and armpits all have
very high numbers of sweat glands. Thus, these areas have the highest production of sweat.
Excessive sweating occurs in about 1% of the population. It goes by a variety of names
including idiopathic hyperhidrosis (meaning you've got it but we don't know why),
essential hyperhidrosis, gustatory hyperhidrosis and diabetic gustatory hyperhidrosis.
Hyperhidrosis may be triggered by eating (gustatory) and stress factors such as public
speaking or meeting new people. Excessive sweating is just that, an exaggerated response
to a situation or stimulus that triggers a normal amount of sweating in most people.
Sometimes excessive sweating can be a sign of an underlying disease. In these instances,
excessive sweating usually occurs at night or has just recently begun in someone who has
never experienced it before. Anyone with a newly onset of excessive sweating or night sweats
should visit their family physician to rule out underlying and correctable illnesses.
Excessive sweating unrelated to disease is not life threatening but is a persistent,
annoying condition that can dramatically affect a person's quality of life. A person
may avoid contact with others because they are embarrassed by excessive facial or hand
sweating. Simply meeting someone new can be an emotional ordeal as the sweating starts
and the person is overwhelmed by a feeling of loss of control. The palms can be so wet
that shaking hands is uncomfortable and embarrassing.
Types of Excessive Sweating
Idiopathic (essential or primary) hyperhidrosis
is a condition that results from over activity of the nerves that send signals to the
sweat glands in the skin. These nerves are part of the sympathetic nervous system.
Acetylcholine is the main chemical messenger involved in this over-stimulation.
The condition often becomes evident during childhood and then persists throughout life.
Idiopathic hyperhidrosis has shown some genetic linkage but definitive work remains to
be done in this area. Men and women are affected in equal numbers.
The excessive sweating typically occurs in four primary locations, the forehead,
the armpits (axillary), the hands (palmer) and the feet (plantar). Excessive sweating
can occur as a generalized symptom or sweating may be more specific and focused.
For example, people with palmer sweating often cite the need to have control over
excessive sweating for work (difficulty holding tools), social occasions, and playing sports.
For some people excessive sweating is brought on by public speaking or a group presentation.
Even seasoned public figures may experience these uncontrollable symptoms. The symptoms
can raise questions in the audience's mind "Why is this person so nervous? Are they hiding
something?"
Some people with generalized, idiopathic hyperhidrosis are embarrassed by their conditions
to the point of severely restricting social activities. This in turn can lead to withdrawal
and depression. Those suffering from excessive sweating often express frustration at the
medical community's inability to find a root cause and a specific cure. Their frustrations
are further heightened by a feeling that their condition is considered minor and of little
consequence, "After all, it is only sweating, it isn't going to kill anyone".
Gustatory Sweating is a condition of profuse sweating on
the side of the face in response to chewing. The facial sweating may extend to the forehead
and neck. Gustatory sweating can be idiopathic (no known cause), triggered by certain foods,
associated with sugar diabetes or it can begin after facial surgery.
Gustatory sweating associated with sugar diabetes is usually a sign of advanced and
long-standing diabetes resulting in nerve or kidney damage. The mechanism causing
excessive sweating in sugar diabetes is not fully understood. Excessive sweating can
occur in 70% of diabetes patients with kidney damage and 40% of diabetes patients nerve damage.
Gustatory sweating after facial surgery usually does not
present as a side effect until several months after the surgery. It is felt that this is the
result of regeneration of nerve fibers damaged because of surgery.
Treatment Options
While there are a variety of treatment options available for excessive sweating, current
pharmacy regulations prohibit us displaying specific information on a website. However our
pharmacists would be glad to review the options available after they know more about your
particular symptoms. For a free online consultation click here.
In general, treatments for excessive sweating fall into three broad categories:
-
Topical and non-prescription products
- Extra strength antiperspirants
- Alcohol based antiperspirant solutions
- Alcohol based antiperspirant gels
- Other topically based products
- Prescription products
- Surgical treatments
Click here to request a
free Excessive Sweating Consultation.
Watch our
Excessive Sweating Video.
More Information
If you need to speak to a pharmacist you may contact us at 1-800-727-5048
or 1-416-960-7768
Prepared October 12, 2002
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