Excessive sweating (hyperhidrosis)

What is it about ?

Our skin is dotted with small glands that produce perspiration. This production of perspiration plays a role in regulating our body temperature. If this temperature rises too much, we start to sweat.

Excessive sweating is characterized by an overproduction of sweating, constant or in the form of a push, without it being necessary to regulate our temperature. There are two forms of excessive sweating: one form primary and an secondary form.

Primary form

In the primary form, there is no underlying affection which can cause excessive sweating. The disorder usually appears in adolescence. In this case, sweating is especially abundant in the following places:

• The palms of the hands;
• Soles of the feet ;
• Armpits ;
• The head.

Sweating is often triggered by certain factors, such as:

• The emotions ;
• Physical effort;
• The heat ;
• Consumption of alcohol or drugs;
• Spicy food.

Likewise, hormonal changes may also be responsible. This is the case for hot flashes that women may experience during menopause.

Secondary form

In the secondary form, it is a underlying condition which is the root cause of excessive sweating. Sweating can be caused by a variety of conditions:

• infections associated with fever;
• Sleep Apnea ;
• overactive thyroid (hyperthyroidism) ;
• diabetes ;
• psychiatric disorders;
• affections of the nervous system;
• malignant diseases.

Some medications, such as antidepressants, and certain high blood pressure medications can also trigger excessive sweating.

How to recognize it?

• The skin visibly sweats.
• You are sometimes Red.
• The skin is often moist, and sometimes cold.
• You can sweating excessively in a specific place, in the palms of the hands and the soles of the feet, armpits and head.
• You can also sweat all over your body. That’s what we call generalized excessive sweating.

How is the diagnosis made?

Discussion and clinical examination

The doctor will ask you detailed questions about your symptoms and perform a physical examination.

• If you are sweating locally and have suffered from it since you were a child, there is usually nothing to worry about.
• If you suddenly start to sweat excessively at an older age or on one side of your body, it is more likely a secondary form. In this case, you also have other symptoms.

Other examinations

If the doctor suspects a secondary form, he will perform additional examinations to find the cause of this excessive sweating. It will start with a blood test thorough. Depending on the result, he will direct you to a specialist for additional examinations.

What can you do ?

• Wear light clothing.
• Regularly wash the areas where you sweat the most, such as the armpits and the folds of the groin.
• In case of localized excessive sweating, you can use local antiperspirants, such as a spray, roll-on, or solution.
  • Apply them once a day at first, then once or twice a week.
  • These antiperspirants are especially effective on the armpits, the palms of the hands and the soles of the feet.
• In case of generalized excessive sweating, seek medical advice.

What can your doctor do?

Medicines for local use

The doctor may prescribe a preparation based on aluminum chloride. The pharmacist can prepare it.

Other drugs

• If topical medicines do not work, you can try them botulin injections.
  • This treatment can be quite painful.
  • It should be repeated every 6 to 12 months.
• If you sweat excessively in your hands and feet, youriontophoresis is another possibility.
  • Treatment involves immersing your hands and feet in a bath of running water.
  • An electric current is then sent through the water to inhibit the functioning of the sweat glands.
  • Sweating decreases after 8 to 10 sessions.
  • This treatment does not cure either, and must therefore be repeated.
• If you suffer from excessive generalized sweating (all over your body), you should first of all have the underlying condition treated.
• Sometimes the doctor prescribes what are called anticholinergics. Unfortunately, these drugs often cause quite a few side effects: dry mouth, eye, bowel and urinary problems.
• For severe hot flashes during menopause, you may want to consider a hormone replacement therapy (HRT).

Source

Foreign clinical practice guide ‘Excessive sweating (hyperhidrosis)’ (2015), updated on 05/26/2015 and adapted to the Belgian context on 06/04/2019 – www.ebpnet.be