Hyperhidrosis is a medical condition in which a person sweats excessively and unpredictably, generated by the sympathetic nervous system. It may affect the hands, feet, and/or armpits. People with hyperhidrosis may sweat even when the temperature is cool or they are at rest.
Primary hyperhidrosis is when there is excessive sweating with no known cause. Primary hyperhidrosis affects 0.5 - 1% of the population.
If the sweating occurs as a result of another medical condition, it is called secondary hyperhidrosis. The sweating may be all over the body, or it may be in one area. Conditions that cause secondary hyperhidrosis include:
- Acromegaly
- Anxiety conditions
- Cancer
- Carcinoid syndrome
- Certain medications and substances of abuse
- Diabetes
- Heart disease
- Hyperthyroidism
- Lung disease
- Menopause
- Parkinson’s disease
- Pheochromocytoma
- Spinal cord injury
- Stroke
- Tuberculosis or other infections
Diagnosis
Visible signs of sweating may be noted during a doctor's visit. A number of tests may also be used to diagnose excessive sweating. Tests include:
- Starch-iodine test. An iodine solution is applied to the sweaty area. After it dries, starch is sprinkled on the area. The starch-iodine combination turns a dark blue color wherever there is excess sweat.
- Paper test. Special paper is placed on the affected area to absorb the sweat, and then weighed. The heavier it weighs, the more sweat has accumulated.
You may also be asked details about your sweating, such as:
- Location
- Time pattern
- Triggers
- Other symptoms, such as: weight loss, pounding heartbeat, cold or clammy hands, fever, or lack of appetite
Treatment Options
The first line of treatment for hyperhidrosis is medication to reduce the amount of sweating. Topical medications may be used, as well as oral anti-cholergenic drugs. If these do not work, surgery may be an option.
Thoracic sympathectomy
Thoracic sympathectomy is a surgery that stops or turns off the nerve signals that tell the part of the body to sweat too much. The surgery involves two to three small incisions (less then a centimeter) on each side of the chest near the armpit. The sympathetic chain is then cut at the appropriate levels, depending on the type of excessive sweating. The surgery is successful in 95-98% of patients with palm sweating and approximately 80% with excessive armpit sweating.
Learn more about hyperhidrosis and surgical treatment in the video below.
