Factsheet: Hyperhidrosis

Hyperhidrosis (excessive sweating) is a distressing condition. Whilst it is not physically harmful it is a socially afflictive disorder which means everyday tasks such as shaking hands become uncomfortable. Here are the facts.

Sweat problems

What is hyperhidrosis?

Hyperhidrosis is a condition in which the body sweats excessively and inappropriately. Usually this sweating happens for little or no reason and can be so profuse as to dominate the sufferer's life because of the amount of wetness produced.

What are the symptoms of hyperhidrosis?

Hyperhidrosis of the hands creates difficulty with handling paperwork, keyboards and sports equipment. Where feet are affected there is inability to wear loose sandals like thongs and slipping on tiled or polished floors is a daily hazard. Other sufferers have problems with wetting bedding due to nocturnal sweating.

How is hyperhidrosis different to normal sweating?

It is well recognised that there is a wide range of what is considered "normal" sweating and this is an important part of the body's temperature regulating mechanism. Hyperhidrosis is well outside the accepted range of so-called normal.

It is also known that some disorders mentioned above can alter the body's metabolism with resulting alterations in the normal sweat production. Hyperhidrosis is however different in that there is no detectable abnormality in the patient's metabolism and furthermore only a segment of the body may be affected.

It is not the same as the excessive sweating which occurs in association with medical conditions such thyrotoxicosis or carcinoid syndrome, and it is not the same as the hot flushes which occur during a woman's menopause

Who is likely to suffer from hyperhidrosis?

Hyperhidrosis is not recognised as a hereditary condition. The problem is usually most noticeable in young adults although most sufferers report that they were first affected during their childhood. Young women are affected almost three times more commonly than young men. Hyperhidrosis is less frequently seen in older people. There is no racial difference in incidence.

Where are the most common sites for hyperhidrosis?

The most common sites for hyperhidrosis are the armpits, hands, feet, face and scalp. It can affect any other part of the body and is sometimes troublesome in the groin, on the back, or the natal cleft between the buttocks.

What causes hyperhidrosis?

While doctors don't know why hyperhidrosis starts, they have successfully linked it to over activity in the sympathetic nervous system, specifically in the Thoracic Sympathetic Ganglion Chain which runs along the vertebra of the spine and controls the sweat glands. Depending on which part of the chain becomes overactive, different parts of the body become affected.

How can it be treated?

True hyperhidrosis does not resolve spontaneously without treatment. Your GP will confirm whether you have hyperhidrosis and as a first course of action will probably begin with a course of 'Aluminium Chloride' (Driclor) antiperspirant. It is not always successful, but is worth trying; especially for hyperhidrosis of the armpit.

If treatment with Aluminium Chloride is unsuccessful your GP will probably refer you to a specialist dermatologist. For those afflicted with hyperhydrosis of the hands and feet, 'tap water iontophoresis' is successful in 85% of cases. This is where the hands or feet are placed in plastic baths of tap water and the water is ionized with a current. The treatment takes between 2-12 weeks and is not painful.

Botulinum toxin ('botox') is licensed in the UK to treat excessive underarm sweating. Botox acts by blocking the nerves that supply the eccrine glands, which prevents them from producing sweat. The effects of the treatment last a few months, the time it takes new nerve endings to grow.

There is also a surgical alternative. Endscopic Transthoracic Sympathectomy is a procedure which destroys selective parts of the sympathetic chain which supply the sweat glands. For details contact The Whiteley Clinic, tel: (0870) 766 1234.