Other names: Excessive Perspiration; polyhidrosis; polyidrosis; Sweating
Hyperhidrosis is another name for excessive or uncontrollable sweating. Although the condition is not life-threatening, it can cause a lot of embarrassment and discomfort and impact on school, work, or social relationships.
Hyperhidrosis affects approximately 2-3% of the population, and most commonly affects the armpits, although it can also affect the palms, feet, or the groin.
What Causes Hyperhidrosis?
Hyperhidrosis occurs from over-stimulation of our sweat glands, mostly our eccrine sweat glands.
We have two types of sweat glands in our bodies:
Apocrine glands: these are present from birth but only mature at puberty and start manufacturing sweat at that time. They produce a milky type sweat and sweat production is increased during times of heightened emotional state (stress or fear)
Eccrine sweat glands: these secrete a watery salty solution in response to heart, exercise or stress. Evaporation of this sweat from the skin provides a cooling effect. We have more than two million eccrine sweat glands and these are concentrated in the soles of the feet, palms, armpits, groin, and forehead.
Hyperhidrosis is classified as either primary or secondary, depending on whether there is an underlying medical condition or not.
Primary hyperhidrosis is the most common type. Although the exact cause is unknown, experts believe it may be due to overactivity of the hypothalamus (the area of the brain that maintains body temperature) which stimulates our nervous system to release sweat from eccrine sweat glands. Sweat production can occur without the effects of heat or physical activity, but certain triggers, such as anxiety, emotion, spicy foods can make it worse. It usually begins in adolescence; however, it can begin in childhood or even in infancy. The condition is particularly common among Japanese people suggesting some hereditary components. People with primary hyperhidrosis rarely sweat during their sleep.
Secondary hyperhidrosis occurs due to an underlying medical condition, such as:
Alcohol abuse
Anxiety
Diabetes
Heart disease
Hyperthyroidism
Menopause
Nerve damage
Obesity
Parkinson’s disease
Respiratory failure
Shingles
Some medications (eg, nortriptyline)
Some tumors
Spinal cord injury
Stroke
Substance abuse
Tuberculosis, malaria, or other infections.
What are the Symptoms of Hyperhidrosis?
Symptoms can vary in severity among people and even in the same person. Symptoms may include:
Wet, clammy palms
Wet, sticky, soles of the feet
Visible sweat patches in your armpits
Frequent sweating
An increased prevalence of fungal skin infections
Stained clothing
Self-consciousness or low self-esteem
Changing clothes frequently throughout the day
Problems with body odor.
How is Hyperhidrosis Treated?
Antiperspirants usually contain an aluminum salt which at concentrations >20% cause a long-lasting closure and shrinkage of the sweat gland. These are usually applied at night for a set period for the best results. If antiperspirants are not effective, referral to a doctor may be necessary to exclude a secondary cause of the hyperhidrosis and to try other types of treatment which may include:
Iontophoresis: This uses a gentle current of electricity to temporarily turn off the sweat gland
Botulinum toxin: This blocks the nerves that stimulate sweating
Anticholinergic drugs: these inhibit the transmission of nerve impulses
Endoscopic thoracic sympathectomy: this is a surgical procedure that involves cutting of the nerve that stimulates sweat production
Removal of the sweat glands by thermolysis, surgery, or other procedures.
Drugs used to treat Hyperhidrosis
The medications listed below are related to or used in the treatment of this condition.
For ratings, users were asked how effective they found the medicine while considering positive/adverse effects and ease of use (1 = not effective, 10 = most effective).
Activity
Activity is based on recent site visitor activity relative to other medications in the list.
Rx
Prescription only.
OTC
Over-the-counter.
Rx/OTC
Prescription or Over-the-counter.
Off-label
This medication may not be approved by the FDA for the treatment of this condition.
EUA
An Emergency Use Authorization (EUA) allows the FDA to authorize unapproved medical products or unapproved uses of approved medical products to be used in a declared public health emergency when there are no adequate, approved, and available alternatives.
Expanded Access
Expanded Access is a potential pathway for a patient with a serious or immediately life-threatening disease or condition to gain access to an investigational medical product (drug, biologic, or medical device) for treatment outside of clinical trials when no comparable or satisfactory alternative therapy options are available.
Pregnancy Category
A
Adequate and well-controlled studies have failed to demonstrate a risk to the fetus in the first trimester of pregnancy (and there is no evidence of risk in later trimesters).
B
Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women.
C
Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use in pregnant women despite potential risks.
D
There is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience or studies in humans, but potential benefits may warrant use in pregnant women despite potential risks.
X
Studies in animals or humans have demonstrated fetal abnormalities and/or there is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience, and the risks involved in use in pregnant women clearly outweigh potential benefits.
N
FDA has not classified the drug.
Controlled Substances Act (CSA) Schedule
M
The drug has multiple schedules. The schedule may depend on the exact dosage form or strength of the medication.
U
CSA Schedule is unknown.
N
Is not subject to the Controlled Substances Act.
1
Has a high potential for abuse. Has no currently accepted medical use in treatment in the United States. There is a lack of accepted safety for use under medical supervision.
2
Has a high potential for abuse. Has a currently accepted medical use in treatment in the United States or a currently accepted medical use with severe restrictions. Abuse may lead to severe psychological or physical dependence.
3
Has a potential for abuse less than those in schedules 1 and 2. Has a currently accepted medical use in treatment in the United States. Abuse may lead to moderate or low physical dependence or high psychological dependence.
4
Has a low potential for abuse relative to those in schedule 3. It has a currently accepted medical use in treatment in the United States. Abuse may lead to limited physical dependence or psychological dependence relative to those in schedule 3.
5
Has a low potential for abuse relative to those in schedule 4. Has a currently accepted medical use in treatment in the United States. Abuse may lead to limited physical dependence or psychological dependence relative to those in schedule 4.
Alcohol
X
Interacts with Alcohol.
Further information
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