Do you sweat too much? Let's talk about hyperhidrosis!

Do you sometimes feel like you sweat excessively for no reason? Perhaps your palms, soles, or armpits are always wet? Or do you sweat so much that your clothes get wet from even the smallest thing? This is a problem that many people have, but it's something they're a little hesitant to talk about. Let's talk about this in detail today.

What is hyperhidrosis? Let's understand it simply!

Simply put, hyperhidrosis is excessive sweating. Normally, we sweat to regulate our body temperature. That means it's normal to sweat when we exercise, when we feel scared, or on a hot day. However, someone with hyperhidrosis may sweat excessively for no apparent reason, perhaps even when in a cold room or just when we're at rest.

Our skin has a type of sweat glands called eccrine glands . These are the glands that produce sweat. When this sweat reaches the surface of the skin and evaporates, the body cools down. In hyperhidrosis, these sweat glands become overactive. It's like a tap that doesn't close properly and leaks water.

There are two main types of hyperhidrosis. What are they?

Yes, doctors have identified two main types of this:

1. Primary Focal Hyperhidrosis:

• This is the most common type. It is actually a chronic skin condition.
• Most often, this is caused by a genetic mutation . This means that if someone in your family has the condition, you are more likely to develop it too.
• This type usually only sweats in specific areas, such as the armpits, palms, soles, and face.
• This often starts in young people under the age of 25 .

2. Secondary Generalized Hyperhidrosis:

• In this type, excessive sweating can be caused by another underlying medical condition (such as diabetes mellitus, Parkinson's disease) or a side effect of some medications you are taking (such as painkillers like naproxen).
• In this type , sweating can occur not only in one area of ​​the body, but also all over the body.
• Sometimes, sweating even while sleeping at night can be a symptom of this type.

How common is this condition? Who is most affected?

Hyperhidrosis is actually a more common condition than you might think. Research shows that about 3% of adults in the United States, between the ages of 20 and 60, suffer from this condition. There are many people in Sri Lanka who have this condition, but some are reluctant to talk about it.

What are the symptoms of hyperhidrosis? How do you feel?

The main symptom is excessive sweating. You may experience:

• Skin always feels wet .
• The clothes you are wearing get wet from sweat.
• It looks like sweat is dripping from your face and forehead.

If this condition persists for a long time, other symptoms may appear:

• Sweat causes itching and inflammation of the skin.
• Body odor. This occurs when bacteria on the skin combine with sweat. Sweat itself does not have an odor, but it is when bacteria accumulate that the odor comes from.
• Cracking or peeling skin, especially on the soles of the feet.

These symptoms can vary from person to person. Some people only have them for a short time and they come and go. For others, they are constant throughout the day and interfere with daily activities.

Most importantly, this condition can also affect your mental health. Many people feel embarrassed and avoid socializing because of excessive sweating. If this is your case, it is important to see a doctor to get help managing these symptoms, as well as to talk to a mental health counselor about your feelings.

Where on the body can you sweat the most like this?

Although we have sweat glands (eccrine glands) all over our bodies, there are more of them in some areas. That's why we can sweat more in those areas:

• Underarms (Axillary hyperhidrosis)
• Plantar hyperhidrosis
• Palms (Palmar hyperhidrosis) - This is the area that affects most people.
• Forehead and cheeks (Craniofacial hyperhidrosis)
• In the genital area
• Lower abdomen

Why do we sweat so much? What are the reasons?

The main reason is overactive sweat glands. Normally, when our bodies get hot, sweat glands work to cool us down. This happens when we exercise or get nervous. But in people with hyperhidrosis, the sweat glands produce sweat even when the body is not hot. Research is still ongoing to find out why this happens.

Some factors (Triggers) that increase sweating:

Some things can stimulate your sweat glands and cause increased sweating:

• Stress, anxiety, fear, and nervous feelings.
• Hot weather or high humidity.
• Exercise or physical activity.
• Certain foods and drinks: spicy foods, oily foods, foods high in sugar and salt, foods high in protein. Beverages such as coffee and alcohol that contain caffeine.

Some medications that can cause sweating include:

Excessive sweating can also be a side effect of some medications you take. Here are some examples:

• Albuterol (Proventil®)
• Bupropion (Wellbutrin®)
• Hydrocodone
• Insulin `(Insulin (Humulin® R, Novolin® R))`
• Levothyroxine `(Levothyroxine)`
• Lisinopril `(Lisinopril)`
• Naproxen (Aleve®)
• Omeprazole (Prilosec®)
• Sertraline (Zoloft®)

If you are taking a medication like this and you are sweating excessively, talk to your doctor. Do not stop taking any medication without medical advice.

Some medical conditions that can cause sweating include:

Secondary (Generalized) hyperhidrosis can be caused by an underlying medical condition. Examples:

• Acromegaly
• Infections (e.g. Tuberculosis)
• Anxiety
• Cancer
• Diabetes
• Heart disease or heart failure
• Hyperthyroidism
• Menopause
• Obesity
• Parkinson's disease

Is this condition hereditary?

Yes, you are at risk, especially if someone in your family has primary focal hyperhidrosis . Research suggests that it may be caused by a hereditary genetic mutation .

Can this excessive sweating cause other complications?

Yes, hyperhidrosis can cause some complications:

• Skin infection.
• Skin changes: pale skin, discoloration, skin cracking or wrinkling.
• Excessive moisture and softening of the skin (Maceration).

In addition to these physical effects, as mentioned earlier, it can also have a major impact on your mental health . You may be tempted to change your daily routine and avoid certain activities (like raising your hand, shaking hands) because you think others will notice you sweating. You may even avoid things you enjoy because of this. Therefore, if this condition is affecting your mental and social life, be sure to seek medical advice.

How do doctors accurately diagnose this as hyperhidrosis? (Diagnosis)

A doctor will determine if you have hyperhidrosis after examining you, listening to your symptoms, and taking your medical history. There are a few criteria they use to determine this. If you have been sweating excessively for at least six months and can answer "yes" to at least two of the following questions, you may have hyperhidrosis:

• Do you sweat under your armpits, palms, soles, or face?
• Do you sweat equally on both sides of your body?
• Do you not sweat at night, or do you sweat less?
• Have you been sweating for at least a week?
• Does anyone in your family have this condition?
• Does sweating interfere with your daily activities?
• Are you under 25 years old?

What tests are done to confirm this?

The doctor may do one or more of the following tests to help find the cause:

• Starch-iodine test: An iodine solution is applied to the sweaty area and starch is sprinkled on top. Areas with excessive sweating turn a dark blue color.
• Paper test: A special paper is placed on the sweaty area to absorb the sweat. The paper is then weighed to see how much sweat is present.
• Blood or imaging tests: These can help find the cause of your symptoms by taking a sample of your blood or taking pictures of what's under your skin.

So, what can be done to treat this condition of hyperhidrosis?

Treatment options vary depending on the part of your body affected, the severity of the condition, and the type of treatment that is right for you. A dermatologist can help you find the best treatment for you. There is no one-size-fits-all treatment.

Simple things you can do at home

• Using antiperspirants and deodorants: Antiperspirants work by blocking sweat glands and reducing sweating. Your doctor may recommend an over-the-counter (OTC) or prescription-strength type. Products that contain aluminum are best for this.
• Bathe or wash your body frequently: Mild symptoms can be relieved by bathing frequently every day.
• Wear breathable, sweat-wicking clothing: Fabrics like cotton are good for this. Synthetic fabrics like polyester can trap heat and make you sweat more, so avoid them.

Medicines that can be taken on medical advice

Your doctor or dermatologist may recommend medications like these:

• Anticholinergic agents (e.g., glycopyrrolate, oxybutynin)
• Antidepressants (some types also help reduce sweating)
• Beta-blockers (especially for cases of sweating due to stress)
• Medicated wipes (e.g., glycopyrronium tosylate, Qbrexza®)
• Aluminum chloride gel `(Aluminum chloride gel)`

Before taking these medications, talk to your doctor about their side effects.

Specific Therapies

If home remedies and medications don't provide much relief, your doctor may suggest specific treatments such as:

• Iontophoresis: Your hands or feet are placed in a shallow bowl of water. A special device sends a low-level electrical current through the water, which over time blocks the sweat glands. Each session lasts about 10-20 minutes. You may need to do this treatment several times. You may also be able to use this device at home.
• Botulinum toxin (Botox®) injections: This can be injected into an overactive nerve and stop sweat production for a few months. However, you will need to get these injections repeatedly.
• Microwave therapy: Your doctor places a special device (such as miraDry®) on your sweaty skin. It releases heat, permanently destroying the sweat glands. This is a treatment that takes about an hour in the doctor's office.

Surgery - as a last resort

If all other treatments fail, the doctor may consider surgery:

• Endoscopic thoracic sympathectomy (ETS): This is a surgery done through a very small incision. The surgeon cuts a nerve in the body, stopping the signal to the sweat glands to produce sweat.
• Sweat gland removal: The surgeon removes the sweat glands using laser, curettage, excision, or liposuction.

Surgery can provide long-term relief for those who have not responded to other treatments. However, it is important to discuss the side effects of surgery with your surgeon before making a decision.

Are there any side effects to these treatments?

Every treatment method can cause some side effects. For example:

• Itchy, cracked, or blistered skin.
• Skin discoloration.
• Pain or discomfort.
• Discoloration or damage to clothing.
• Scarring.

Your doctor can tell you exactly what the side effects of the treatment are. Discuss this carefully before starting treatment.

How soon will I feel better after starting treatment?

You may feel a difference right away when you start treatment. Or it may take several weeks or months for your symptoms to improve. The time it takes for each treatment is different. Your doctor will tell you about this.

Are there ways to prevent this condition of hyperhidrosis?

Not all cases of hyperhidrosis can be prevented. For example, primary focal hyperhidrosis is genetic and therefore difficult to prevent. However, if you have the secondary (generalized) type, it can be reduced by controlling the underlying medical condition or managing the side effects of medications.

What to expect when living with hyperhidrosis?

Although there is no cure, there are many treatments available to help manage the symptoms. It is not a life-threatening condition, but it can have a significant impact on your life. You may feel embarrassed or embarrassed to talk about it. It may also cause you to withdraw from activities you enjoy. So, if this condition is affecting your mental health, talk to a doctor or mental health counselor .

So there is no complete cure for this?

There is no cure for primary focal hyperhidrosis. However, treatment can reduce symptoms and improve quality of life. Secondary generalized hyperhidrosis can sometimes go away completely if the underlying medical condition or medication that caused it is managed. However, not all secondary cases can be cured.

When should I see a doctor?

If excessive sweating causes any of these symptoms, definitely see a doctor:

• If it negatively affects your life .
• If you have to stay away from activities or people you love.
• If the situation worsens over time.
• If you sweat while sleeping at night .

Emergency: Sometimes excessive sweating can be a sign of a serious, even life-threatening condition. If you experience symptoms such as chest pain, nausea, or dizziness along with sweating, seek immediate medical attention.

What should I ask the doctor about this?

If you have hyperhidrosis, you can ask your doctor questions like these:

• What makes me sweat like this?
• What treatment options do I have?
• What treatment would you recommend first?
• Are there other things I can do to reduce these symptoms or improve my overall health?
• How long will it take for my symptoms to subside?
• How can I help myself maintain my mental health?

Why does sweat sometimes smell? There are two types of sweat glands in our skin!

The sweat from our eccrine glands doesn't actually have a smell. But it does smell when that sweat combines with bacteria on our skin. Sweat is mostly water. Our skin naturally has a small amount of bacteria. When these bacteria combine with sweat droplets, they break down the tiny particles in the sweat. That's what causes the strong odor.

We also have another type of sweat gland called apocrine glands . These are located in areas where there are hair follicles, such as the armpits and genital areas. The fluid from these glands is slightly thicker than the fluid from the eccrine glands. When this thicker fluid combines with bacteria on the skin, body odor occurs.

Finally, the most important things you need to remember (Take-Home Message)

Hyperhidrosis can be a short-term or long-term condition, and it can be challenging to manage. You may also avoid social interactions because of fear of how others will react to your symptoms (e.g., shaking hands with sweaty hands).

Although there is no cure for this, help is available! Your doctor may prescribe an antiperspirant or medication to help reduce your symptoms. This is not something you should go through alone. You have the right to talk about it and ask for help. So, don't be ashamed or afraid to seek medical advice. Take steps to make your life more comfortable today!

` Sweating, excessive sweating, hyperhidrosis, sweating, sweat glands, skin diseases, treatment