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Complications of Hyperhidrosis
Hyperhidrosis Treatments
Types of Hyperhidrosis
Compensatory Sweating and How You Can Stop It
Written by Katie Crissman
October 01 2020

Endoscopic thoracic sympathectomy (ETS) is a type of surgery used to treat primary focal hyperhidrosis. While hyperhidrosis itself is not dangerous, the effects of the condition can be so devastating that some people consider surgery. During an endoscopic thoracic sympathectomy a surgeon makes a small incision between a patient’s ribs and then uses a tiny camera to search for the nerves that control sweat production in the upper extremities.They then attempt to sever or destroy these nerves so that the nervous system can no longer use the neural pathways associated with creating extra sweat. This prevents the patient from sweating in specific, undesirable areas, depending on where the nerves were disabled. Usually, these areas include the palms and sometimes the axillary region. The surgery is usually very effective in alleviating sweat in these areas, however, it comes with a heavy price. There is also a type of surgical procedure called endoscopic lumbar sympathectomy that can also lead to compensatory sweating, but most doctors don't recommend getting it because of the serious adverse effects it can cause.[3]

Between 3% and 98% of patients who have undergone ETS develop compensatory sweating. It is the most likely side effect associated with the surgery and, in some cases, its effects are so bad patients assert that it is worse than the original condition. For those with severe compensatory sweating, it can cause as much anxiety as the hyperhidrosis problem they originally had. Compensatory sweating occurs because the body is attempting to make up for the lost sweat production in the treated areas. It redirects sweating to other, broader parts of the body. These parts of the body often include the abdomen, chest, back, legs and gluteal area. In some cases excessive sweating of the groin occurs. Sweating from this side effect is more generalized and can be debilitating, depending on its severity.[3] Besides finding ways to manage their sweat, there are medical interventions that can help those who develop compensatory sweating.

Who is At Risk of Developing Compensatory Sweating

Anyone who undergoes ETS surgery is at risk of developing compensatory sweating. However, there are some factors that make some people more prone to developing it than others. It has been shown that children undergoing a transaction not involving T2 have the lowest rates of compensatory sweating. That is why it is actually a recommended medical treatment for children with hyperhidorsis. Adults who already have a propensity to sweat in inguinal folds, buttocks, back or upper thighs are considered to be at the highest risk of developing the condition.[3] One study showed that the higher a patient’s bmi (body mass index) the more likely they were to develop compensatory sweating. This same study also suggests that the higher the resection is performed on the sympathetic chain the more afferent fibers would be harmed and that this would increase the intensity and occurrence of compensatory sweating. Other factors like age, sex, family history and the co-occurrence of plantar hyperhidrosis are also thought to increase the likelihood of an individual developing compensatory sweating.[1]

Compensatory Sweating Solutions

Due to the fact that compensatory sweating can be so devastating there have been multiple attempts to correct this unfortunate side effect. It has been associated with a decrease in quality of life and it is important for patients to find ways to manage their sweat and eliminate it, if possible. One easy way to manage compensatory sweating is to use antiperspirant, there are antiperspirants that can be used on the groin, and other sensitive areas that may be affected by compensatory sweating. If you are worried about what antiperspirant will do to your body then you don't need to be overly concerned as many studies have shown that it is quite safe. You may also want to consider using baby powder which can help with sweat related issues like chafing.

Medications

One way doctors have attempted to treat compensatory sweating is through the use of oral medications used to treat hyperhidrosis. The most common types of medications used are called anticholinergics. These drugs act by blocking the neurotransmitter acetylcholine in both the central and peripheral nervous systems. This is the neurotransmitter responsible communicating with sweat glands, so taking the medication reduces sweating. These drugs have a systemic effect which is desirable when treating a condition that affects multiple areas of the body like compensatory sweating does. They do have side effects, like dry mouth, among others. The most commonly prescribed anticholinergics are glycopyrrolate and oxybutynin.[3] One study found that combining the use of oral oxybutynin while treating the affected area with Botox greatly relieved suffering.[1]

Botox

One ways doctors seek to improve patient’s symptoms is through the use of Botox injections. Botox is used for axillary hyperhidrosis, and in many cases, botox is used for the treatment of palmar and plantar hyperhidrosis. Botox can be helpful for those suffering from compensatory sweating, especially when combined with medication.[1] Between 60% and 90% of patients who undergo ETS for axillary hyperhidrosis will develop compensatory sweating. In these cases, Botox is especially useful. Before beginning a procedure the doctor will have a patient identify the problem areas affected by compensatory sweating. Then, the doctor will perform a starch-iodine test, a painless test that shows areas of sweat, to confirm where the problem areas are located. After an anesthetic is given and injection sites are mapped out, Botox injections will be delivered throughout the problem areas. Unfortunately, due to the large surface area that is typically affected by compensatory sweating, Botox alone is usually not enough.[3] However, in combination with oral medication, Botox can provide much needed relief from compensatory sweating and can an important part of a patient’s treatment plan.

Surgery Reversal

Some surgeons who perform ETS surgery use clips to prevent nerves from communicating, rather than destroying the pathways. They do this with the intent that if a patient does experience severe compensatory sweating, they will be able to remove the clips and reverse the surgery. In these surgeries doctors often attempt to regraft the nerve as well. In one study of patients who had clips removed due to compensatory sweating, 48% reported a large reduction in their sweating while 42% reported that their compensatory sweating remained the same. This is due to the fact that nerves may still be damaged even when clips are used.[3] Another study done on patients who opted for a reversal of their ETS surgery found that those who had reversal procedures done were less satisfied than patients who received iontophoresis therapy for their compensatory sweating.[4] Treatment with iontophoresis is for palmar and plantar hyperhidrosis in most situations. It is usually not an option for those with compensatory sweating due to the fact that large areas of the body are required to be submerged in water, but it is an interesting idea for the future. Overall, surgical reversal can be quite helpful for some but does not offer a consistent benefit to all patients. The outcome is prone to chance, depending on whether or not a patient’s nerve was damaged irreversibly or not.

Prevention is Key and Management is Possible

Up to 94% of patients who undergo ETS surgery say that it improved their quality of life, regardless of compensatory sweating.[3] However, for the other 6%, compensatory sweating is the most likely reason they regretted having the procedure done. It is extremely important that patients know the risks of ETS and other similar surgical procedures so they can make an informed decision about the risks. There is a very high chance that those undergoing surgery will develop some level of compensatory sweating. If a patient has certain risk factors for developing severe compensatory sweating they need to be made aware before a procedure is performed. For those that have irreversible compensatory sweating, hyperhidrosis can be managed with a doctor and satisfactory results can be achieved.

Sources
  1. Karlsson-groth, A., Rystedt, A., & Swartling, C. (2015). Treatment of compensatory hyperhidrosis after sympathectomy with botulinum toxin and anticholinergics. Clinical Autonomic Research, 25(3), 161-167. doi:10.1007/s10286-015-0278-x
  2. Milanez de Campos, J. R., Wolosker, N., Takeda, F. R., Kauffman, P., Kuzniec, S., Jatene, F. B., & De Oliveira, S. A. (2005). The body mass index and level of resection Predictive factors for compensatory sweating after sympathectomy. Clin Auton Res, 15, 116-120. doi:10.1007/s10286-005-0259-6
  3. Pariser, D. M. (2014). Hyperhidrosis (4th ed., Vol. 32). Philadelphia, PA: Elsevier.
  4. Stefaniak, T., Cwigon, M., & Laski, D. (2012). In the Search for the Treatment of Compensatory Sweating. The Scientific World Journal. doi:10.1100/2012/134547
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Body Areas Affected by Hyperhidrosis

Can Athlete’s Foot Cause Sweating?

By JP Carter /

The answer is “no” - Athlete’s foot does not make you sweat more, but it can make excessive sweating even more uncomfortable than it already was. Here is an in-depth look at what Athlete’s foot really is and how excessive sweating impacts it.

Athlete’s foot, known scientifically as tinea pedis, is caused by a fungal infection (called dermatophytes) that affects the skin of the feet, especially the skin between the toes. The fungus causes skin to redden and crack and the affected areas are often flaky and itchy. Sometimes affected skin can also become inflamed. The fungus is able to infect a foot when it enters the top layer of the skin through small cracks or wounds. The infection can be passed on from person to person through direct contact or when someone steps on infected flakes of skin from another person. In order to grow and thrive, the fungus that causes Athlete’s foot needs a dark, moist environment and feet provide the perfect breeding ground due to those conditions. Furthermore, the skin of the feet contain large amounts of Keratin which the fungus feed on. There are certain risk factors that make it more likely for someone to develop Athlete’s foot, these include:

  • Genetic predisposition (seems to affect some families more than others)
  • History of allergies and eczema
  • Excessively sweaty feet (history of hyperhidrosis)
  • A weakened immune system
  • Poor circulation in the legs
  • Playing certain sports, particularly running and swimming[1]
  • Athlete’s foot appears to be a very common problem as anywhere between 3% and 15% of the population are thought to struggle with it at any given time. It is not physically dangerous, but it typically won’t go away on it’s own. Therefore, it is important for people with the condition to seek treatment.[1] While no studies have shown that Athlete’s foot causes people to sweat more, it has been noted that excessive sweating of the feet makes the development of Athlete’s foot much more likely. This is especially true for people who suffer from a condition called primary focal hyperhidrosis.[2] Hyperhidrosis causes people to sweat excessively from specific parts of the body like the hands, feet, armpits, face, and head. It affects about 3% of the US population making hyperhidrosis quite common, like Athlete’s foot.[3] The reason so many people with hyperhidrosis develop Athlete’s foot is because the condition causes the feet to constantly produce sweat which promotes the exact environment fungus need to thrive.[2] Luckily, there are several effective ways to prevent Athlete’s foot and manage the symptoms of hyperhidrosis.

    How To Prevent Athlete’s Foot

    Preventing Athlete’s foot predominantly consists of specific types of self-care to keep feet dry and certain precautions to limit exposure to infectants. Often times, treating hyperhidrosis symptoms, which are how you stop foot sweat and its odor, can greatly reduce the likelihood of developing a fungal infection like Athlete’s foot. Here are some practical solutions you can use to make your feet a less habitable environment for the fungi that cause Athlete’s foot:

  • Thoroughly drying feet after any activity that gets them wet. This includes activities like showering, bathing, swimming, or after sweating profusely while wearing shoes.
  • Wearing breathable shoes that don’t constrict your feet.
  • Not wearing the same pair of shoes two days in a row. It can be useful to have two pairs of shoes that you alternate each day.
  • Taking shoes off and airing out feet as frequently as possible.[1]
  • If you are suffering from hyperhidrosis and practical lifestyle changes are not enough to keep your feet dry, then you may want to consider other treatments for sweaty feet. These include treatment options like using over-the-counter topical treatments like antiperspirant to more invasive procedures like botox injections.[3] Due to the fact that hyperhidrosis treatments reduce the amount of moisture your feet are exposed to they can drastically reduce the likelihood that you will develop Athlete’s foot.[2]

    In addition to maintaining a dry pedal environment, it is also important for people to limit their exposure to the fungi that cause Athlete’s foot. Here are some tips to avoid contracting it:

  • Wear your own flip flops when swimming, using communal showers, and using communal changing rooms.
  • Do not share towels, shoes, and socks with other people.
  • Wash all towels, bedding, and socks in hot water that is greater than 60 degrees C.
  • Add antifungal laundry sanitizer if you wash your laundry at a lower temperature.[1]
  • How to Treat Athlete’s Foot

    Due to the fact that Athlete’s foot is so common, even when practicing prevention procedures, people often develop the condition at some point in their lives. In most cases, Athlete’s foot can be treated with over-the-counter remedies that are available at local pharmacies. These treatments come in the form of creams, gels, or sprays that contain an active ingredient that stops fungal growth of kills off fungus completely. In rare cases, tablets can be prescribed for people who haven’t had success with over-the-counter treatment options. There are also natural remedies that people use, which include tea tree oil some herbal foot bath solutions, although there is not scientific evidence that they are effective.[1]

    Once you have treated Athlete’s foot it is important that you continue to use preventative care practices so that you don’t develop it again. If you do also happen to suffer from hyperhidrosis, then getting treatment for it should keep your feet more comfortable and prevent you from developing Athlete’s foot as easily. There are many effective treatment options and it is important to make sure that you are taking proper care of the skin on your feet.

    Sources
    1. Athlete's foot: Overview. (2015). Retrieved May 31, 2019, from https://www.ncbi.nlm.nih.gov/books/NBK279549/
    2. Common Complications of Hyperhidrosis. (n.d.). Retrieved May 31, 2019, from https://www.webmd.com/skin-problems-and-treatments/common-complications-of-hyperhidrosis
    3. Pariser, D. M. (2014). Hyperhidrosis (4th ed., Vol. 32). Philadelphia, PA: Elsevier.
    Causes of Hyperhidrosis

    Everything you need to to know about Hyperhidrosis (or Excessive Sweat)

    By Chris Reid /

    What Is Hyperhidrosis?

    Hyperhidrosis, or excessive sweating, is characterized by sweat that is produced in excess of what is necessary for thermoregulation (the ability to maintain a healthy temperature). Sweating is a perfectly natural and necessary function the body uses to cool itself down. However, if you have hyperhidrosis, you’ll start sweating even when your body isn’t overheating.[1] Sweating that has no apparent cause is known to doctors as diaphoresis.[2]

    If you have hyperhidrosis, you can experience sweating on several parts of the body, including in the hands, underarms, face, scalp, and feet. Some people even experience excessive groin sweat and sweating under the breasts. The type of hyperhidrosis you have will determine whether you experience sweating all over your body or if it is just in specific areas. Some people with hyperhidrosis sweat in several different areas simultaneously, while others only experience excessive sweating at one location - it is a highly individualized condition. Hands, feet, and underarms are the parts of the body that are most likely to be affected by hyperhidrosis.[3]

    People who suffer from hyperhidrosis have the same number and size of sweat glands as people who don’t have the condition. Their sweat glands are just overactive, compared to what they would normally be.[1]

    What Are the Symptoms of Hyperhidrosis?

    If you’re wondering how to tell whether you have hyperhidrosis , here is a checklist of symptoms for you to review.

    • Noticeable sweat:Even when you’re sitting down and taking it easy, you’ll notice your clothes are wet. On your bare skin, you’ll often see beads of sweat.
    • You leave a trail in your wake:You might not just see sweat on your clothes and skin. You might be transferring it to everything you touch, including door knobs, keyboards, and papers that you touch.
    • Your skin is white and peeling:You might notice white and peeling skin from the constant moisture.
    • You have skin infections:Skin infections can happen to people who don’t have hyperhidrosis. However, if you have repeated skin infections due to constant moisture, like athlete’s foot, you might suspect hyperhidrosis.[1]

    Different dermatologists characterize hyperhidrosis in various ways. What’s important is the fact that if you are uncomfortable with the level of sweat that your body produces (wherever it’s being produced), there are solutions that are available. You have access to over-the-counter topical treatments, prescription options, and medical procedures that can help. If you are interested in medical solutions, you can book an appointment with your dermatologist and learn how to manage hyperhidrosis with a dermatologist.[3]

    Now that we’ve answered the question “what is hyperhidrosis?”, It’s important to understand the different types of hyperhidrosis. The approaches used to understand and treat hyperhidrosis are very different depending on the type you have.

    The Two Main Types of Hyperhidrosis

    There are two main types of hyperhidrosis. There are a few other types that are much less common, but the vast majority of people will either have primary focal hyperhidrosis or secondary generalized hyperhidrosis. Let’s look at each type of hyperhidrosis and what they entail.

    Primary Focal Hyperhidrosis

    Primary Focal Hyperhidrosis (PFH) is by far the most common type, affecting up to 90 percent of people who have hyperhidrosis. The cause is not well understood, but it is thought to have a genetic component.[3]

    People with primary focal hyperhidrosis only sweat in particular areas like the hands, feet, armpits, face, and groin. Sweat will occur on both sides of the body in the same place. For example, if someone has one sweaty hand it is likely their other hand will also be sweaty. Additionally, the sweat will usually occur in more than one area — one common problem with PFH is that the sweating occurs on hands and feet simultaneously. It can also affect other body parts individually or simultaneously, it just depends on a person’s specific situation.[3]

    Symptoms usually begin in childhood or adolescence and tend to last for a person’s entire lifetime. There is evidence that primary focal hyperhidrosis is hereditary, meaning it has a genetic component and often runs in families.[3]

    Secondary Generalized Hyperhidrosis

    While primary focal hyperhidrosis appears to be something you’re born with,secondary generalized hyperhidrosis (SGH) is a condition that shows up during adulthood. Think of SGH as an uninvited guest who arrives on your doorstep with no warning. Unfortunately, it may be a little harder to get rid of than an uninvited guest.[3]

    You might suddenly wonder why you’ve been so sweaty lately. And you’d be right to wonder, because this type of hyperhidrosis can point to an underlying problem.

    When someone has secondary hyperhidrosis the biggest problem isn’t the hyperhidrosis – it’s the disease or condition that might be causing it. That’s why it’s known as secondary hyperhidrosis. The true cause may be a medical condition and the symptom of that condition is hyperhidrosis.[3]

    Before you panic that you’re suffering from a mysterious disease, keep in mind the source of this type of hyperhidrosis can also be a medication. Many common medications can cause hyperhidrosis as a side effect.[3]

    Unlike primary focal hyperhidrosis, the sweating from secondary hyperhidrosis tends to occur all over the body. This is a telltale sign of the condition.[3]

    Unlike primary hyperhidrosis, this condition doesn’t have to be permanent. If the instigating condition is found and treated, it can fix the hyperhidrosis. It may take a little work, but you CAN kick this guest off your porch.[3]

    If you are concerned that your hyperhidrosis might have an underlying cause, schedule an appointment to talk to your doctor and find out.[3]

    The Impact of Hyperhidrosis

    While hyperhidrosis isn’t particularly dangerous physically, it can be embarrassing for those who suffer from it. It won’t just give you clammy skin – the sweat can literally drip off. That can cause a great deal of anxiety for those who experience it.[3]

    Shaking hands can become a nightmare because you may be so self-conscious about how sweaty your palms are. Your socks can become wet even if you don’t do any exercise. It can make basic human experiences extremely stressful.

    Unfortunately, hyperhidrosis is more serious than just uncomfortable sweating. Up to a third of people who deal with excessive sweating from hyperhidrosis say that they are constantly bothered by their sweating. One study done in the US found that 75% of respondents reported that hyperhidrosis negatively impacted their social, emotional, and mental health.[4] That’s a lot of people who are suffering! Due to these issues, hyperhidrosis and anxiety often go hand in hand.[3] Many people find it helpful to utilize anxiety reduction methods that are known to lessen excessive sweating.

    Hyperhidrosis is hard for adults to deal with, so it is especially important to find help for kids with hyperhidrosis.

    Some people refer to hyperhidrosis as a silent handicap because of the impact it has upon the lives of those who live with it. It can deeply impact their confidence and hyperhidrosis can even keep people from doing the things they love most.[5]

    Is Hyperhidrosis Common?

    It is thought that about 3% of the US population struggles with hyperhidrosis. In other countries the percentage of the population that has it is even higher.[3] Other sources have stated that up to 5% of the population might even have it![6] This means that hyperhidrosis is a very common issue.

    While most doctor’s offices are familiar with managing hyperhidrosis, they generally don’t see a lot of patients who suffer from it. However, because hyperhidrosis is such an embarrassing and overlooked condition, many individuals avoid reporting the issue to their doctor. This means that the number of people who have hyperhidrosis might even be higher than we currently think.[3]

    Those with family members who have this ailment are more likely to get it – making it an inherited condition. If you have a family member teased for their sweaty hands constantly, there could be a chance they have hyperhidrosis. [3]

    What Causes Hyperhidrosis?

    Doctors don’t truly understand what causes primary focal hyperhidrosis yet. One theory is that particular nerves that control the amount of sweat overreact or malfunction. That malfunction can cause the excessive sweating that can be life-changing for those who suffer from it.[7]

    Since hyperhidrosis affects so many people, researchers are now shifting into full gear to discover the causes of excessive sweating so they can develop better treatments. Future treatments and research for hyperhidrosis are being developed more rapidly than ever before.[3]

    What Conditions Can Cause Secondary Generalized Hyperhidrosis?

    Many diseases and medical conditions can cause hyperhidrosis. However, just because you have one of the conditions listed below this paragraph doesn’t mean you’ll develop hyperhidrosis.

    Here are some of the more common conditions that may be causing the hyperhidrosis you have developed as an adult.

    • A febrile illness
    • Menopause
    • Hyperthyroidism
    • Heart failure
    • Diabetes
    • Frostbite
    • Alcoholism - Alcohol can cause excessive sweating when someone is intoxicated, withdrawing, or in someone with an intolerance.
    • Gout
    • Lymphoma and some other cancers and tumors.
    • Obesity
    • Pregnancy
    • Parkinson’s disease
    • Rheumatoid arthritis
    • Stroke[3]

    There are also several types of common medications that cause hyperhidrosis as a side effect. So, if you are on medication and you begin experiencing new or increased amounts of sweating mention it to your doctor. Some of these medications include antidepressants, painkillers, blood pressure medications and many others.a [3]

    If you think you might have secondary generalized hyperhidrosis it is very important that you speak to a doctor. Many of the things that cause it can be resolved, and it could be a sign of a more serious problem. Don’t panic, but it is wise to look into the reason you are sweating more.

    What Are the Treatments for Primary Focal Hyperhidrosis?

    If you are diagnosed with primary focal hyperhidrosis, there are many things you can do.These are the existing treatments for hyperhidrosis, but new treatments are currently being explored by scientists:

    • Antiperspirants:There are many over-the-counter antiperspirants that can be very useful when trying to curb sweat. If a regular antiperspirant isn’t cutting it for you, ask your doctor to write a prescription for a stronger one. You can apply antiperspirant to places other than just your underarms. Use it on your hands, hairline, or feet as well. There are even antiperspirants for the face and groin that are made specifically for sensitive areas.
    • An Iontophoresis machine:This medical device sends low-voltage currents into a pan of water where your hands or feet are sitting. The electricity can lessen the activity of your sweat glands, at least for a while. However, it can take up to 10 sessions with the iontophoresis machine to deactivate your sweat glands. You may need to use this machine up to three times a week in the beginning and one treatment can take up to 40 minutes. Although iontophoresis as a treatment for palmar and plantar hyperhidrosis may give your hands and feet a much needed break, the iontophoresis machine is anything but convenient. Iontophoresis really does work, but patients have to be willing to keep up with a regular treatment regimen for it to work successfully.
    • Botox:If other treatments aren’t enough in your, you might need Botox injections. Botox can be particularly useful for axillary hyperhidrosis, but botox can also be a treatment for palmar and plantar hyperhidrosis. Botox can provide up to 6 months of reduced sweating. If you’re going to pursue this route, you should look for someone who is experienced at doing Botox injections in the underarms to ensure the right area is targeted.
    • Anticholinergics:A few oral medications can for hyperhidrosis can reduce the amount of sweat you produce by stopping your sweat glands from working. Most commonly patients are prescribed anticholinergics like glycopyrrolate or oxybutynin as a treatment for hyperhidrosis. These medications also have several side effects, including heart palpitations, blurry vision, and dry mouth.
    • ETS Surgery:An endoscopic thoracic sympathectomy (ETS) is a surgical treatment for primary focal hyperhidrosis. It is an operation where an individual actually has the nerve endings that transfer sensory information to the sweat glands destroyed. Since no known successful reversal of an ETS surgery has ever been recorded, this option isn’t usually on the table unless the other treatments have failed. As with any surgery, it can be risky. There is also a type of surgery called an endoscopic lumbar sympathectomy which is used to treat plantar hyperhidrosis, but this surgery can be very dangerous and is almost never recommended.[3]

    Defeating Hyperhidrosis

    Undoubtedly, hyperhidrosis can be a hard condition to cope with. Until recently, the lack of research into hyperhidrosis had made hyperhidrosis difficult to manage. Thankfully, however, new treatments and awareness has made hyperhidrosis much easier to handle. Keep trying treatments until you find what works for you and remember that you are not alone in suffering with this condition. It’s just a matter of figuring out what you can do to control your sweat instead of your sweat controlling you!

    Sources
    1. MedicineNet Medical Journal. (2016, May 13). Definition of Hyperhidrosis. Retrieved May 14, 2018, from https://www.medicinenet.com/script/main/art.asp?articlekey=16272
    2. Diaphoresis: What causes excessive sweating? (n.d.). Retrieved May 20, 2020, from https://www.medicalnewstoday.com/articles/321663#overview
    3. Pariser, D. M. (2014). Hyperhidrosis (4th ed., Vol. 32). Amsterdam: Elsevier Pub. Co., 2014. Retrieved from https://www.elsevier.com/books/hyperhidrosis-an-issue-of-dermatologic-clinics/pariser/978-0-323-32607-0
    4. Lenefsky, M., & Rice, Z. P. (2018). Hyperhidrosis and Its Impact on Those Living With It. AJMC. Retrieved from https://www.ajmc.com/journals/supplement/2018/hyperhidrosis-managed-markets-update-treatments/hyperhidrosis-and-its-impact--on-those-living-with-it
    5. Nordqvist, C. (2017, December 21). Hyperhidrosis: Symptoms, causes, diagnosis, and treatment. Retrieved May 14, 2018, from https://www.medicalnewstoday.com/articles/182130.php

      Doolittle, James, et al. “Hyperhidrosis: an Update on Prevalence and Severity in the United States.” Archives of Dermatological Research, vol. 308, no. 10, 2016, pp. 743–749., doi:10.1007/s00403-016-1697-9. Retrieved from https://pubmed.ncbi.nlm.nih.gov/27744497/

      Huddle, J. R. (2014). Hyperhidrosis: Causes, Treatment Options and Outcomes. New York, NY: Nova Science. Retrieved from https://www.bookdepository.com/Hyperhidrosis-Janine-R-Huddle/9781633215160

    Complications of Hyperhidrosis

    Things to Avoid when Treating Hyperhidrosis

    By Katie Crissman /

    Hyperhidrosis affects upwards of 3% of the population, making it a very common medical condition. This means that there are many people seeking treatment for their excessive sweating. While there are several effective treatments for people with hyperhidrosis, there are some pitfalls that people need to be aware of. All of the medically recommended treatments for hyperhidrosis have been tested by the medical community but it doesn’t mean that they don’t come with their own risks. For those that suffer from primary focal hyperhidrosis proper treatment can make an immense difference in their quality of life.[1] Here is what people with hyperhidrosis need to watch out for as they figure out which treatments work best for them:

    Skin Irritation

    The first line treatment that dermatologists will recommend for hyperhidrosis is the use of antiperspirant. Antiperspirant is a type of topical treatment for hyperhidrosis that prevents skin from producing sweat.[1] It is considered to be a drug by the FDA due to the fact that it changes the function of skin. Most antiperspirants, even powerful ones, can be found over-the-counter and are quite effective at stopping a person from producing excessive sweat.[2] Typically, antiperspirant is used for axillary sweating although it has been used on other parts of the body more frequently as time goes on. One of the most bothersome side effects of antiperspirant is the irritation it can cause. When used on the less sensitive skin of the armpit this is not as big of an issue, but it is a problem when antiperspirant needs to be used on other, more sensitive, areas of the body.[1]

    The reason that antiperspirant can be so irritating is because of its active ingredient. Most antiperspirants use aluminum chloride, aluminum chloride hexahydrate, or a newer generation ingredient, like aluminum zirconium trichlorohydrex. These products can easily irritate skin. One study published in the journal of Dermatologic Clinics found that 26% of patients being treated with aluminum chloride antiperspirant reported stinging and itching sensations after use. If you are struggling to use antiperspirant because of skin irritation there are things you can do. Using antiperspirant consistently over a period of time seems to reduce skin irritation. You can also apply 1% hydrocortisone cream the morning after applying antiperspirant to clear up irritation. If you are sensitive to irritation then you may benefit from trying a newer generation antiperspirant with aluminum zirconium hexahydrate as the active ingredient. Studies have found that these antiperspirants tend to cause less irritation. There are also specific antiperspirants that are made for sensitive skin that you can try. Ultimately, you shouldn’t have to put up with skin irritation to talk to your doctor and see if you can find the antiperspirant that works best for your skin.[1]

    Stains

    Antiperspirants can be extremely helpful for those with excessive sweating, but they come with another major downfall - they stain clothing. Unfortunately, antiperspirant can leave a yellowish stain on clothing, especially when it is mixed with sweat. One study showed that up to 70% of people with axillary hyperhidrosis reported having to change their clothes at least two times a day. If a person is regularly sweating through their clothes it is safe to assume that they are also getting antiperspirant residue on their clothing. Antiperspirant is usually worth the inconvenience, and thankfully, there are effective ways to get antiperspirant out of clothes.[1]

    Medication Side Effects

    Doctors often treat hyperhidrosis with oral medications when other, more conservative, therapies have failed to work. Most of the time patients are prescribed a type of medication that falls into the class of anticholinergics. Anticholinergics work on the part of the nervous system that innervates sweat glands and stops the body from producing as much sweat. Unfortunately, they can also act on other parts of the body as well and cause unintended and unwanted side effects. The side effects a person will experience depend on their individual biological makeup and the specific medication they use. Some of the side effects of anticholinergics include dry mouth, constipation, nausea, vomiting, and many other possibilities. If you are planning to try oral medications for your hyperhidrosis, make sure that you work closely with your doctor to make sure that you aren’t suffering from intolerable side effects so that you can find the best medication for your body.[1]

    Not Trying Less Invasive Therapies First

    Almost all doctors that treat hyperhidrosis will recommend that patients begin trialing the most conservative treatments first before they move on to more invasive options. Sometimes, however, patients are exasperated with their condition and want to move on to more extensive options before trying all of the more conservative treatments. This is a big mistake because some of the most effective options are local therapies which are less invasive.[1] For example, a patient with palmar hyperhidrosis who didn’t respond well to an antiperspirant may try iontophoresis, but be inconsistent with their routine and fail to see a benefit. They may want to move on to botox injections, or even surgery, when iontophoresis may have worked if they had given it a proper chance. This would require them to take less risk and cost them less money. However, this isn’t the case for everyone and sometimes patients decide to go with more invasive treatments first for a variety of legitimate reasons. The most important thing is that you communicate openly with your doctor to find the treatment that is most effective for you.

    Giving Up

    Sometimes, despite their best efforts, patients can’t find an effective treatment for their hyperhidrosis. This can be extremely frustrating and disheartening because hyperhidrosis is a condition that negatively impacts quality of life.[1] However, it is important that patients continue to try new treatments as they come out and that they remain open to using the treatment options they do have. Even if your hyperhidrosis symptoms are not completely under control, most people find at least some relief from treatment. There are new treatments coming out every year and as awareness grows the future continues to look brighter for those with hyperhidrosis.

    Sources
    1. Pariser, D. M. (2014). Hyperhidrosis (4th ed., Vol. 32). Philadelphia, PA: Elsevier.
    2. Zirwas, M. J., & Moennich, J. (2008). Antiperspirant and Deodorant Allergy Diagnosis and Management. The Journal of Clinical and Aesthetic Dermatology, 1(3), 38-43. Retrieved August 22, 2019, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3013594/
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