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Hyperhidrosis Basics
Sweat Biology
Is Hyperhidrosis Common?
Written by Katie Crissman
October 01 2020

Hyperhidrosis is a sweating disorder characterized by sweating that is in excess of what is needed by the body. The reason that humans sweat is to maintain homeostasis of thermoregulation, or to regulate their body temperature. When someone sweats, it releases heat and cools down their core body temperature. People with hyperhidrosis sweat excessively, even when there is no physiological need to. This may sound like an uncommon condition, but it is actually quite prevalent.

It is estimated that approximately 2.8% of the United States population has a form of hyperhidrosis. This number was reached after a survey inquiring about excessive sweating was sent to 150,000 people who live in the US. Other studies have found that up to 5% of the US population have hyperhidrosis, but it is impossible to know the exact number.[2] This is because hyperhidrosis isn’t well known by many doctors, and it is thought that because hyperhidrosis can be an embarrassing condition, it is often underreported. Of those who have hyperhidrosis, it is thought that about 93% have primary focal hyperhidrosis. This is a version of the disease that typically develops during adolescents and affects a person throughout their lifetime. Secondary generalized hyperhidrosis is the second most common type of the disease. It begins suddenly in adulthood, and this type of hyperhidrosis is usually caused by a medication, or a physiological condition or disease. There are other forms of hyperhidrosis, like Hexsel’s hyperhidrosis, Gustatory sweating, localized unilateral hyperhidrosis, and a few others, but they are much more rare.[1]

Both sexes are affected by hyperhidrosis, but it may affect men more prevalently and with more intensity. For example, a study of in Japan found that 16.66% of men had hyperhidrosis while only 10.66% of females had it. A contradictory study in Canada found that women were more likely to report severe hyperhidrosis symptoms, so more studies need to be done in order to know for sure. Men are more likely to have craniofacial sweating and sweating in other areas while women are more likely to have axillary sweating.[1]

People who have primary focal hyperhidrosis most often experience sweating of the face, armpits, hands, and feet. Other locations can be affected, but less commonly so. Roughly 29% of people had an isolated axillary distribution of sweating (affecting the armpits only), while 25% had a pattern of sweating that only affected the hands and the feet. Other patterns of sweating occur, but with less frequency. Only 1.3% of cases involved excessive groin sweating. When a person develops the condition especially early, before puberty, 88.9% of the time it involves palmar or plantar sweating.[1]

It is evident that hyperhidrosis is a common disorder and that it affects people around the World. There are other conditions that cause sweating issues, but they tend to be less common than hyperhidrosis. Luckily, there are several effective treatments for hyperhidrosis that allow people to live more comfortable and productive lives.

Sources
  1. Pariser, D. M. (2014). Hyperhidrosis (4th ed., Vol. 32). Philadelphia, PA: Elsevier.
  2. 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.
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Causes of Hyperhidrosis

How to Tell if I Have Hyperhidrosis

By Katie Crissman /

Are you dealing with excessive sweating? If you’re a super sweater, here's how you can tell whether your symptoms may be related to a condition called hyperhidrosis.

What is Hyperhidrosis?

Hyperhidrosis is a medical condition categorized by excessive sweating that isn’t related to temperature regulation. It affects roughly 3% of people and it’s very treatable.[1]

If you have hyperhidrosis then you may experience symptoms like: 

  • Sweating that specifically affects your hands, feet, underarms, face or groin.
  • You can’t find an environmental trigger for your sweat like heat.
  • Your sweat so much that it impacts your self confidence and interferes in your personal or work life.
  • You have to change clothes often due to sweat problems.[1]

You get the idea - hyperhidrosis causes sweating that’s disruptive and more or less constant. It’s important to know that there are two types of hyperhidrosis. They are called primary focal hyperhidrosis, and secondary generalized hyperhidrosis. In this article we are going to focus on the symptoms of primary focal hyperhidrosis.[1] 

However, if you have excessive sweating that doesn’t seem related to primary hyperhidrosis read our article on secondary generalized hyperhidrosis as it’s caused by underlying health conditions and it’s important to get them looked at. 

Back to primary hyperhidrosis! Here are some quick facts to know about the condition:

  • It’s categorized by profuse sweating in one or more specific areas of the body, the main areas affected are:
    • Hands
    • Feet 
    • Underarms 
    • Face
    • Groin
    • Breast
  • It typically starts in adolescence or during early adulthood. Sometimes kids can experience excessive hyperhidrosis as well.
  • It’s not a result of any other disease or disorder - the excessive sweating itself is the disorder.
  • Men are more likely to have it.
  • It tends to run in some families.
  • The sweating tends to be symmetrical on the body. For example, if your right hand sweats your left hand will too.
  • It’s treatable![1]

Factors to Consider When Self-Diagnosing Hyperhidrosis

If you can relate to our description of hyperhidrosis consider these factors when self diagnosing. The first thing to know is that you should consult a doctor! Specifically, a dermatologist who’s trained in dealing with hyperhidrosis. If you’re still interested in more information consider the following: 

1. Temperature and Weather

 

First and foremost, you should be cognizant of whether or not you sweat in response to high temperatures in your surrounding environment. Since sweat is produced primarily as a means to cool the body via thermoregulation, all people should sweat when the temperature is high. Typically, the higher the temperature, the more sweat produced to keep the body cool. However, the first sign of both primary and secondary hyperhidrosis is whether or not your body sweats even when the temperature is at a comfortable, or even cool, level. 

For those with hyperhidrosis, they have sweat glands that are overactive because they are receiving and reacting to too many signals from the spinal cord and brain. Due to the fact that these synaptic signals are sent regardless of temperature, gauging the temperature of the environment when sweating occurs is a strong indicator of potential hyperhidrosis.

2. Environmental Triggers

In addition to temperature, you should be aware of whether or not other environmental triggers are causing excessive sweating on a repeated basis. For example, situations that are anxiety producing like meeting new people, anticipating handshakes, preparing for major assignments or tests, and public speaking may prompt an individual’s hyperhidrosis to worsen. This is because hyperhidrosis and anxiety are closely related. 

When thinking of your own sweatiest moments, are they tied to a specific set of conditions? If so, you may have primary focal hyperhidrosis that is triggered by those specific conditions. 

However, an important distinction between hyperhidrosis and stress sweating related to anxiety must be made; just because someone sweats in a specific situation doesn’t mean they have hyperhidrosis. Most people will sweat a little before a business meeting, and many people find the idea of a public speech to be intimidating. 

The important distinction is to determine whether or not your body is producing sweat to aid with thermoregulation (i.e. keeping you cool and calm when you become a little worried before an event) or producing sweat at an excessive and uncontrollable rate. 

3. Timing of Your Sweat

The third factor to evaluate in order to tell if a person’s sweating is indicative of hyperhidrosis is the length of time a person has been experiencing excessive sweating. If you’ve been sweating excessively since adolescence or young adulthood it’s a sign you may have primary hyperhidrosis. If it just started suddenly later in life it’s less likely to be secondary hyperhidrosis. 

If you think you might have hyperhidrosis there are many ways to manage your sweat and there are several treatments you can try. A great starting place is finding a good antiperspirant - we recommend Carpe antiperspirant lotion. They have products tailored to each specific part of your body and their special formula is gentle on skin.

Are you still curious about whether you have hyperhidrosis? Take this quiz.

Sources
  1. 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 
  2. Kamudoni, P., Mueller, B., Halford, J., Schouveller, A., Stacey, B., & Salek, M. (2017, June 8). The impact of hyperhidrosis on patients' daily life and quality of life: A qualitative investigation. Retrieved May 21, 2018, from https://hqlo.biomedcentral.com/articles/10.1186/s12955-017-0693-x
  3. MiraMar Labs, O'Shaughnessy, K., & Melkerson, M. (2011). 510(k) Summary. Division of Surgical, Orthopedic And Restorative Devices. Retrieved May 23, 2018, from https://www.accessdata.fda.gov/cdrh_docs/pdf10/K103014.pdf.
    Body Areas Affected by Hyperhidrosis

    How to Cure Sweaty Hands Permanently at Home

    By Daniel McCarthy /

    How to Cure Sweaty Hands Permanently at Home 

    Scenario 1: You’re invited into the office, confident you will land the job. You’ve prepared, you’re highly qualified, you have absolutely nothing to worry about. You walk in and confidently reach out to shake the CEOs hand. But then, your confidence turns to dread as the CEO pulls her hand back, wet with your sweat. 

    Scenario 2: You’re at home, playing video games with your friends and absolutely dominating. They get so upset, they tell you to take a break to let another friend play. But there’s another problem... nobody wants to use your controller after you finish. Despite your domination, your palmar hyperhidrosis (excessively sweaty hands) has taken center stage. 

    Do these scenarios sound familiar? Wondering how to cure sweaty hands permanently? Although you may not have had these exact things happen to you, your sweaty hands likely have caused something similar and you’re looking for a home remedy. To stop sweating these situations, let’s talk about how to cure sweaty hands permanently at home. 

    One of the best ways to cure sweaty hands at home is actually not related to the hands at all. Instead, working on reducing anxiety can have immensely positive results on how to cure sweaty hands permanently naturally. There are many root causes of anxiety, and some or many may be related to your hyperhidrosis. Likewise, it is easier said than done to reduce anxiety. But there are also many ways to work on reducing anxiety that are worth a try. One interesting way to reduce anxiety, and in turn, sweaty hands, is to be grateful. Specifically, Petrocchi and Couyoumdjian found that “grateful people experience less anxiety mostly because they are able to encourage and be compassionate and reassuring toward themselves when things go wrong in life” [1]. Other ways include stepping outside for a walk, drinking tea, or even distracting yourself. In general, starting with anxiety reduction not only can help with how to cure sweaty hands, but also your wellbeing in general. 

    Another great way to cure sweaty hands at home permanently is to reduce consumption of coffee and alcohol. Now you may be reading this and thinking “Hey, those are all my favorite things! I’m done with this article!”. And while I wholeheartedly agree and enjoy coffee and alcohol myself, consumption in moderation is key, especially with hyperhidrosis. Caffeine, for example, activates part of the brain that is already a main part in causing hyperhidrosis symptoms. Instead of giving it up, try to reduce consumption to under 200 mg or add in decaf to your routine. Alcohol can affect hyperhidrosis in a similar manner, but like coffee, 1-2 glasses of alcohol may be okay. When figuring out how to cure sweaty hands permanently naturally, it is important to find a balance of coffee, alcohol, and managing your hyperhidrosis. And remember to always drink responsibly, in moderation. 

    Tackling how to cure sweaty hands permanently, naturally, and at home may require more than behavioral changes we’ve talked about so far. Luckily, there are other great remedies you can try at home! First, finding the right antiperspirant is of paramount importance, especially appropriate antiperspirant for hands. Another possible over the counter option is anti-sweat wipes. If neither of these work for you, another option to cure your sweaty hands permanently is to buy your very own iontophoresis machine for at-home use. This machine delivers mild electrical currents to your hands (or other affected body part) while submerged in water. A combination of these treatments may have your hands feeling less clammy in no time! 

    Ultimately, your palmar hyperhidrosis may not be treatable at home and permanently, but these recommendations may help alleviate some of your symptoms. If symptoms persist, consult a medical professional for further assistance with how to cure sweaty hands. 



    Sources

    Sources

    1. Nicola Petrocchi & Alessandro Couyoumdjian (2016) The impact of gratitude on depression and anxiety: the mediating role of criticizing, attacking, and reassuring the self, Self and Identity, 15:2, 191-205, DOI: 10.1080/15298868.2015.1095794

    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

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