What is Secondary Generalized Hyperhidrosis?

When a person has hyperhidrosis it means that they experience excessive sweating of some kind. Specifically, secondary generalized hyperhidrosis refers to hyperhidrosis symptoms that are secondary to another factor that causes the hyperhidrosis. Secondary hyperhidrosis is also reffered to as diapehoresis, sudden unexplained excessive sweating, in the medical community. People with this type of hyperhidrosis experience excessive sweating all over their body, not just in a particular area or distribution. It is the second most common type of hyperhidrosis; one review of hyperhidrosis patients found that only 7% of hyperhidrosis cases were caused by secondary generalized hyperhidrosis. Secondary generalized hyperhidrosis tends to begin after the age of 25, although it can have an earlier age of onset. The sweating caused by secondary generalized hyperhidrosis can occur symmetrically on both sides of the body, or less commonly, it can occur on only one side. It’s symptoms are typically worse at night and many patients with the condition experience night sweats. The most important feature of secondary generalized hyperhidrosis, however, is that it has a specific cause. The causes of this type of hyperhidrosis can be bad for you health, so it is important to seek out medical attention.[1]

The Causes of Secondary Generalized Hyperhidrosis

There are several potential causes of excessive sweating related to secondary generalized hyperhidrosis, some of which are benign while others are more dangerous. It is important for anyone with this condition to manage their hyperhidrosis with a doctor so that they can determine its cause. Secondary generalized hyperhidrosis is most commonly caused by certain medicines or drugs, as either a side effect or a symptom of withdrawal. Some of the medications that are most likely to cause hyperhidrosis are antidepressants, antiglycemic agents, cholinergics, antipyretics, and several others. Alcohol can also cause hyperhidrosis as either a side effect of intoxication or as a symptom of withdrawal. The good news is that when a person stops a medication that is causing hyperhidrosis the symptoms will go away completely.[1]

Certain diseases and physiologic conditions can also cause secondary generalized hyperhidrosis, and it can sometimes be a sign of a larger problem. Some of the physiological conditions that can cause hyperhidrosis are pregnancy, menopause, fever, and excessive heat. These are all normal conditions that happen to people, especially women, over the course of a lifetime and they are not dangerous. In most cases hyperhidrosis is not dangerous, but secondary generalized hyperhidrosis can be indicative of a larger medical issue. This is especially true if a disease is causing diaphoresis and pallor at the same time. Some of the pathological causes of hyperhidrosis include malignancy (cancer), carcinoid syndrome, hyperthyroidism, tuberculosis, HIV, endocarditis, and many other diseases. If someone suddenly develops secondary generalized hyperhidrosis, as is most often the case, then they need to manage their hyperhidrosis with a doctor to determine whether they are suffering from a damaging condition.[1]

How to Get Rid of Secondary Generalized Hyperhidrosis

Luckily, secondary generalized hyperhidrosis is easily treatable. In most cases, once the causative agent is removed or dealt with the excessive sweating will stop. This means discontinuing any medications or drugs that cause hyperhidrosis or treating an underlying condition that is causing it. In some situations, a person might not be able to stop a medication that is causing excessive sweating. For example, a patient with a severe psychological condition that has only responded to one particular medication can’t reasonably stop their treatment. In this case, a person can choose to deal with the excessive sweating or use an oral medication to treat hyperhidrosis.[1]

Are you worried that you might have hyperhidrosis? Take this simple test to find out.

Sources

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

What Causes Palmar Hyperhidrosis?

Palmar (hand) hyperhidrosis is caused by a condition called primary focal hyperhidrosis (PFH). It is the most common type of hyperhidrosis and it is a lifelong condition, but hyperhidrosis may get better with age. Hyperhidrosis is fairly common, as about 3% of the population is thought to have it. Symptoms usually appear between the ages of 14 and 25, although some people experience symptoms much earlier. In fact, up to 88% of the people who experience symptoms before the onset of puberty have either palmar or plantar (foot) hyperhidrosis, or both. Palmar sweating is just one manifestation of PFH and it can also affect the feet, armpits, face, and occasionally other areas of the body. One retrospective chart review found that 25% of the people with hyperhidrosis had both palmar and plantar involvement while only 6% had only palmar involvement. That means that most people with palmar hyperhidrosis also have excessive sweating on another part of their body. So, what causes primary focal hyperhidrosis?[1]

The Causes of Primary Focal Hyperhidrosis

There are several factors that play a role in the development of primary focal hyperhidrosis, but the causes of the disorder are not well understood. It is thought that hyperhidrosis is a hereditary condition. This is especially true in the case of palmar hyperhidrosis. One study of families with palmar hyperhidrosis found that 65% of patients had other family members with the disorder. This is significant because it shows that palmar hyperhidrosis is likely to have a genetic link. Getting hyperhidrosis at an earlier age, which is often associated with palmar involvement, was shown to correlate with a positive family history of the disorder - meaning that there may be a genetic component. So, it is suspected that palmar hyperhidrosis may be caused by genetics, at least in part. However, more research needs to be done in order to determine how much genetics play a role in the development of hyperhidrosis.[1]

Primary focal hyperhidrosis may be caused by genetics and other unknown factors, but that does not explain the physiological issue that causes people with hyperhidrosis to sweat excessively from their hands. The sweat glands of people with hyperhidrosis are morphologically the same as an average person, and they have the same number of sweat glands on their body, but their sweat glands are overactive. This is thought to occur due to dysfunction of the autonomic nervous system, which is responsible for bodily functions that are not consciously controlled, like breathing. There are two main parts of the autonomic nervous system: the sympathetic nervous system and the parasympathetic nervous system. The sympathetic nervous system is responsible for activating what is known as the “fight or flight” response, while the parasympathetic nervous system is responsible for calming bodily functions down. Sweat glands are activated by the sympathetic nervous system, so if a person’s sympathetic nervous system is overactive then it makes sense that they might have overactive sweat glands. Some studies have found differences in parts of the sympathetic nervous systems of people who have hyperhidrosis. More research needs to be done in order confirm that this is the cause of PFH, but it is a promising lead.[1]

While future research and treatments are being developed, there is currently no cure for hyperhidrosis. There are, however, effective treatments for for sweaty hands. By using the treatments that are available people with palmar hyperhidrosis can learn to manage their symptoms and minimize the impact hyperhidrosis has on their life.

Sources

1. Pariser, D. M. (2014). Hyperhidrosis (4th ed., Vol. 32). Philadelphia, PA: Elsevier.
2. Huddle, J. R. (2014). Hyperhidrosis: Causes, Treatment Options and Outcomes. New York, NY: Nova Science.

Caffeine is massively popular in today’s culture, in fact one study has estimated that 85% of the adults in the United States drink at least one caffeinated beverage a day.

For most people this is not a bad thing, several studies have documented the positive effects of moderate caffeine consumption.

Benefits of caffeine: 

• mental alertness
• concentration
• fatigue reduction
• athletic performance[1]

However, for certain people, caffeine can cause side effects that have a negative influence on their quality of life.

This is especially true for people who suffer from hyperhidrosis, a condition in which a person sweats in excess of what their body needs for thermoregulation.[2]

For people who already struggle with excessive sweating, adding caffeine can cause a bad problem to become worse.

Coffee Causes People to Sweat

Caffeine is a type of mild stimulant.

Even though most people don’t think of it as a drug, it does cause notable psychological and physiological changes in the human body when ingested.

As it is a stimulant, caffeine accelerates the functions of the central nervous system.

While caffeine speeds up several processes within the central nervous system, its specific ability to increase thermogenesis of the body is the primary reason that caffeine causes people to sweat.[3]

Thermoregulation, the ability of the body to regulate its internal temperature, is the reason why humans sweat.

As caffeine accelerates thermogenesis, or causes the body to creates heat, the temperature of the body exceeds its natural set point in the hypothalamus.

The hypothalamus is the part of the brain that regulates physiological processes and it acts as a natural thermostat.

So, when the hypothalamus alerts the body that it is too hot it activates the sympathetic nervous system, which causes physiologic changes like sweating and vasodilation.

Hyperhidrosis, The Nervous System and Coffee

Primary hyperhidrosis is sometimes described as a disease caused by chronic autonomic nervous system dysfunction. The autonomic nervous system is responsible for unconscious bodily functions that keep a person alive, like breathing, temperature regulation and heartbeat.

Specifically, it is thought that the overactive sweat glands and excessive sweating caused by primary focal hyperhidrosis is a result of a hyperactive sympathetic nervous system, a part of the autonomic nervous system that is responsible for the “fight or flight” response.[4]

This is interesting because caffeine consumption also activates the sympathetic nervous system which then causes people to sweat. For someone with hyperhidrosis, drinking caffeine directly activates the part of their brain that is causing their problems in the first place.

Caffeine is also associated with a higher incidence of stress sweating.

This is because it can trigger emotional activity, which by itself can stimulate sweat glands to produce sweat, and affect the neurotransmitters that sweat glands utilize.

Secondary hyperhidrosis is a type of hyperhidrosis that is caused by a specific biological factor.

For example, many common medicines cause hyperhidrosis as a side effect. There are also several conditions and diseases that cause hyperhidrosis as a result of their impact on the body.

Menopause is one of the conditions that can cause secondary hyperhidrosis, and caffeine can actually have an effect on the amount of night sweats and hot flashes that women in menopause experience.

Studies have shown that caffeine intake increases the amount of night sweats and hot flashes menopausal women experience due to the way it influences the nervous system.[5]

The Takeaway

Surveys have shown that the majority of caffeine that adults in the U.S. consume comes from coffee.

This differs from children, who get the most caffeine from carbonated soft drinks.

It has also been found that coffee does not have any substantial health risks when a quantity of 400 mg per day or less is ingested.[1]

That is equivalent to about four cups of coffee.

For someone with hyperhidrosis, it is probably best for them to consume less than that daily maximum.

Caffeine can induce sweating, even when consumed in lower doses, so it is important for individuals with hyperhidrosis to understand how caffeine affects their body specifically.

The goal for a person with hyperhidrosis is the find a balance between drinking the amount of caffeine they want and minimizing the symptoms it causes.

It is not necessary to completely cut out coffee, but in order to manage their sweat, a person with hyperhidrosis should aim to consume around 200 mg per day or less.

Unfortunately for those with hyperhidrosis, like caffeine, alcohol can also cause excessive sweating. So, in order to keep sweating in check, using moderation when consuming tasty beverages is key.

Sources

1. Mitchell, D. C., Knight, C. A., Hockenberry, J., Teplansky, R., & Hartman, T. J. (2014). Beverage caffeine intakes in the U.S. Food and Chemical Toxicology, 63, 136-142. doi:10.1016/j.fct.2013.10.042
2. Pariser, D. M. (2014). Hyperhidrosis (4th ed., Vol. 32). Philadelphia, PA: Elsevier.
3. Tae-Wook, K., Young-Oh, S., Jeong-Beom, L., Young-Ki, M., & Hun-Mo, Y. (2010). Effect of caffeine on the metabolic responses of lipolysis and activated sweat gland density in human during physical activity. Food Science and Biotechnology, 19(4), 1077-1080. doi:10.1007/s10068-010-0151-6
4. Huddle, J. R. (2014). Hyperhidrosis: Causes, Treatment Options and Outcomes. New York, NY: Nova Science.
5. Caffeine intake may worsen menopausal hot flashes, night sweats. (2014, July 14). Science News. Retrieved September 27, 2018.

Anatomy and Physiology of the Sweat Gland

The human body contains two types of sweat glands, they are called eccrine glands and apocrine glands. What sweat is made of is determined by the type of sweat gland it was secreted by, as eccrine and apocrine sweat glands each produce a different kind of sweat. Both types of sweat glands can be affected by hyperhidrosis so that they are overactive and produce sweat in excess of what the body needs to maintain homeostasis of thermoregulation. Thermoregulation is the reason why humans sweat.[1]

Eccrine Glands

Eccrine glands cover the entire surface of the skin, except for the tympanic membrane, life margins, nipples, labia minora, clitoris and penis. They are most densely concentrated on the soles of the feet, the palms of the hands, the armpits, and the face. An eccrine gland is a long tubular structure that begins in the deep layers of the dermis and opens at the surface of the skin. Sweat produced by eccrine glands is predominately made of water, although it also contains substances the body has removed from the blood. These other substances are waste products that the body no longer needs, and typically consist of sodium chloride, urea, uric acid, proteins and immunoglobulins. This type of sweat can be described as watery and odorless. Eccrine glands are innervated by the sympathetic nervous system and are controlled by the hypothalamus in the brain.[1]

Apocrine Glands

Apocrine glands are larger than eccrine glands, and are located within hair follicles in the deep layers of the dermis. They secrete sweat directly into the hair canal. Unlike eccrine glands, apocrine glands are only present on a few areas of the body. These areas include the armpits, perineal region, areola, scrotum, pubic mound and the labia minora. Apocrine glands secrete sweat that is thick and yellowish. This is due to the composition of the sweat they produce, as it contains high concentrations of proteins and fatty acids. The sweat produced by apocrine glands tends to give off an unpleasant odor because of bacteria living on the surface of the skin. They break down the fatty acids and proteins from the sweat into isovaleric acid and androsterone, which give off a bad smell. Apocrine glands receive adrenergic innervation which means they are sensitive to adrenaline and noradrenaline, a factor that causes them to be activated by emotional stimuli.[1]

The Cause of Overactive Sweat Glands

Overactive sweat glands can be explained by a condition called hyperhidrosis. In short, hyperhidrosis is a chronic medical condition in which the body constantly produces more sweat than it needs. The two most common types of hyperhidrosis, primary focal hyperhidrosis and secondary generalized hyperhidrosis, are responsible for most cases of overactive sweat glands. The type of hyperhidrosis a person has will determine the cause of their excessive sweating. Interestingly, the sweat glands of those with hyperhidrosis are morphologically the same as an average individual. So, the cause of hyperhidrosis is not related to an issue within the sweat gland. If someone is experiencing overactive sweat glands, it is advisable that they understand what there is to know about hyperhidrosis, so that they can better understand their condition and the options available to them. In some instances, alcohol and caffeine are known to cause excessive sweating and make symptoms of hyperhidrosis worse.

Primary Focal Hyperhidrosis

Primary focal hyperhidrosis usually arises during adolescents, and it is localized to specific areas of the body. People who have this type of hyperhidrosis most often have excessive sweating of one of more of the following areas: the palms, soles, armpits, craniofacial region, and groin area. Currently, doctors do not completely understand the etiology of the disease and there is no cure for hyperhidrosis. However, there are several treatments options that are able to help people manage their sweat, and researchers are beginning to better understand the underlying causes of the disease.[1]

It is thought that primary focal hyperhidrosis is a disease caused by dysfunction of the autonomic nervous system. The autonomic nervous system is responsible for unconscious bodily functions that keep a person alive, like breathing, temperature regulation and heartbeat. There are two subsections of the autonomic nervous system called the sympathetic nervous system and the parasympathetic nervous system. The sympathetic nervous system activates the “fight or flight” response and the parasympathetic nervous system calms it down. It is thought that the excessive sweating response seen in primary focal hyperhidrosis is actually caused by hyperactivity of the sympathetic nervous system. This understanding is crucial, because it allows researchers to understand that even though primary hyperhidrosis affects sweat glands and causes them to be overactive, it is the nervous system that is most likely at the root of the issue. That is why people with hyperhidrosis find that sweating is worse during times of stress. Further research needs to be done in order to establish how and why the nervous system is dysfunctional in this way, as it is poorly understood. In the future, a better understanding of the relationship between the nervous system and hyperhidrosis may lead to better treatment options, or even a cure.[1]

Secondary Generalized Hyperhidrosis

Secondary hyperhidrosis usually has a sudden onset, and is typically seen in adults who have not previously suffered from excessive sweating. Most people with secondary hyperhidrosis suffer from generalized sweating all over the body, rather than the loclaized sweating that occurs in primary focal hyperhidrosis. Secondary hyperhidrosis has a definitive underlying medical cause, which can make it easier to identify the problem. The side effects of many common medications can cause secondary hyperhidrosis, and this is the most frequent reason that people suffer from it. In other cases, there are specific diseases and conditions that cause secondary hyperhidrosis, which may need to be addressed. If someone suspects that they have secondary hyperhidrosis, it is important for them to manage their hyperhidrosis with a doctor to ensure that they get proper care. Some of the underlying medical issues that can cause secondary hyperhidrosis are dangerous, so that is why it is important for people to seek medical attention in this situation.[1]

Overactive sweat glands can cause a great deal of psychological and physical discomfort, but there are effective treatment options available, and future treatments and research for hyperhidrosis are being developed every day.

Sources

1. Huddle, J. R. (2014). Hyperhidrosis: Causes, Treatment Options and Outcomes. New York, NY: Nova Science.
2. Pariser, D. M. (2014). Hyperhidrosis (4th ed., Vol. 32). Philadelphia, PA: Elsevier.

Do you struggle with groin sweat? If you do, it’s unfortunate, but you aren’t alone! Here are the things that can cause groin sweating and what you can do about it.

Possible Causes of Groin Sweat

One of the most common causes of groin sweat is primary focal hyperhidrosis. When a person has this condition it often impacts specific areas - like the groin. According to an article in the British Medical Journal, about 3% of the population is suspected to have hyperhidrosis, but only 9.3% of that population struggles with excessive sweating of the groin.[1] That means that not only is groin sweating hard to deal with, but that it is not particularly well studied.

Compared to other parts of the body impacted by primary focal hyperhidrosis, the groin has received very little attention. This is most likely due to the fact that there are more people with axillary, palmar and plantar hyperhidrosis, but that should not minimize the issue for those who suffer from sweating in the inguinal region[2].

The most common cause of excessive groin sweating is primary focal hyperhidrosis, but groin sweat can also be a symptom of secondary generalized hyperhidrosis, or even compensatory hyperhidrosis. Secondary hyperhidrosis can occur suddenly, and typically causes sweating to occur all over the body, and this can include the groin region. However, sweating is usually not uniformly focused in that one area. So, while secondary hyperhidrosis may cause the groin to sweat more, it would also equally impact other areas of the body.

If you believe your groin sweating is caused by secondary hyperhidrosis then it is important that youmanage your hyperhidrosis with a dermatologist. Secondary hyperhidrosis can be caused by diseases and conditions that may be dangerous if left untreated.[2] Certain common medications can also cause secondary hyperhidrosis to occur.

Compensatory sweating can also could also cause groin sweating to arise. This type of hyperhidrosis is actually a side effect of endoscopic thoracic surgery, which ironically, is used to treat palmar and axillary hyperhidrosis. A large percentage of those who undergo surgery develop this condition and it can often include groin sweat.[2]

Factors that Make Groin Sweat Worse

When groin sweating is caused by primary focal hyperhidrosis there is no exact cause that can be found, but certain factors can make sweating worse. One of the most important factors is stress sweating. Stress will cause even a healthy person to sweat due to natural changes that occur in the autonomic nervous system, but these effects can be exacerbated in those with hyperhidrosis. Stress sweating is often associated with groin sweat, specifically because of the type of sweat glands that are located there. These glands are called apocrine glands and they produce a different type of sweat than eccrine glands.[3]

There are two types of sweat glands: eccrine and apocrine:

• Eccrine glands occur all over the body and secrete a clear fluid that is primarily made of water and some of the body’s waste products. The sweat from these glands is relatively odorless.
• Apocrine glands are only present on the axilla, perianal region, areola, scrotum, pubic mound and labia. That means apocrine glands are responsible for most groin sweat.

Apocrine glands are located within hair follicles and secrete sweat into hair canals. The sweat produced by apocrine glands is thick and yellowish. It often has a displeasing smell because it has a high concentration of proteins and fatty acids, which bacteria from the skin quickly break down into foul smelling acids. These glands are innervated by the same systems that regulate stress. This means they can be activated by emotional responses.[4] This is why groin sweating and stress are so closely related.

Treatments and Products Available to Stop Groin Sweat

One of the simplest means of controlling groin sweat is to keep the area as clean and dry as possible. This can be difficult and time consuming for hyperhidrosis sufferers, but it can prevent skin breakdown and reduce odor.[2] One option that can be used to keep groin skin dry is the use of absorbent underwear. These are available at most large clothing retailers and can give sufferers a sense of security that sweat will not show through clothing and it will keep moisture away from sensitive skin. Using absorbent underwear can also keep the groin area more comfortable and reduce irritation.

Antiperspirants

Antiperspirants can be used to control groin sweat! There are many antiperspirants available on the market. These differ from deodorant in that they contain an active ingredient that can reduce sweat production. Topical aluminum chloride is present in many of the over-the-counter topical treatments for hyperhidrosis, but it can be irritating in such a sensitive area.

A new formulation of 15% aluminum chloride in salicylic acid gel has been found to reduce irritation and was found to provide between good and excellent results in 100% of patients with groin sweating.[5] Look for products specifically made for use in sensitive areas. Many antiperspirants can be used in the treatment of craniofacial hyperhidrosis which also involves areas with sensitive skin. If regular strength antiperspirants are not enough, then try using clinical strength over-the-counter antiperspirants. There are prescription antiperspirants you can get from your doctor, but often a clinical strength over-the-counter antiperspirant is just as good. Talk to your doctor if you are struggling to find an antiperspirant that works for you.[2]

Botox

Botox injections are an option for patients who do not receive enough symptom relief from topical treatments. There have not been many studies done on the efficacy of botox in the treatment of groin sweat, but it is a viable solution. Before botox can be administered, a doctor will perform a starch-iodine test to determine where sweating is the worst. After this, the doctor will mark the areas that need to be treated and begin giving the botox injections. Patients can expect relief from symptoms to last for three to six months before another session is needed. There have been few recorded side effects, but some reports have mentioned temporary edema (swelling) and small hematoma (clotted blood under skin) formation near the injections sites. Botox can provide patients with a relatively reliable and safe method to stop groin sweating without having to worry about daily or weekly treatments.[2]

Oral Medications

Depending on the severity of a patient’s sweating a doctor may choose to put them on an oral medication for hyperhidrosis. The most common medications doctors use are called anticholinergics and they can reduce the amount of secretions the body produces. Glycopyrrolate and oxybutynin are used to treat sweating in most cases. Both are anticholinergics most suited for the treatment of hyperhidrosis. These medications may also be used in conjunction with another localized treatment to keep sweating to a minimum.

Less frequently, doctors may use other types of medications to manage sweating. These medications include beta blockers, clonidine, benzodiazepines, and antidepressants. When excessive sweating is exacerbated by chronic anxiety a doctor will often use an antidepressant to treat the psychological symptoms. Alternatively, benzodiazepines and beta blockers can minimize the physical symptoms of anxiety and stress which also reduces sweat production.[2]

Groin sweat makes life hard, so don’t stop looking for a solution until you find what works! There are many ways to control sweat so that you can feel comfortable in your own skin - never give up on that.

Sources

1. Benson, R. A., Palin, R., Holt, P. J., & Loftus, I. M. (2013). Diagnosis and management of hyperhidrosis. British Medical Journal (Online), 347. doi:10.1136/bmj.f6800. Retrieved September 5, 2018, from https://pdfs.semanticscholar.org/4064/16bd4a9ba1fe433e59c95e0aab9d3dd83cb5.pdf
2. 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
3. Harker, M. (2013). Psychological Sweating: A Systematic Review Focused on Aetiology and Cutaneous Response. . Skin Pharmacology and Physiology, 26(2), 92-100. doi:10.1159/000346930. Retrieved September 5, 2018,from https://www.researchgate.net/publication/262042314_Psychological_Sweating_A_Systematic_Review_Focused_on_Aetiology_and_Cutaneous_Response
4. 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
5. Walling, H., & Swick, B. L. (2011). Treatment Options for Hyperhidrosis. American Journal of Clinical Dermatology, 12(5), 285-295. Retrieved September 5, 2018, from https://search-proquest-com.proxy187.nclive.org/docview/1467836763?pq-origsite=summon

Sweat Problems

If you have ever wondered why humans sweat, there is a good reason for it. Humans essentially sweat to aid in thermoregulation, the body’s way of regulating its internal temperature.[1] When people sweat, it releases heat from the body and cools down their internal temperature. Heat leaves the body when sweat evaporates from the skin. This is one of the evolutionary adaptations that allows humans to survive in such varying climates. However, for some people, sweating is less of an advantage and more of a hindrance. There are reasons that the body sweats differently when you are sick, but some people experience excessive sweating or too little sweating for other reasons. There are sweat related disorders that can cause all kinds of trouble for those who have them. Some people have excessively stinky sweat, some sweat too much, some people have colored sweat and others can’t sweat at all. Here is a look at the various conditions that can cause these issues and how they impact the people that have them.

Anhidrosis: Why People Don’t Sweat

It might make sense to be worreid if your body doesn't produce sweat. Hypohidrosis, also called anhidrosis, is the inability of the body to produce sweat or bring sweat to the skin’s surface in the presence of appropriate stimuli. This is why some people never sweat. Anhidrosis can be caused by a large variety of physical phenomenon that effect anything from the brain to the skin itself. Some of the most common conditions that cause people experience hyperhidrosis are anhidrotic ectodermal dysplasia, congenital insensitivity to pain with anhidrosis, Ross syndrome, generalized anhidrosis of unknown causes and localized hypohidrosis. There are other causes but they are rare. In most cases, a person who suffers from anhidrosis will have other symptoms of a disorder as well. For example, anhidrotic ectodermal dysplasia is an X-linked genetic disorder that can also cause conical shaped teeth, a saddle shaped nose and a prominent forehead. Congenital insensitivity to pain with anhidrosis (CIPA) is another interesting manifestation of a disorder that can cause hypohidrosis. People with CIPA lack the ability to feel pain or extreme temperatures in addition to the inability to sweat.[1]

In some cases, the inability to sweat can occur in just a few places on the body. This is what is referred to as localized hypohidrosis. This can often be caused by damage to the sweat glands. So, sometimes, something as simple as surgery or a bad burn can cause localized anhidrosis. This type of anhidrosis is usually not dangerous but systemic anhidrosis can be life threatening. The inability to sweat also means that a person also has the inability to cool their body temperature down. So, high temperatures can be deadly for someone with anhidrosis if they are not careful. Most people take it for granted that their body will automatically adjust to temperature changes but people with anhidrosis can’t.[1]

Hyperhidrosis: Why People Sweat Too Much

One of the most most common sweating disorders is called hyperhidrosis. Hyperhidrosis is a disorder that causes people to sweat in excess of what their body needs for thermoregulation. This is why some people sweat too much. There are two main types of hyperhidrosis: primary focal hyperhidrosis and secondary generalized hyperhidrosis. There are various causes of excessive sweating that can explain the reason people develop secondary hyperhidrosis, but the cause of primary focal hyperhidrosis is not well understood. Primary focal hyperhidrosis describes people who experience excessive sweating in specific areas of the body. These are the people who constantly have sweaty palms, feet or armpits. The onset of the condition is usually in late childhood or adolescence and is typically experienced over a lifetime. Luckily, there are many treatments available for the condition. Some of the management options include over-the-counter topical treatments for hyperhidrosis, iontophoresis for palmar and plantar hyperhidrosis, Botox for axillary hyperhidrosis and even surgery in severe cases. There are also oral medications for hyperhidrosis that can be taken to reduce sweating.[3]

Hyperhidrosis is not considered dangerous, and with so many treatment options available, it can managed effectively. However, hyperhidrosis and anxiety are closely related. This is because many people who have the disorder struggle with social anxiety and feelings of isolation due to the excessive sweat they produce. This makes it important for those who are affected by hyperhidrosis to seek treatment if they feel their quality of life is suffering. It is also important for people who suddenly develop symptoms of hyperhidrosis to seek medical treatment. Secondary hyperhidrosis usually occurs suddenly in adulthood and can signal a medical problem. Some common medications can cause hyperhidrosis as a side effect and certain serious medical conditions and diseases cause secondary hyperhidrosis.[3]

Bromhidrosis: Why Some People Have Stinky Sweat

Bromhidrosis is defined as sweating that creates an offensive body odor.[4] This is what causes some people to stink. Bromhidrosis is caused by bacteria that break down the proteins and fatty acids in odorless sweat and produce isovaleric acid and androsterone which are unpleasant smelling. The areas of the body that are most likely to produce a bad odor are the armpits, groin and breast area. This is because these are the only areas of the body that contain apocrine sweat glands. This type of sweat gland is located within hair follicles and is responsible for creating a thicker, yellowish type of sweat that is readily metabolized by bacteria.[5] Corynebacterium is located in the armpit and is thought to be responsible for creating the foul smell people typically associate with sweat. In some cases, eccrine glands, which cover the entire body and usually produce a clear odorless sweat, can cause a bad smell. This usually happens when an individual has consumed certain foods or drinks like garlic and alcohol.[4]

Bromhidrosis is not dangerous, but it can be extremely socially isolating. It is often associated with excessive sweating (hyperhidrosis) and together, these conditions create a situation that can lead to extreme social embarrassment. The odor from bromhidrosis can also send nonverbal cues to other people that the person suffering is undesirable. There are ways to stop sweating from causing body odor, but it is tougher for those who have bromhidrosis. Regular washing and hair removal are the first steps used to treat bromhidrosis. It can also be helpful for patients to use fragrant antiperspirants to reduce sweating. Many antiperspirants contain metal ions or antimicrobial ceramics, including zeolite antimicrobial ceramics and calcium phosphate that can be helpful in eliminating the bacteria that cause sweat to stink.[4]

Chromhidrosis: Why Some People Have Colored Sweat

There is a condition called chromhidrosis that can cause people to secrete sweat of different colors. There are various causes of the disorder. One underlying cause is called apocrine chromhidrosis. The colored sweat is a result of pigments called lipofuscin that are present in a patient’s apocrine sweat. The resulting sweat can vary in color from blue or black to yellow and green. In this case, the disorder is often treated with capsaicin gel which is thought to inhibit the release of acetylcholine (a neurotransmitter) at the sympathetic nerve ending.

There are many reasons that people struggle with sweat problems but many of these issues are manageable and their effects can be minimized with the proper treatment.

Sources

1. Definition of Thermoregulation. (2018). Retrieved September 10, 2018, from https://www.merriam-webster.com/dictionary/thermoregulation
2. Sato, K., Kang, W. H., Saga, K., & Sato, K. T. (1989). Biology of sweat glands and their disorders. II. Disorders of sweat gland function. American Academy of Dermatology, 20(5), 1st ser., 713-725. Retrieved September 10, 2018.
3. Pariser, D. M. (2014). Hyperhidrosis (4th ed., Vol. 32). Philadelphia, PA: Elsevier.
4. Eshini, P., & Sinclair, R. (2013). Hyperhidrosis and bromhidrosis: A guide to assessment and management. Australian Family Physician, 42(5), 266-269. Retrieved September 7, 2018, from http://ezproxy.co.wake.nc.us/login?url=https://search.proquest.com/docview/1430424903?accountid=14867
5. Huddle, J. R. (2014). Hyperhidrosis: Causes, Treatment Options and Outcomes. New York, NY: Nova Science.
6. Gandhi, V., Vij, A., & Bhattacharya, S. (2006). Apocrine chromhidrosis localized to the areola in an Indian female treated with topical capsaicin. Indian Journal of Dermatology, Venereology and Leprology, 22(5), 382-383. Retrieved September 10, 2018.