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Normal sweating is a necessary function of the body. It keeps the body cool and excretes some waste products of the body. Hyperhidrosis is excessive sweating - more than what is needed to regulate body temperature. Any part of the body can be affected by hyperhidrosis.
Hyperhidrosis can start during adolescence or even before, and it appears that there is a genetic predisposition to the disorder. Symptoms tend to worsen over time and don't disappear on their own. In some people, excessive sweating occurs only under severe stress. In others, it happens all the time.
There are three main types of hyperhidrosis:
Primary Focal Hyperhidrosis
Primary focal hyperhidrosis is a medical condition that is not caused by medication or another medical problem. Excessive sweating occurs on specific areas of the body (focal), including the feet, hands, underarms, and face. The sweating may be so severe that sweat drips from the hands, feet, or armpit. If the face is affected, the sweating usually occurs during a social or functional situation and can be accompanied by a reddened facial blush.
Primary hyperhidrosis often begins in childhood or adolescence, and it may be inherited. The condition can be difficult to handle psychologically and can lead to anxiety and depression. Physically, primary hyperhidrosis can cause skin irritations and infections. In the armpit area, it can result in a foul-smelling condition called bromhidrosis.
There are a number of treatment options for primary focal hyperhidrosis, including medications and surgery.
Generalized Idiopathic Hyperhidrosis
Generalized idiopathic hyperhidrosis occurs when large areas of the body sweat. This condition is usually treated with medications.
Secondary Generalized Hyperhidrosis
Secondary generalized hyperhidrosis causes large areas of the body to sweat. It may be caused by a medical condition, such as menopause, diabetes, an overactive thyroid or stroke. Medications, exercise and heat also cause secondary generalized hyperhidrosis. The sweating can occur during sleep. This condition should be evaluated by a dermatologist for diagnosis and treatment.
Areas of the Body Affected
While hyperhidrosis can occur anywhere in the body, the most common areas affected include:
Palms (Palmar Hyperhidrosis)
Excessive hand sweating is the most common type of hyperhidrosis. It is caused by heightened activity in the sympathetic chain of nerves, part of the autonomous nervous system that involuntarily controls activities in the body. The sympathetic chain is located in the chest cavity.
Excessive hand sweating can range from mild to very severe, and may be genetic in origin. Sweaty palms usually begin early in childhood and can get worse in the late teenage years and early adulthood.
Most people with severe sweaty palms don't benefit from conservative treatment with medications, iontophoresis or biofeedback, although health insurance companies may dictate that these remedies be tried first. For severe palmar hyperhidrosis, the best option may be a surgical procedure called endoscopic thoracic sympathectomy (ETS).
Armpits (Axillary Hyperhidrosis)
All humans sweat in the armpits, but people who suffer from axillary hyperhidrosis experience extreme, dripping sweat in the armpit area. The disorder is caused by overstimulation of the sympathetic nervous system, which is located in the chest cavity. Many people with the condition also suffer from excessive hand sweating. Specific foods, anxiety, stress, and emotional situations may worsen axillary hyperhidrosis.
Another type of axillary hyperhidrosis is bromhidrosis, in which case certain bacteria that are on the skin convert the sweat to a foul-smelling condition.
Excessive armpit sweating usually starts around puberty and can become socially stigmatizing. Patients change their clothes often, try to hide the problem with certain clothing styles or colored fabrics, and can be subjected to rude comments from co-workers or fellow students.
Although excessive sweating can be resistant to deodorants, antiperspirants, and odor-controlling medications, conservative treatment with one or several of these is often a good start.
Face (Facial Hyperhidrosis/Blushing)
Excessive facial sweating and/or facial blushing usually occurs during mild social situations that would not normally cause these conditions. It usually starts after puberty.
Facial hyperhidrosis is caused by a hyperactive sympathetic nervous system, which is located in the chest cavity. Sympathetic facial blushing caused by hyperhidrosis differs from rosacea, another condition that causes facial redness. Rosacea is a skin condition characterized by blemished skin and constant redness around the cheeks. Sympathetic blushing is marked by facial redness brought on during certain social or functional situations. Sympathetic blushing comes on in short bursts of facial redness. Frequently, patients who experience excessive sweating of the palms also suffer from facial sweating and/or facial blushing.
Because facial sweating may be as a result of an adrenal dysfunction or overproduction of adrenaline-like materials, your doctor may suggest a medical evaluation to rule out other medical conditions. Most people diagnosed with facial sweating an/or facial blushing try medications before considering surgery.
Feet (Plantar Hyperhidrosis)
Many people who have sweaty palms also suffer from excessive sweating of the feet. Sweaty feet can ruin shoes, limit the types of footwear that can be worn (including sandals and flip flops), and result in foot odor and fungal infections.
Patients may try to treat the condition by applying foot powder after bathing. Leather shoes and wool socks should not be worn. Rubber and synthetic materials should be avoided.