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Imagine for a moment that you have hyperhydrosis. Your palms, feet, armpits or face is just pouring out sweat. It’s nasty and embarrassing. You just want to run away and hide.

Unfortunately, for some people this isn’t hypothetical – they actually suffer from hyperhydrosis – or excessive sweating – and what you have just read really does happen to them.

What causes hyperhydrosis?

Sweating is healthy under normal circumstances. It’s how our bodies cool themselves. However, some people experience constant or frequent excessive sweating or what’s called hyperhydrosis.

Unluckily for hyperhydrosis sufferers, no one knows what causes this condition – making it more difficult to treat. Some doctors believe it is caused by sympathetic over-activity. Nervousness or excitement can make the situation worse for many sufferers. It is also thought that factors such as certain foods and drinks, caffeine, nicotine and even some smells can trigger the condition.

How hyperhydrosis is diagnosed

If you suspect that you have hyperhydrosis, the best doctor to see is a dermatologist. He or she will most likely start with a physical exam. If you do have hyperhydrosis, the doctor will probably see sweat droplets even when you aren’t anxious and have a normal blood pressure and heart rate.

The dermatologist may also do blood tests to rule out serious conditions such as hyperthyroidism, acromegaly (a growth hormone disorder), diabetes and pheochromocytoma, which is a tumor of the adrenal gland.

If you have severe hyperhydrosis, the doctor may recommend tests to pinpoint the areas where sweating originates. In one such test, the doctor applies an iodine solution to the skin, along with dry starch powder. The powder turns a dark blue in those areas where sweating is excessive. Your doctor will measure the volume of sweat by applying sensitive filter paper to the blue regions for 60 seconds. He or she then weighs the filter papers to see the rate of sweat production. This is to help determine the severity of the hyperhydrosis.

Another test that is used to diagnose hyperhydrosis is called a thermoregulatory sweat test. In this case, the doctor covers your skin with a moisture-sensitive powder that changes color in areas of excessive seating. The powder color changes are first recorded at room temperature with a digital camera and then taken to a tented heating cabinet where humidity and temperature can be increased. The color changes are again recorded.

Treating hyperhydrosis

Hyperdydrosis can be treated a number of different ways. These range from over-the-counter antiperspirants and prescription antiperspirants to surgery.

For example, aluminum chloride is used in most off-the-shelf antiperspirants. But people with hyperhydrosis need solutions with a much higher concentration of the aluminum chloride than is found in regular antiperspirants. These “extra strength” antiperspirants can be very effective in treating auxiliary hyperhydrosis but be aware that it usually takes about three to five days before you see any results.

Some dermatologists have had success treating hyperhydrosis with Botulinum toxin Type A injections – the effects of which can last from four to nine months. Other treatments that have shown promise include anticholinergic drugs such as Oxybutynin, Glycopyrrolate, propantheline bromide (Probanthine) and benzatropine (Cogentin).

Finally, in cases where nothing else seems to work, there is a surgical option called thorascopic sympathectomy where the surgeon removes certain auxiliary tissue. And while surgery may seem radical solution, it can provide a satisfactory and permanent solution to what has is a very frustrating problem.

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