Excessive sweating: Understanding hyperhidrosis and its impact on daily life

Hyperhidrosis can occur in various areas of the body, including the underarms, palms, feet, lower back, and face. Picture: Avi Richards/ Unsplash

Hyperhidrosis can occur in various areas of the body, including the underarms, palms, feet, lower back, and face. Picture: Avi Richards/ Unsplash

Published Sep 28, 2023

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Do you ever find yourself sweating excessively, even in situations where it doesn't seem necessary? If so, you may be experiencing a condition called hyperhidrosis.

This condition affects around 5% of South Africans and can have a significant impact on daily life.

Dr Alek Nikolic, an aesthetic medicine specialist, explains that sweating is a natural function of the body and it helps regulate body temperature. However, for those with hyperhidrosis, the sweat glands become overactive and produce more sweat than needed.

Hyperhidrosis can occur in various areas of the body, including the underarms, palms, feet, lower back, and face. There are two main types of hyperhidrosis: primary and secondary.

Primary hyperhidrosis is the most common and typically starts during puberty, while secondary hyperhidrosis is less common and usually caused by an underlying condition.

What is hyperhidrosis?

Hyperhidrosis is a medical condition that leads to excessive sweating beyond the body's natural cooling needs.

There are two main types of hyperhidrosis: primary and secondary:

Primary hyperhidrosis is the most common form and usually starts during puberty. Secondary hyperhidrosis is less common and is usually caused by an underlying condition.

Hyperhidrosis typically affects areas such as armpits, palms, soles of the feet, and face. These areas have a high concentration of sweat glands.

“The diagnosis of primary focal hyperhidrosis can be made on the presence of visible and excessive sweating of at least six months’ duration without any apparent cause,” explained Nikolic.

Along with excessive sweating, at least two of the following characteristics also need to be present:

• Impairs daily activities.

• Frequency of at least one episode per week.

• Younger than 25 years old.

• Positive family history.

• Sweating during sleep.

Treatment options for hyperhidrosis

Hyperhidrosis can have a significant impact on one's life which can lead to social embarrassment and anxiety, a knock on self-confidence, and can interfere with daily activities.

There are a range of treatment options available to treat this medical condition – many of which are guided by budget and the severity of the condition.

Some of the non-invasive treatment options include topical antiperspirants, oral medication and iontophoresis.

Nikolic suggests applying topical antiperspirants that contain aluminium chloride hexahydrate right before bed on dry skin as it is more effective than in the morning on damp skin. This will temporarily block the sweat glands.

General practitioners can also prescribe oral medications such as anticholinergics to help reduce sweating; while iontophoresis involves passing an electrical current through water and then placing the affected area into this “charge” water.

Invasive treatments include surgery such as local sweat gland resection and endoscopic thoracic sympathectomy.

The most popular invasive treatment to treat hyperhidrosis, however, is botulinum toxin commonly known as botox, which treats sweating the same way it prevents wrinkles.

“When injected, botulinum toxin blocks the nerve signals that stimulate sweat production, which essentially decreases the secretion of sweat,” said Nikolic.

There is no proof that using botulinum toxin to treat hyperhidrosis can result in the return of excessive sweating in other parts of the body.

The results are fast-acting and one can see the full effect of the treatment about two weeks after the injections.

The results will last a minimum of three months but are also dependent on how fast the body metabolises botulinum toxin and where it is injected.

Nikolic advises consulting with a medical professional to discuss the best treatment plan for specific conditions and address any concerns or questions. Stating that, like any treatment there may be temporary side effects, such as bruising, but these are generally manageable.

If you believe you may have hyperhidrosis, seeking medical advice is recommended. There are various treatment options available that can help manage your symptoms and improve your quality of life.