Hyperhidrosis: Causes, Symptoms, Treatment and Cost

Hyperhidrosis is a condition in which a person experiences excessive sweating, usually on their palms, feet, face, and armpits. The condition affects both sexes equally and people of all ages.

• Primary focal hyperhidrosis: This type of hyperhidrosis is the most common and typically affects the palms, feet, face, underarms and scalp. It is characterised by excessive sweating that is localised to a specific area of the body and does not occur as a result of another medical condition or physical activity.
• Generalised hyperhidrosis: This type of hyperhidrosis is also called secondary hyperhidrosis because it occurs as a result of another underlying medical condition such as diabetes, thyroid disorders or certain medications. It usually affects large areas of the body in a symmetrical pattern.
• Palmar (palmoplantar) hyperhidrosis: This type of hyperhidrosis affects only the palms and feet. Sweating that occurs during physical activity or hot weather does not count as palmar hyperhidrosis, it must be excessive sweating not caused by heat or exercise to be considered this type of hyperhidrosis.
• Craniofacial (gustatory) Hyperhidrosis: This type of Hyperhidrosis affects only the face, neck and scalp areas. It often occurs when an individual has certain foods or drinks that cause an intense emotional reaction such as embarrassment, anger or fear.
• Axillary Hyperhidrosis: Also known as primary axillary Hyperhidrosis this form typically impacts the underarm region and can cause excessive sweating when there are no other trigger factors present such as increased temperature or physical activity.

• Hyperhidrosis can be caused by physiological or psychological factors, such as hormones, nerve damage, menopause and anxiety; medication side effects; genetics; infection or environmental factors.
• Other causes include thyroid disorders, low blood sugar, medical conditions that involve the autonomic nervous system (such as diabetes and stroke), reactions to medications and food allergies.
• Hyperhidrosis can also be a symptom of more serious underlying diseases such as tuberculosis and Hodgkin’s disease.

• Symptoms include increased sweating on the palms, soles of feet, underarms and/or face.
• The sweating is often persistent, with episodes occurring at least once a week for at least 6 months.
• Individuals may also experience clammy skin and redness in affected areas.

• Wear clothes made of natural fibres that are breathable.
• Avoid caffeine, spicy foods, and alcohol, as these can trigger sweat in some people.
• Use an antiperspirant or deodorant to reduce sweating in the underarms and other areas.
• Control stress levels and get adequate sleep as these can be triggers for excessive sweating.
• Exercise regularly to keep the body temperature under control.
• Seek medical help if the above remedies do not offer relief from hyperhidrosis symptoms associated with the medical condition known as primary focal hyperhidrosis.

• Physical examination: The first step in diagnosing hyperhidrosis is for a doctor to confirm that excessive sweating is directly related to increased sympathetic nervous system activity. This can involve discussing the patient's medical history and performing a physical examination.
• Electro Diagram (EDG): A test which measures the electrical activity of sweat glands by attaching electrodes to areas of excessive sweating and measuring their response.
• Thermoregulatory Sweat Test (TST): A test in which temperature sensors are placed on areas of skin that tend to sweat excessively, and then changes in these areas are observed while the body is subjected to controlled air temperatures.
• Skin biopsy: An examination of tissue taken from a person’s skin in order to assess any possible underlying diseases and disorders.
• Blood tests: Used to assess the patient’s overall health and look for abnormalities that could be contributing to increased sweating levels.

• Skin Infection: Sweat can cause the skin to become irritated and infected, resulting in dry, itchy patches of skin or open sores.
• Social Embarrassment & Low Self-Esteem: Excessive sweating can lead to humiliation, anxiety and self-consciousness in social situations.
• Work Difficulties: Hyperhidrosis can make daily tasks (typing, gripping tools) challenging and increase risk for work injury due to slippery hands/fingers.
• Chafing & Rashes: In individuals with severe sweating episodes, skin inflammation may happen due to friction caused by clothing.

• Drinking ginger tea: Ginger can be consumed in the form of a decoction or tea to reduce excessive perspiration.
• Applying sandalwood paste: Sandalwood is known for its cooling and soothing effects on the body, and applying a paste of it on the affected area can help in reducing sweating.
• Eating coriander seeds: Coriander seeds mixed with sugar can help improve body temperature and sweat patterns.
• Cleaning the skin with rosewater: Rosewater has cooling properties which make it an effective remedy for hyperhidrosis when used for body cleansing and rinsing .
• Ayurvedic massages: Abhyanga and marma therapies, both of which involve massage treatments, can be helpful in alleviating increased sweating associated with hyperhidrosis.

• Drink plenty of water and other fluids to stay hydrated throughout the day.
• Eat fruits, vegetables and whole grains that are high in antioxidants, which may reduce inflammation and help manage excessive sweating.
• Consume foods that have cooling properties such as cucumber, mint, asparagus or watermelon.
• Include lean meats such as chicken or fish in your diet for protein sources that can help support energy levels throughout the day without overly taxing the body with sweating side effects.

• Processed sugary snacks and sweets: Candy, cookies, cake, etc. are all loaded with refined sugars that can spike blood sugar levels, leading to excess sweating.
• Refined grains: Processed and refined grains such as white rice, white breads and pastas can cause inflammation in the body that can exacerbate hyperhidrosis symptoms.
• Alcohol: Excessive consumption of alcohol causes an increase in sweat production.
• Caffeinated beverages: Caffeine is a stimulant and can trigger increased sweating in people with hyperhidrosis or other underlying conditions like anxiety disorder or thyroid issues.
• Spicy foods: Eating spicy food increases sweat production as our bodies attempt to cool down from the heat created by the spices used to prepare them.

• Medication: Taking certain medications, such as anticholinergics or beta blockers, can help reduce sweating.
• Lifestyle changes: Making certain lifestyle changes, such as using an antiperspirant or avoiding certain activities that trigger sweating, can help keep your sweat levels under control and reduce unpleasant symptoms associated with hyperhidrosis.
• Endoscopic thoracic sympathectomy (ETS): It is a surgical procedure involving cutting or clipping off the nerves that are located in the chest wall, in order to control excessive sweating.
• Local sweatectomy: It involves removal of sweat glands from an affected area, usually on the face, underarms, or hands using laser energy or suction curette.
• Laser treatments: This type of treatment can be used to treat localised areas such as the armpits and palms by constricting sweat ducts through precision laser-induced heat.
• Iontophoresis: This is an electrical current that is applied directly to the skin by way of water-filled tubs with electrodes attached; it helps block transmission of signals that trigger excessive sweating in the treated area

Hyperhidrosis is usually treated by a primary care physician or a dermatologist.

Your doctor can provide you with the best diagnosis and determine the most appropriate treatment for your individual situation.

• Antiperspirants: These are topical medications applied directly to the affected areas like the armpits, palms, etc. Examples include aluminium chloride hexahydrate or aluminium zirconium tetrachlorohydrex gly.
• Oral Medications: These medications work systematically so they require ingestion and can include anticholinergics such as oxybutynin, benztropine, and glycopyrrolate; beta blockers like propranolol and atenolol; calcium channel blockers such as amlodipine; and certain antidepressant medications such as paroxetine or fluoxetine.
• Botox: Botulinum toxin type A injections are used to treat focal excessive sweating in some cases including hyperhidrosis of the hands and feet or axillae (underarms). The type A form relaxes muscles where it is injected, reducing sweat production in those areas.

Hyperhidrosis usually takes 4-6 weeks to recover from. During this period, treatment typically combines medication, lifestyle changes and physical therapy.

The results of treatment for hyperhidrosis vary from person to person. Generally, most treatments are not permanent, and some may require maintenance or repeat treatments to maintain results.

Botox injections have been shown to have good long-term outcomes in many cases lasting up to six months or more. Additionally, laser ablation treatments may be used for larger areas and can produce more permanent results. Lastly, iontophoresis is another effective treatment that has been known to provide long-term relief as well as address underlying causes of excessive sweating.

• Avoid strenuous activities for six weeks following surgery and follow all doctor’s orders for physical therapy and activity restrictions.
• Ice the treated area up to three times a day for 15 minutes each time with an ice pack, to control swelling and aid in healing.
• Keep the area covered with bandages or special dressings to keep it dry after showering and bathing, as directed by your doctor’s instructions.
• Clean and disinfect any wounds or incisions daily, by gently washing with mild soap and warm water, patting dry, then applying ointment or antibiotic cream as instructed on the label or your doctor’s instructions.
• If sutures have been used, they should be removed by seven days following surgery unless otherwise instructed by your physician; some surgical methods may take longer to heal fully than others so be sure you follow post-operative instructions closely.
• Remain in close contact with your healthcare provider during the recovery process, keeping any scheduled visits for wound care treatment and going to medical appointments promptly if needed.

The cost of hyperhidrosis treatments in India depends on the severity and type of treatment, but can range from Rs. 1000 to Rs. 20,000.

Common treatments include laser therapy, Botox injections, topical solutions, and iontophoresis. Additionally, surgery might be recommended in some cases. Consultation fees with a dermatologist or other medical professionals may also need to be taken into account before engaging in any treatment options.

• Botox injections: minimal side effects and temporary mild discomfort.
• Anticholinergic medications: dry mouth, blurred vision, constipation and difficulty urinating.
• Surgery (sympathectomy): Increased risk of infection and nerve injury.
• Iontophoresis: Skin irritation and minimal risk of electric shock.

If you are suffering from any complications relating to hyperhidrosis then you should consult a doctor nearby as they can cause complications like 'Skin Infection, chafing and rashes, etc.' for which treatment course can range from a few months to years depending on the severity of the situation.