By Dr. Tom Rosenfeld
Chief of Dermatology

It’s normal to work up a sweat when you’re doing yardwork or exercising at the gym. However, if you are sweating profusely when you are not exercising or inside a temperature-controlled environment, you may be suffering from hyperhidrosis.

Hyperhidrosis occurs when your body’s sweat glands become overactive, causing an extreme amount of perspiration. It happens because the sympathetic nerve that controls sweating becomes oversensitive, causing the overproduction of sweat. People suffering from hyperhidrosis can visibly sweat through their clothing and even drip sweat from their palms. Typically, hyperhidrosis occurs most often on the hands, underarms, and trunk. Some sufferers also experience extreme sweating on their faces.

There are actually two types of hyperhidrosis – primary hyperhidrosis and secondary hyperhidrosis. Primary hyperhidrosis is usually inherited, which means if some of your family members have a problem with excessive sweating there’s a chance you may too. With this type of hyperhidrosis, people often experience excessive sweating from only one or two parts of their body, while the rest of their body sweats normally.

Secondary hyperhidrosis is caused by certain medical conditions as well as some medications. This type of hyperhidrosis can happen in one or more locations on the body or it can affect people all over. Some of the medical conditions that cause it include:

• Diabetes mellitus
• Gout
• Overactive thyroid
• Neurologic syndromes
• Menopause
• Alcoholism
• Obesity
• Thyrotoxicosis
• Head and spinal cord injuries

If you think you have a problem with hyperhidrosis, you should first talk to your primary care provider. You may be referred to a dermatologist for diagnosis and treatment. Diagnosis can include questions about your sweating patterns and sometimes bloodwork to determine if there is an underlying cause for your hyperhidrosis.

Treatment for hyperhidrosis

The good news is that if you do suffer from hyperhidrosis, there are a number of ways to help, including:

Medications
You may be prescribed medications that help prevent your sweat glands from releasing sweat. However, these medications may not be a good option if you have certain medical conditions or live in a part of the country with high temperatures. This is because sweating is needed to help cool the body so it doesn’t become overheated.

Prescription strength antiperspirants
If your regular antiperspirants are not effective, your doctor may prescribe prescription-strength antiperspirants to help. These can be applied overnight and/or under a layer of plastic wrap to improve their penetration into the skin and enhance their effectiveness.

Injections
Botulinum toxin (Botox) injections are FDA-approved for use with people who suffer from hyperhidrosis. The shots are injected into the armpit area and work by blocking the release of chemicals that cause sweating.

Iontophoresis
This method works by temporarily turning off the sweat glands by delivering a low voltage current to the nerves that control them. It is performed while you soak both hands and/or feet in a shallow pan filled with water. Treatment needs to be repeated at certain intervals to achieve good results.

MiraDry®
MiraDry is an FDA-approved, non-invasive treatment that utilizes thermal heat energy to target and eliminate the sweat glands in your underarms. The treatment is performed in your doctor’s office and typically takes under an hour.  Not only does MiraDry assist with hyperhidrosis, it can also reduce underarm hair growth.
MiraDry works by targeting and destroying the sweat glands. Once the sweat glands are destroyed, they are permanently removed.

Surgery
In some cases, surgery is used to alleviate hyperhidrosis. However, the methods listed above are more common.

There’s no doubt that hyperhidrosis can cause embarrassment and affect people’s quality of life. Fortunately, there are a number of effective treatments. So, if too much sweating is affecting your quality of life, be sure to talk to your primary care provider about the best way to treat hyperhidrosis.