Hyperhidrosis & Mental Health Impact

According to a 2022 American Psychiatric Association study, 37% of Americans rate their mental health as being fair or poor, compared to 31% saying the same in 2021. That’s a big jump. Similarly, a CDC report notes that visits to the Emergency Department in the U.S. due to mental health concerns (like anxiety, eating disorders and depression) have increased significantly. 

And the problem is global. 

Around the world, says a report in The Lancet, mental ill-health is rising. Young people are at particular risk with the World Health Organization reporting that depression is the third leading cause of illness and disability among adolescents, and suicide is the third leading cause of death in teenagers between the ages of 15 and 19.

While this should concern everyone, those living with hyperhidrosis (Hh or excessive sweating) and their healthcare providers should pay particular attention as research shows that excessive sweating often brings additional mental health risks. 

The good news? 

Appropriate care for both skin and mental health can help. 

For example, according to Practical Dermatology, “structured psychotherapeutic interventions, cognitive behavior therapy, behavior therapy, progressive muscle relaxation, guided imagery, mindfulness meditation, yoga, tai chi, and structured breathing techniques all have been associated with improved therapeutic outcomes and improvement in overall well-being [in patients with skin disorders].” These, ideally, should be taught by a mental health specialist that understands and has experience with skin conditions, so that, combined with concrete and effective treatment for the skin issue (like Hh), both the skin problem and any related emotional suffering can be improved.

What Do We Know About Hh and Mental Health? 

Here are some examples of the mental health impacts of Hh documented by research: 

• Reported psycho-social ramifications of Hh include decreased confidence, depression,¹ embarrassment, anxiousness, sadness, anger, and feelings of hopelessness.²
• People with Hh tell IHhS about sweat “ruining” life and “controlling” life; feelings of self-harm/suicide, anxiety, isolation, depression, “doom”, shame, and being an "outcast."  Other terms we hear include:  isolation, stress, panic, disdain, disgust, and “drowning.”
• 75% of those with excessive sweating say the condition has had negative impacts on their social life, sense of well-being, and emotional and mental health.³ 
• The prevalence of anxiety and depression is significantly higher in those with Hh than those without Hh (21.3% vs 7.5% and 27.2% vs 9.7%, respectively).⁴

In-person observations back these facts up. For example, Dr. Dee Anna Glaser (International Hyperhidrosis Society President and Co-founder) told the American Academy of Dermatology (AAD) she noticed something concerning among her hyperhidrosis patients over the years. “Many of them had either anxiety or depression. There were some who had said they had suicidal thoughts because their sweating was ruining their life.” 

This led Dr. Glaser to conduct research (with co-authors) in the hope of better understanding the potential connection between mental health and hyperhidrosis. The results were presented at the AAD in a poster presentation with these key points:

• People with hyperhidrosis were more likely than the general population to have anxiety and depression, regardless of gender or age.

• Of the 500 hyperhidrosis patients involved in the study, 13.8% had anxiety and 12.4% had depression — rates significantly higher than those reported in the general population. 

In light of this, Dr. Glaser says it’s imperative for healthcare providers caring for hyperhidrosis patients to:

• Proactively ask about symptoms of mental health conditions

• Let patients know that these health concerns, along with hyperhidrosis, can be pretty common, and

• Help patients find the care they need from appropriate professionals

This is especially important, Dr. Glaser noted, for teens and young adults with hyperhidrosis (when the condition usually first manifests). “This population can be vulnerable to mental health conditions,” she said. “Often they feel isolated and feel they’re the only ones with these problems.”

Fortunately, research shows there can be improvement in mental health with hyperhidrosis treatment. This is similar to research with other skin conditions which found that successful treatment, that improved skin symptoms, led to improvement in psychological symptoms and better quality of life.

If you or a loved one or your patients are dealing with Hh, there are treatments and combinations of treatments that can make a significant difference for physical, social and emotional well-being. And seeking help from mental health professionals can compound improvements while simultaneously helping you to cope with the full range of life challenges.

Learn about all the options for Hh treatment on this website and find informed Hh medical care through our Clinician Finder. 

If you or anyone you know is in emotional crisis and in the United States, call 988 to access the Suicide & Crisis Lifeline for 24/7, free and confidential support for people in distress and prevention and crisis resources. 

To find suicide hotlines in other countries, look here and here. 

References:

1. Hamm H, Naumann MK, Kowalski JW, Kutt S, et al. Primary focal hyperhidrosis: disease characteristics and functional impairment. Dermatology 2006;212:343–353.

2. Hasimoto EN, Cataneo DC, dos Reis TA, Cataneo AJM. Hyperhidrosis: prevalence and impact on quality of life. J Bras Pneumol. 2018;44(4):292–298. doi: 10.1590/s1806-37562017000000379.

3. Doolittle J, Walker P, Mills T, Thurston J. Hyperhidrosis: an update on prevalence and severity in the United States. Archives of Dermatological Research. 2016;308(10):743-749. doi:10.1007/s00403-016-1697-9.

4. Bahar R, Zhou P, Liu Y, et al. The prevalence of anxiety and depression in patients with or without hyperhi- drosis (HH). J Am Acad Dermatol. 2016;75(6):1126-1133.