The Effects on Patients' Lives: Occupational Tasks and Activities of Daily Living

Palmar hyperhidrosis can interfere with activities of daily living as well as with occupational tasks. Having sweaty palms makes it difficult to grip tools, play musical instruments, and use electronic devices, and paper can be stained and ink smeared by dripping sweat.[9,134] Prior to sympathectomy surgery, 95% of patients with palmar hyperhidrosis reported that their condition interfered with their ability to perform daily tasks.[2] These patients reported difficulty writing or drawing, getting frequent electric shocks, and dropping glass objects.[2] There are anecdotal reports of patients in the police or armed services having difficulty holding weapons, a secretary whose sweat drenched a keyboard,[32] and the excess sweat from patients known as “rusters” corroding metal surfaces.[57]

There can be occupational difficulties for those with axillary or generalized hyperhidrosis who need to change clothes frequently or are anxious about making presentations in front of audiences because of sweat-stained clothing.[32] Less than 20% of patients with axillary hyperhidrosis evaluated prior to therapy were satisfied with their ability to perform current work activities, with many noting an effect of their excess sweating on both performance and productivity.[100] In a U.S. national consumer survey, 13% of patients with axillary hyperhidrosis reported decreasing the amount of time at work.[135]

Since primary hyperhidrosis begins in childhood, adolescence, or young adulthood,[9] career choices of affected patients may be negatively impacted by their symptoms. In a series of sympathectomy patients, 19% said their choice of career was directly influenced by their hyperhidrosis.[46] Positions like education or sales and marketing that require frequent handshaking or presentations before groups may be difficult. For those with palmar hyperhidrosis, occupations involving contact with paper, metal, or electric and electronic equipment are said to be “unattainable.”[95] Given these occupational limitations, there are potential negative economic consequences for hyperhidrosis patients.