The Effects on Patients' Lives: Social Embarrassment and Psychological Effects

Embarrassment associated with soaked clothing and wet palms can be severe. Patients with axillary hyperhidrosis use varying strategies to deal with the potential for excessive sweat to soak through their clothing in minutes, using pads, shields, absorbent tissues, and frequent clothing changes.[42] A college professor with axillary hyperhidrosis was embarrassed to find that his students made daily bets on whether his sweat stain would reach his belt by the end of the lecture.[140] Baseline evaluation of a series of patients treated for axillary hyperhidrosis found 90% of the group reported an effect on their emotional status, and over 70% had to change clothes two or more times per day.[100] Over 50% of patients with axillary hyperhidrosis identified in a U.S. national consumer survey reported feeling less confident, 38% are frustrated by some daily activities, 34% feel unhappy, and 20% are depressed.[135]

The damp hands of patients with palmar hyperhidrosis are constantly wiped on clothing or towels, and handshaking is avoided when possible.[43] Damp hands can be misconstrued as a sign of anxiety by others,[9] but anxiety about how they appear may itself be a stimulus for increased sweating, creating a vicious cycle.[57] Social embarrassment was reported by 90% of patients with palmar hyperhidrosis evaluated prior to sympathectomy, and 40% had psychological difficulties attributed to their symptoms.[2] In another series of patients with palmar hyperhidrosis who were to undergo sympathectomy, 77% avoided shaking hands and 17% had to wear gloves to do some tasks.[46]