Hyperhidrosis in the Media

As summer temperatures soar, everyone's sweating.

That's because your four million sweat glands are working to keep you cool.

And while everyone sweats, some people have a condition called hyperhidrosis. It's characterized by excessive sweating that is above and beyond what is needed to keep the body cool. Hyperhidrosis is not a normal reaction to stress. People with hyperhidrosis may sweat four or five times more than normal regardless of external conditions and their sweating is so extreme that it interferes with daily life – affecting work, family, and fun.

Take this quiz, created by the International Hyperhidrosis Society, to find out whether your sweat is normal or whether you might have a medical condition warranting medical treatment.

Take the quiz now!

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The last few days of summer are rapidly approaching, and we're all trying to get in as many warm-weather workouts as possible. But with the rare day of scorching temperatures still popping up, outdoor exercisers can experience dehydration and excessive sweating. We spoke with experts from the International Hyperhydrosis Society to find out how to keep cool, stay dry and recognize when sweating becomes serious.

Hydration is key. "Drinking water helps cool the body off," says Kelley Redbord, MD, FAAD, a board-certified dermatologist in private practice in Vienna, Virginia and associate professor at George Washington University. If your body isn't hydrated it won't produce sweat, which could lead to heat stroke, says David M. Pariser, MD, founding member and secretary of the International Hyperhidrosis Society and professor of dermatology at Eastern Virginia Medical School in Norfolk. Body temperature is regulated during hot weather by sweat evaporating off your skin.

Apply antiperspirant at night. Both Redboard and Pariser recommend using an antiperspirant (which decrease sweating, while deodorants decrease odor-causing bacteria) in the evening because your skin will, most likely, be drier. "In the morning you're body is moving and making heat, causing your body to sweat," says Pariser. Wet skin makes antiperspirants less effective.

Look for clinical strength. These antiperspirants have higher amounts of the active ingredient aluminum salt that makes them more effective than standard ones, says Pariser. They are sold over-the-counter at most local drugstores. Redboard recommends Secret Clinical Strength for women and Gilette Clinical Strength for men.

Apply it anywhere. Antiperspirants are not reserved for under your arms. You can apply them anywhere you find you perspire like your hands, knees, feet, back or chest. Just be aware that these areas might be more sensitive than your underarms so choose an unscented product, advises Redboard.

Excessive sweating may require treatment. If you find perspiration affecting your daily life, you may have a condition called hyperhydrosis. It sounds serious, but this just means you sweat more than necessary, and the condition is testable and treatable, Redboard and Pariser say. Symptoms include excessive sweating while resting, physical discomfort and sweaty palms making writing or shaking hands difficult. Consult with your doctor or dermatologist if you think you may suffer from hyperhydrosis.

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Ever heard the old adage that men sweat and women glow? Turns out, the two sexes do sweat differently—just not in the ways you might expect. We spoke to the experts to get the scoop on everything from surprising treatments for excessive sweating to fascinating emotional responses caused by perspiration. Read on for info that will change the way you think about sweat.

1. Your fitness level can affect how much you sweat.

When the water in sweat evaporates on your skin, it cools down your body, which is the whole purpose of sweat—to prevent overheating. According to the International Hyperhidrosis Society, athletes sweat more than regular people because their bodies have become adept at keeping cool by increasing the amount they sweat. That same study published in the Journal of Experimental Physiology also found that the core body temperature in unfit women, who perspired the least, had to rise significantly more for them to sweat at maximum capacity.

2. Men sweat more than women.

In general, males really do produce more sweat than females—approximately four times more per day, according to David Pariser, MD, founding member and secretary of the International Hyperhidrosis Society. While both sexes have about the same number of sweat glands, Dr. Pariser says that, because men are larger, they have more surface area to cool off, not to mention the hormonal variations that cause them to sweat more. A study published in the Journal of Experimental Physiology found that when physically fit men and women exercised intensely, the men produced more sweat—even though both sexes had the same number of active sweat glands. The study also followed unfit men and women and found that the unfit women perspired significantly less than their male counterparts.

3. All sweat is not created equal.

Though you might assume all perspiration is the same, there are actually two different types of sweat, according to Hratch Karamanoukian, MD, director of the Center for Excessive Sweating. Eccrine sweat glands are responsible for producing "water sweat," which is composed mostly of water and salt. These glands are found all over the body, but are usually more concentrated on the hands, feet and face, and work to cool off your body, whether due to exercising or hot temperatures. Apocrine sweat glands, on the other hand, produce much less sweat, are located where hair follicles are (such as in your armpits) and are responsible for odor-containing sweat. While the purpose of the apocrine glands is unclear, they are believed to be "scent" glands, according to the American Academy of Dermatology.

4. Sweat may give off stress signals.

Think your facial expressions, body language and voice are the only ways to convey how you're feeling? If your sweating is caused by stress, you may unknowingly be sending tension to those around you. "When you're stressed, you sweat from both the odor sweat glands and the water sweat glands. But the [odor sweat glands] get a head start," says Dr. Pariser—which means that as soon as you start to feel stressed, you could be emitting a scent that's detectable by others. A study published in the journal PLoS One showed changes in brain activity when participants were exposed to the sweat of other people in an emotionally tense situation—in this study's case, skydivers. The participants had a subsequent chemical reaction to the sweat, which caused them to become more alert to potential threats, and display higher levels of vigilance.

5. There's a name for excessive sweating.

Think you perspire more than the average person? You very well might. According to Dr. Karamanoukian, anywhere from 1% to 3% of the population has hyperhidrosis, a condition characterized by excessive sweating due to over-active sweat glands. Though the exact cause of hyperhidrosis is unknown, the symptoms usually begin around adolescence. "These people will sweat for no apparent reason; it makes no difference if they're in a cool room and aren't feeling any stress. The areas most affected by hyperhidrosis are the underarms, hands, feet and face." Hyperhidrosis can be treated with a variety of procedures. Botox, for instance, which is largely known for smoothing wrinkles, has also been approved by the U.S. Food and Drug Administration (FDA) to treat excessive underarm sweating. "After an injection, those sweat glands will stop producing sweat for three to six months," says Dr. Karamanoukian. Other options include clinical strength antiperspirants, liposuction or FDA-approved electromagnetic treatments. If you think you suffer from excessive sweating, be sure to visit your doctor to rule out any underlying causes.

6. The best time to apply antiperspirant is at night.

Antiperspirants usually contain aluminum or zirconian as active ingredients, both of which, upon contact with water, will physically clog the sweat glands and stop them from producing sweat. "Antiperspirants are most effective when applied to very dry skin," says Dr. Pariser. "If you apply them in the morning right before you head out, or right after you get out of the shower, you'll likely already be sweating or have wet underarms. If the skin's surface is wet, the chemical reaction that forms from the aluminum will happen on the surface of the skin instead of in the pores, preventing the sweat glands from getting blocked." Instead, he recommends applying these products at night when sweat production is at its lowest. Even when you shower the next morning, the antiperspirant will still be effective, since it can last for a few days. Then, after your shower, if you want a scent, you can apply a deodorant for fragrance. Though there are concerns amongst some people that the aluminum salts in antiperspirants may cause Alzheimer's disease or breast cancer, both the Alzheimer's Association and the National Cancer Institute report that no scientific evidence has linked antiperspirants to either disease.

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Are you drenched in sweat when others around you seem cool as cucumbers? You're not alone. Millions of people deal with excessive, life-altering sweating — but there's hope. Here's how to manage.

Sweating is your body's way of cooling itself. Everyone does it, but some people do it more than others. Excessive sweating — producing as much as five times more sweat than is needed — occurs when a person's cooling system is kicked into overdrive. It can be an embarrassing and life-altering problem. But you don't have to suffer in sticky, sweaty silence. There are several treatments available to help you sweat less — and live more.

Excessive sweating is a real medical condition called hyperhidrosis. The most common type affects an estimated 8 million Americans, or 3 percent of the population. It's an equal opportunity problem, affecting men and women at about the same rate. People with hyperhidrosis sweat profusely nearly all day, every day.

When it comes to women's health, the problem can be particularly bad. "It affects personal relationships, the ability to be productive at work, intimate relationships, exercise and leisure activities, and really all aspects of life," says Dee Anna Glaser, MD, president of the International Hyperhidrosis Society and professor and vice chairman of the dermatology department at Saint Louis University School of Medicine.

Sophia Wastler, a 36-year-old small-business owner from Virginia Beach, Va., knows that firsthand. She started noticing excessive sweating on her palms and under her arms when she was just 9 or 10 years old. "My teachers would mark my work as messy since the sweat from my palms would get on the paper and smudge the ink," she recalls, adding that she withdrew socially because she didn't want other kids to see her sweat. "I would try to hide myself with baggy clothes."

What Causes Excessive Sweating?

The most common type of excessive sweating is called primary focal hyperhidrosis, meaning the sweating occurs only in specific small areas of the body and is not caused by another medical condition or a medication. The most common areas involved are the armpits, face, palms of the hands, and feet. As in Wastler's case, it often begins in childhood or adolescence and does not usually occur when the person is asleep.

The cause of this type of excessive sweating has not been conclusively pinpointed, but Dr. Glaser says it's definitely not a hygiene problem. Genetics is thought to play a role; Wastler says there are other cases of excessive sweating in her family tree.

Another type of excessive sweating, known as generalized or diffuse hyperhidrosis, is caused by underlying medical conditions or some medications. The sweating is usually over larger parts of the body and may occur during sleep. Common causes include:

Anxiety

Menopause

Diabetes

Thyroid, lung, or heart disease

Cancers such as leukemia

Infections such as tuberculosis

Generally, treating these conditions also helps treat the sweating, too.

Excessive Sweating Treatments Available to You

According to statistics, 67 percent of women with excessive sweating seek treatment, while only 32 percent of men with the condition do so. But Glaser urges everyone to talk with their doctors, because there are effective options that can be tailored to each person. Excessive sweating treatments include:

Prescription antiperspirants. These formulas contain higher doses of aluminum chloride, which can help you sweat less by plugging sweat ducts. They work under your arms but can also be effective on hands, feet, and the face. Side effects may include skin irritation.

Injections. When antiperspirants don't work, botulinium toxin type A (Botox) injections, approved by the U.S. Food and Drug Administration (FDA), can treat severe underarm sweating. The local injections effectively turn off sweating at the injection site. Botox does not cure excessive sweating; the shots are usually effective for several months and then need to be repeated. Botox is sometimes used to stop sweating in the hands, face, and feet, as well, but side effects like muscle weakness and drooping eyelids have been reported.

Iontophoresis. This procedure uses a small machine to send a mild electrical current through water and is very effective in treating sweaty palms and feet. It's believed that the electricity and the minerals in the water work together to slightly thicken the top layer of skin to block the flow of sweat to the skin's surface. Several iontophoresis sessions are needed to help hands and feet sweat less. Eventually, people are put on a maintenance schedule of once a week or once a month, depending on their individual needs.

Medication. Anticholinergic drugs, like glycopyrrolate (Robinul, Robinul-Forte), help prevent stimulation of the sweat glands. However, doctors are hesitant to prescribe the drugs long-term because of the potential for serious side effects such as confusion, trouble breathing, chest tightness, and memory loss. Beta blockers or benzodiazepines also can help reduce sweating related to stress.

Surgery. There are two types of surgery. To relieve underarm sweating when other treatments have failed, surgeons sometimes use a surgical procedure to cut out and remove these sweat glands. Another procedure called endoscopic thoracic sympathectomy is used to disrupt signals coming from spinal cord nerves to the sweat glands. This is considered a treatment of last resort because of the risk for severe complications.

In addition, the FDA has approved a new handheld device to treat severe underarm sweating. It uses electromagnetic energy to break down sweat glands. Called miraDry, it should be available from trained doctors by the end of the year.

The Benefits of Treating Excessive Sweating

Wastler finally got treated for her excessive sweating when she was 31 years old. A combination of Botox and iontophoresis has not only gotten her hyperhidrosis under control, she says, but the treatments literally changed her life. "I felt so invincible that I left my secure job [as a public school teacher] and started my own company," she says. It's called the "Starz Program!" and teaches dance, cheerleading, and sports to children in preschools, daycare centers, and private schools at three locations in two states.

Wastler is doing great now, but she does feel that she waited too long to get treatment and wants to warn others against making the same mistake. "I strongly suggest that anyone who thinks they have hyperhidrosis get treated right away," she says. "After I got treated, it was like a veil was lifted and I could start living and have more confidence in my life."

For more information on excessive sweating and its treatments, go to The International Hyperhidrosis Society.

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Physical symptoms of stress can be varied and unusual. Here are a few ways to find out if you're over the edge.

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A little sweat? No big deal. But, what about excessive sweating? USA Today gets the facts about treating excessive sweating from hyperhidrosis experts David Pariser, MD and Dee Anna Glaser, MD.

By Kim Painter, USA TODAY

A little sweat can be a very good thing: You wouldn't want to plant a summer garden, ride your bike or a run a marathon without it.

Sweat helps keep you cool and healthy. But too much sweat at the wrong time? Not cool. "There are people who put on a clean shirt and sit down in an air-conditioned room and within half an hour have a dinner-plate-size wet spot on each side of their shirt," says David Pariser, a Norfolk, Va., dermatologist.

Pariser, who is president of the American Academy of Dermatology, says sweaty hands can be especially vexing: He has met lawyers who ruin documents with their wet hands, and one police officer whose hands were so sweaty he could not fire a gun. A simple handshake can be mortifying for such folks, he says.

"I think I was even dumped once because of it," says Therese Hernando, 26, a Lake Forest, Calif., office worker. "A boyfriend said my hands were too sweaty."

The medical name for extreme sweating is "hyperhidrosis." It can affect the underarms, hands, feet and face. Nearly 3% of Americans say they sweat too much, according to a study published in 2004 in the Journal of the American Academy of Dermatology. One-third of those with heavy underarm sweating said it was "barely tolerable" or "intolerable" and interfered with daily life.

Such sweating can be socially crippling, says study co-author Dee Anna Glaser, a St. Louis dermatologist and president of the International Hyperhidrosis Society, a non-profit group that gets money from companies that sell treatments for the disorder. "It does not kill people, but it can really impact their ability to get along in the world."

And it can have medical consequences: People with hyperhidrosis are at increased risk for skin infections, ranging from warts to athlete's foot to invasive bacteria, says Hobart Walling, a Coralville, Iowa, dermatologist. He reported his findings in May in the dermatology journal.

Doctors say they can help. Treatments include:

•Antiperspirants. Prescription and over-the-counter "clinical strength" brands help at least one-third of people with heavy underarm sweating, Walling says. Key tip: Apply it at bedtime, even if you plan to shower in the morning.

•Iontophoresis. In this unlikely-sounding treatment, patients put their hands or feet in shallow trays of water with a device that emits a mild electrical current. It's thought that the electricity and minerals in the water work together to slightly thicken the skin, blocking the flow of sweat. The downside: Each home treatment takes 20 to 40 minutes and must be repeated several times a week, Pariser says.

•Botox injections. In 2004, the Food and Drug Administration approved Botox for excess underarm sweating. The toxins affect the nerves that trigger sweating and work for four to eight months at a time, Pariser says. Doctors also use Botox for hands and other areas. But costs are high — typically $700 to id="mce_marker",500 for both underarms and more for hands, Pariser says — and, while insurers often pay, not all doctors accept insurance for the treatments. Hand injections also can cause temporary muscle weakness in thumbs and fingers. Hernando recently had her hands treated with Botox. The injections hurt a bit, and she had trouble opening jars for a while. But, she says, it was worth it: At her wedding, in May — to a man who never complained about holding her sweaty hands — she shook hands with guests without embarrassment. "It was one less thing I had to worry about," she says.

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