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Do you sweat on large areas of your body? Or do you sweat "everywhere"? You are not alone.
We hear about this problem a lot and we want to help you find potential treatment and relief. The first step is to determine whether an underlying medical condition or a medication may be the root of the problem.
With any type of sweating problem, it is important to find a knowledgeable physician about all-over sweating (often termed secondary generalized sweating). A physician, such as a dermatologist, can look at your medical history, provide an examination, run any necessary tests, consider any medications you may be taking (remember to tell your doctor about all medications you're using – including over-the-counter and herbal/natural products) and provide other professional insights.
To help you and your physician investigate your sweating problem, we've compiled lists of medications that can cause secondary hyperhidrosis (excess perspiration or sweating) as a side effect, and a list of diseases and conditions that can cause secondary hyperhidrosis. Of course, not everyone who takes one of these medications or who suffers from one of these conditions will experience excessive sweating. The lists are provided as a starting point for a discussion with a physician.
Only a knowledgeable physician, who has experience with hyperhidrosis, can diagnosis and treat excessive sweating. We encourage patients who think they may suffer from secondary hyperhidrosis, and physicians, to print out the lists mentioned above and use them as part of a thorough investigation into what may be causing a generalized sweating problem. If a medication or another medical condition is causing excessive sweating, you and your doctor can discuss ways to mitigate this side effect. So, how do you know which type of hyperhidrosis you have? And how do you know where to turn for help?
"It's actually pretty easy to figure out," says Toronto dermatologist and IHHS Board Member Dr. Nowell Solish, co-author of "Focal Hyperhidrosis: Diagnosis and Management" (Canadian Medical Association Journal, Jan. 4, 2005.) "With secondary hyperhidrosis, the onset is sudden."
Unlike secondary hyperhidrosis, primary hyperhidrosis is a longstanding medical condition that begins before age 25. Primary hyperhidrosis can affect one or more body areas, most often the palms, armpits, soles of the feet or face and sometimes the groin and under the breasts in men and women. Secondary hyperhidrosis, on the other hand, is generalized, typically involving the whole body. This type of excess sweat may seem to come on for no apparent reason – although a closer look at the patient will typically reveal a root problem. This is why this type of hyperhidrosis is called "secondary." The excess sweat is secondary to the more primary condition.
"Someone comes in and says, 'I'm 40 years old, and I just got it.' I'm a little more suspicious than if someone comes in and says, 'I'm 12 years old, and I've got it under my arms and nowhere else.' That fits the classic build, and I don't worry," says Solish, who treats hundreds of patients at his Sweat Clinics of Canada where he specializes in Botox injections for hyperhidrosis."
Whether you have primary or secondary hyperhidrosis can be determined by asking yourself a few questions as outlined by (and published in the Journal of the American Academy of Dermatology, 2004, Vol. 51, P. 274-86) St. Louis dermatologist Dr. Dee Anna Glaser. Dr. Glaser is an IHHS founding board member and an internationally recognized expert in hyperhidrosis. First, says Glaser, ask yourself if you have experienced focal visible excess sweat for at least six months without apparent cause. If the answer is "yes," then the next step is determining whether you meet at least two of the following criteria:
If you meet at least two of the above criteria, chances are you have primary hyperhidrosis, and you should make an appointment with a medical professional familiar with treatment options for people with hyperhidrosis. (Check our physician finder database for a doctor near you.) Some dermatologists believe upwards of 90 percent of people who present with excessive sweating will be diagnosed with primary hyperhidrosis.
"Certainly we know that hyperhidrosis seems to affect at least three percent of the population, if not more, depending on which research is looked at," says Dr. Glaser. "That's pretty consistent around the globe. For the dermatological community, most patients that we see are more likely to be in that primary category."
If you don't meet the criteria for primary hyperhidrosis, then it gets a little more complicated, as your doctor may end up needing to do a complete workup to determine why you are sweating excessively. The cause may be as simple as a new medication you've been taking. Or, you might be suffering from one of a range of medical conditions – most commonly an infective or malignant disease or another medical disorder such as cancer, diabetes or gout. A hormonal imbalance related to pregnancy or menopause could be another potential root cause. For a complete list of medications and diseases that can cause excess sweat, click here.
A person who thinks he or she is suffering from secondary hyperhidrosis should seek help from a general practitioner, ideally an internal medicine specialist. It's important to find the right doctor (again see our section on choosing the right doctor) as not all doctors will delve deep enough to find the cause of the excessive sweating.
"Generalized excessive sweating can occur in response to so many different medical conditions, disease states and medication treatments," says Dr. Glaser. "It's kind of a moving target depending on what kinds of medications are being used for different problems."
"If you see one physician and don't get the sense that the answer given is sufficient or satisfying, you certainly may need to seek out a second opinion. Sometimes that first response is: 'Don't worry about it. It's not going to kill you.' If you get an answer like that, and it's not satisfying to you, you should go ahead and seek out another opinion. "Whatever the reason for your excessive sweating, there are people in the medical community who want to help. Finding a nearby physician sympathetic to and experienced in treating patients with hyperhidrosis may be as simple as going to the physician finder service on our Web site and within seconds you will have the names and phone numbers of physicians near you. The "IHHS Educated" notation under a physician's name means the physician is not only familiar with treatment options for hyperhidrosis, but also that he or she has attended at least one of our educational events.
If medications and medical conditions have been ruled out, we encourage you to learn more about treatments for different body areas and consider a combination of treatments for the most troublesome body areas. For instance we have sections on: sweaty underarms, sweaty hands or sweaty palms, sweaty feet, sweaty face and even information for those who experience excessive sweating in other areas like groin, the breasts, and back.
Our Web site can also provide you with a comprehensive collection of insurance and reimbursement tools, including downloadable forms that can help you work with your physician and health insurance plan to get the correct coverage for necessary hyperhidrosis treatments.
However you find help, don't let fear or embarrassment keep you from seeking out the attention you need and deserve. Always remember you are not alone. We are here to serve and help you on your path to care and relief!
For updates about new research, the latest treatments, and daily management tips, be sure to subscribe to our free e-mail newsletter, SweatSolutions. We also have an extensive library of hyperhidrosis articles from peer-reviewed medical journals, so you can see share reliable medical data with your physician.