The Effects on Patients' Lives: Occupational Tasks and Activities of Daily Living
Occupational tasks, occupational choices, and activities of daily living can all be negatively affected by hyperhidrosis (Hh) with impacts varying depending on the focal locations where extreme sweating is exhibited.
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. These patients reported difficulty writing or drawing, getting frequent electric shocks, and dropping glass objects. There are anecdotal reports of patients in the police or armed services having difficulty holding weapons, of office workers drenching a keyboard, of mothers dropping their babies, and of patients' sweat corroding metal surfaces and musical instruments.
Those with axillary or other types of trunk or leg sweating often report needing to change clothes frequently and feeling anxious about (or avoiding entirely) making presentations in front of audiences because of sweat-stained clothing and visible sweating (such as on the face/scalp). In research, 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. In a U.S. national consumer survey, 13% of patients with axillary hyperhidrosis reported decreasing the amount of time at work.
Since primary hyperhidrosis begins in childhood, adolescence, or young adulthood, educational, training, and career choices of affected patients may be negatively impacted by sweating symptoms. In a study of sympathectomy patients, 19% said their choice of career was directly influenced by their hyperhidrosis. Positions like those in education, sales, marketing, or healthcare that require frequent handshaking, presentations before groups, or physical contact may be difficult. For those with palmar hyperhidrosis, occupations involving contact with paper, metal, or electric and electronic equipment are said to be “unattainable.”
A study published in 2017 in Health and Quality of Life Outcomes1a found that:
- 75% of those self-identifying as having Hh reported that they felt it was "difficult" to be in public view.
- 57% reported difficulties interacting with others. Common situations such as being in a shared office or shared classroom, going to a party, eating at a restaurant, using public transportation, or sitting in a movie theater were reported as challenging. Participants said they often avoid such situations.
- 50% of the people with hyperhidrosis in this study indicated that their lives were restricted by excessive sweating. Some talked of hyperhidrosis “taking over.” One individual described the experience of living with hyperhidrosis as “being trapped.”
- 63% of participants said that their sweating interferes with their performance at work or school. The majority regarded this as the most important impact of the condition.
- 41% of patients said hobbies are affected by hyperhidrosis including physical as well as non-physical activities such as cycling, exercising in the gym, playing musical instruments, doing yoga, reading books or newspapers, and crocheting/knitting. One patient said, “I don’t like exercising on the street or anything like that… people tend to look at me if I am really sweaty and that makes me really nervous”.
- 33% reported choosing careers to accommodate their sweating. One participant declined the opportunity to become a policeman “settling for a boring office job” instead.
- The majority of respondents said hyperhidrosis interferes with general tasks like holding objects, turning door handles, opening jars, working with tools, driving, shopping, and manual work. 33% said they have problems with household chores such as cleaning, cooking, ironing, and caring for young children.
- 20% of the respondents reported problems using touch technologies including computer keyboards, computer mice, mobile phones, and touch screens.
Feelings of shame, anxiety and embarrassment related to Hh can also impact success at school, at work and socially. In the 2017 research mentioned above, the majority of respondents reported having low self-esteem and self-confidence as a result of hyperhidrosis. One participant said, “It massively eats away at my self-confidence, it makes me feel awful...”1a
1a. Kamudoni P, Mueller B, Halford J, Schouveller A, Stacey B, Salek MS. The impact of hyperhidrosis on patients' daily life and quality of life: a qualitative investigation. Health and Quality of Life Outcomes. 2017 15:121.