Hyperhidrosis is a medical condition in which a person sweats excessively and unpredictably. Individuals with Hyperhidrosis can sweat even when the ambient temperature is cool, sweating indoors and outdoors in cool and cold temperatures in the dead of winter. Excessive sweating can also occur without exercise and during resting periods. Excessive sweating (Hyperhidrosis) in the palms, soles, and armpits (axillae) is not only embarrassing, but can also be a sign of an underlying disease.
Before dismissing excessive sweating as simply being due to emotions or social situations, it is important to rule out other possible causes. Hyperhidrosis can be caused by dysfunction of the autonomic nervous system (ANS). Sweating is controlled through the opposing actions of the sympathetic and parasympathetic divisions of the ANS. If the sympathetic system (“fight or flight” system) is overly stimulated, for instance, excessive sweating will occur. This cause of primary Hyperhidrosis can now be easily treated with a simple outpatient surgical procedure.
The most common diseases to cause secondary Hyperhidrosis are diabetes and hyperthyroidism. Diabetes mellitus is a disease of poor glucose (sugar) control. Over time, diabetes disrupts the proper function of the ANS. Diabetes is also associated with obesity, which itself can cause excessive sweating. An easy way to find out if you have diabetes is to have your blood glucose (sugar) checked by your primary doctor with a simple blood test. The thyroid gland, which is located in the neck, produces important hormones in response to signals in the brain. These hormones act by either increasing or decreasing the body’s metabolic rate. Hyperthyroidism occurs when the thyroid is overactive and secretes more hormone than in the usual resting state. This stimulates a faster metabolic rate in the body, producing increased sweating, nervousness, heart palpitations and weight loss. If you are experiencing any of these symptoms, a doctor can check your thyroid function and level of thyroid hormones through a simple blood test.
Other causes of excessive sweating include infections, menopause, medications, alcoholism, and certain types of cancers. These medications include antidepressants which should not be stopped without physician supervision. Infections often are associated with a fever, as the body tries to fight off the bacteria or virus causing the infection. If you are experiencing other symptoms associated with sweating, such as a cough, nausea, vomiting, or fatigue, it is important to take your temperature using a thermometer, and also make an appointment to see your primary doctor.
Normal body temperature is 98.6 degrees Fahrenheit taken orally. Menopause is the termination of monthly menstrual cycles in females, usually around the age 50. Common symptoms include sudden hot flashes and night sweats. If you have noticed an irregularity in your menstrual cycle, and are having hot flashes or night sweats, you should see your primary doctor or gynecologist to discuss various treatment options. A more serious cause of excessive sweating, especially night sweats, is cancer. For example, Hodgkin’s disease is a type of lymphoma often associated with night sweats. Patients also usually present with enlarged lymph nodes in the neck, axilla, or groin, unexplained fever, pruritis (itching), and weight loss. This requires a more complete work-up by your doctor including blood tests, x-rays, and CT scans.
All other possible causes of excessive sweating need to be excluded first. But note, localized sweating in the palms, armpits or feet in an otherwise healthy person is primary Hyperhidrosis. These can simply be treated with great success with endoscope thoracic sympathectomy (ETS). In this procedure, two tiny puncture wounds are made in each axilla (underarm) and a camera and clip applier are introduced into the chest cavity and clips placed on the sympathetic nerve trunk. This immediately eliminates excessive sweating in the head, underarms and palms in the vast majority of patients. When performed by a board certified thoracic surgeon, this procedure is highly effective and successful and can be performed in the outpatient setting. Sweating stops immediately and patients will experience some discomfort in the chest and can return to most of their daily activities within several days. ETS is associated with compensatory sweating in the lower body which is well tolerated by most people.
Alternatively, Hyperhidrosis of the palms or underarms can be treated with Botoxtm injections. Injection is typically repeated every 4 months and can be uncomfortable because of the needle sticks. Topical aluminum chloride solutions can also be used in the underarms which plug up the sweat glands and stop sweating for 3-4 days. Sweating resumes once the aluminum chloride ‘plug’ is extruded by the sweat gland. These topical medications however can cause skin irritation in some people with primary Hyperhidrosis prompting discontinuation of their use.
