excessive sweating that could ruin your life

Most people sweat when they are exercising or when it is hot. But some people sweat a lot more than that. Hyperhidrosis – excessive sweating – can be a devastating disease that has a considerable impact on the quality of life and can even prevent those who suffer from it from performing daily tasks. For some, this has affected their relationships. Others are so embarrbaded by their sweat that they feel unable to leave their home.

Sweating is a normal physiological process that helps the body regulate its temperature. When we are too hot or we exercise, sweat evaporates from the skin and has a cooling effect. People often notice that they sweat when they are anxious or in a situation that makes them nervous. But for about 3% of people with hyperhidrosis, sweating can be almost constant.

The areas of the body most commonly affected by hyperhidrosis are the hands, feet, armpits, face and head, although other areas may also be affected. Some people with hyperhidrosis sweat everywhere, rather than in certain parts of the body. People with hyperhidrosis often sweat in situations where others do not, for example when it's cold.

It is unclear what causes hyperhidrosis, although it is thought that the nerves that make us sweat become excessively active. Hyperhidrosis often begins in childhood or adolescence, but can manifest itself at any time in life. There is probably also a genetic element, because there is often a family history in people who sweat excessively on the hands.

Few answers

Without a clear understanding of the causes of hyperhidrosis, it is more difficult to find effective treatments. That's why my colleagues and I have studied the situation. We asked people with hyperhidrosis and the health professionals who treated them what questions they wanted to see resolved. 268 people volunteered to propose nearly 600 research questions.

We found that hyperhidrosis has a wide range of seriousness. At the end of the spectrum, the effects may be minimal – a minor inconvenience or inconvenience. But as gravity increases, the impact on quality of life becomes much greater. And the condition can have a huge impact on the quality of life, affecting people's career choices and leading to social isolation. For example, some people have sweat-sweaty hands to the point that it's difficult to hold a pen or use a keyboard.

People with hyperhidrosis are often anxious in work situations, such as job interviews or meetings, where they may shake hands. Their social lives may also be affected, with many people feeling embarrbaded by their sweating and some people have avoided intimate relationships for this reason. Some people have to change clothes a few times.

Many people with hyperhidrosis do not seek medical help because of the stigma of the disease. They may not even know that it is a health problem. Those who do report often find it difficult to be taken seriously, lack of access to specialists and treatment that is not considered a priority.

Available treatment

There are a number of treatments available for hyperhidrosis, which depend on the area of ​​the body affected. Temporary treatments include:

• Strong antiperspirants containing aluminum chloride
• Ionophoresis, where the affected areas are placed in water and crossed by a low voltage electrical current
• Botox, which blocks a chemical at the nerve endings so that it can not activate the sweat glands
• Oral medications, called anti-cholinergics, which also act by blocking nerve endings, throughout the body

But these are all temporary and do not work for everyone. Antiperspirants can cause skin irritation and oral medications block nerve endings throughout the body. They can therefore cause side effects such as a dry mouth and problems to urinate. Botox and iontophoresis, meanwhile, need to be repeated regularly and can be expensive.

There are also more permanent solutions available. Some patients have undergone surgery to remove or destroy sweat glands in a localized area (such as the armpits) or an endoscopic thoracic sympathectomy (ETS), where the nerves that control sweating are cut off. ETS is effective in reducing sweating in the intended areas, but can cause very serious side effects such as nerve or organ damage. Most patients end up having some level of sweating in other areas (compensatory sweating) and this may be worse than the initial problem. This surgery is therefore generally used only as a last resort. A newer permanent treatment uses electromagnetic energy to destroy the sweat glands.

Although it is a common skin condition, hyperhidrosis is not widely known and research is poorly funded. Awareness is essential so that people feel comfortable enough to ask for help and advice.