Vancouver Coastal Health Research Institute scientist Dr. Youwen Zhou describes the signs, symptoms, and treatments for hyperhidrosis.
Q: How do I know whether I’m sweating a normal amount or if I have hyperhidrosis?
A: The most straightforward sign of hyperhidrosis is that you are sweating when others in the same situation are not.
Scientifically, hyperhidrosis is defined by sweating that is not provoked by any normal stimuli of sweating, such as mentally stressful situations, being in a hot environment, or doing physical activities. In our research looking at 1,018 subjects at Vancouver General Hospital’s Skin Care Center, approximately 12 per cent of patients presented with primary hyperhidrosis1.
There are two types of hyperhidrosis: 1) Primary hyperhidrosis occurs with no underlying medical causes. It most frequently occurs on the hands, feet, and armpits, but can also occur on the face and central body. It often is exacerbated by mentally stressful situations. 2) Secondary hyperhidrosis is often generalized in distribution (i.e. across large sections or all over the body) and associated with night time sweating.
Q: What causes hyperhidrosis?
A: At present, it is unknown what causes primary hyperhidrosis. Our research showed that more than 80 per cent of hyperhidrosis individuals also have at least one other family member with the condition, suggesting a strong genetic predisposition. We are currently working to identify the genes causing hyperhidrosis.
Secondary hyperhidrosis is caused by medical conditions such as advanced cancers, chronic infections such as tuberculosis, hyperthyroidism, hypoglycemia, menopause, and by taking certain medications such as antidepressants.
Q: Is hyperhidrosis a treatable disorder? What are treatment options?
A: Yes, hyperhidrosis is treatable. Secondary hyperhidrosis treatment depends on identifying and correcting the cause.
Primary hyperhidrosis treatment consists of topical antiperspirants, botulinum toxin (botox) injection, electricity stimulation, or, in highly selected situations, sympathectomy (severing the sympathetic chain). By far, the most effective and safe treatment is botox injection.
Q: At what point might excessive sweating require medical attention?
A: For the most part, hyperhidrosis is a small concern and does not interfere with an individual’s daily activities. However, in about one-third of the cases, excessive sweating is negatively affecting the psychological wellbeing of the affected individual, causing them to avoid social situations or reduce academic or occupational participation and performance. These situations require active medical intervention.
Q: How important is it for me to stay hydrated if I have hyperhidrosis?
A: Because people with hyperhidrosis have an exaggerated sweating response in hot environments and other situations where sweating is normally triggered, they can be more vulnerable than other people to developing dehydration and electrolyte disturbance. Therefore, for individuals with hyperhidrosis – but even for individuals who don’t have the condition – it would be wise to exercise extra caution to stay well hydrated in the summer.