Hyperhidrosis

Many people suffer from a condition of excessive sweating, known in the medical field as "hyperhidrosis."  Hyperhidrosis is a common disorder, and a survey of 150,000 US households found that around 2.8% of people suffer from hyperhidrosis.  The most common areas where hyperhidrosis occurs are the hands, face, feet, and axilla (armpit).  This leads to complaints of excessive sweating from multiple areas, including sweaty palms, sweaty feet, sweaty armpits, and a excessive sweating of the face.  The condition often begins in adolescence but can occur in people of all ages.  In many patients, excessive sweating improves with age.

 

What is the Purpose of Sweat?

The human body uses perspiration to maintain body temperature.  During perspiration, sweat is produced in specialized glands of the body.  As the sweat evaporates from the top of the human body, heat is passed from the body to the surrounding environment.  This heat exchange results in cooling of the body.

 

What Causes Excessive Sweating from Hyperhidrosis?

In general, excessive sweating is thought to be due to increased activity of the sympathetic nervous system that occurs in patients with hyperhidrosis.  The reason some people develop excessive sweating from hyperhidrosis is unknown, but there appears to be a genetic tendency.  In one study, 49 of 58 patients receiving surgery for hyperhidrosis had a family member who also suffered from the disorder. 

 

What is the Sympathetic Nervous System?

The sympathetic nervous system is a group of nerves that starts in the brain and extends into the body.  The primary purpose is to create changes in the body in response to fear.  When a person feels fear (when threatened by a wild animal for example), the sympathetic nervous system is stimulated.  This leads to changes in the body that allow for a better reaction to the fear stimulus, including an increase in heart rate,  dilation of the eyes (for better visibility) and increased blood flow to the brain and other important organs.

The sympathetic nervous system is also the way the body controls sweating, including about five million sweat glands in the body with about half of these located in the hands.  The signal to produce sweat originates in the brain and travels through the thoracic cavity (behind the lungs) in a large bundle of nerves known as the sympathetic chain.  These nerves end in the armpit, hands, feet, and other areas of the body and stimulate sweating.

 

What are the Options for Treatment of Hyperhidrosis?

People with excessively sweaty palms, sweaty feet or facial blushing often seek treatment because the condition causes great distress.  Hyperhidrosis may impair quality of life, causing numerous psychological, educational, and occupational problems.  Fortunately, there is effective surgical treatment and non-surgical treatment for excessive sweating.  Non-surgical treatments include medications, botox for palm sweating, anti-persperants, and iontophoresis. 

 

There is also effective surgical treatment for excessive sweating.  This is known as endoscopic thoracic sympathectomy, where the sympathetic chain is cut or tied off during surgery.  Remarkably, this procedure has relatively small side-effects, and does not affect the function of the sympathetic nervous system on other parts of the body.

More Information:

    • Hyperhidrosis Information from the National Institutes of Health
    • Hyperhidrosis Information from the Society of Thoracic Surgeons
    • Information on sweating from the National Institutes of Health
    • Excessive Sweating Information from Kidshealth.org
    • Excessive Sweating Conditions
    • Frequently Asked Questions
    • Treatment for Excessive Sweating