Hyperhidrosis FAQs with Dr Dawn Harper
Hyperhidrosis is the medical term for excessive sweating. Sweating is the body’s natural response to cooling down, so it is normal to sweat if you are in a very hot environment or when exercising, but if you sweat when your body doesn’t need to cool down, you could be one of the 1% of UK adults living with hyperhidrosis.
The sweating is noticed most commonly in the armpits, on the palms of the hands or soles of the feet, on the face or in the groin, but it can affect any part of the body. In some people, the whole body is affected, and this is called generalised hyperhidrosis.
What causes hyperhidrosis?
Hyperhidrosis can run in families – it is thought that 30 – 50% of sufferers have a relative who also has the condition.
It can occur as a side effect of some medications, including some antidepressants, opioid painkillers, diabetic treatments like insulin and gliclazide, antipsychotic drugs and nicotine replacement therapy.
You should never stop prescribed medication without talking to your doctor, but if you develop hyperhidrosis after starting a new medicine, speak to your doctor about an alternative treatment.
It can be associated with the menopause, pregnancy or with neurological conditions such as Parkinson’s disease or spinal cord injury.
It is often worse in individuals suffering with stress or anxiety and can be triggered by eating spicy foods or drinking caffeine or alcohol.
How is hyperhidrosis diagnosed?
The diagnosis is usually made by taking a detailed history from you regarding your symptoms. Some patients may be offered a sweat test to measure how much sweat is being produced, but as far as I am concerned, if an individual tells me they are sweating excessively and it is affecting their quality of life, then we need to act.
You may also be offered blood tests to check for underlying causes, such as an overactive thyroid.
Are there lifestyle changes that help manage hyperhidrosis?
Yes. Wearing loose-fitting clothing and natural fabrics like cotton rather than man-made fibres will help. If feet are affected, wearing leather shoes rather than trainers will help and try to wear different shoes day to day.
If you think spicy foods, alcohol and caffeine could be a trigger for you, then cutting back on these will also help.
What treatments are available for hyperhidrosis?
Your first port of call should be to the pharmacist to discuss aluminium-based antiperspirants, which are available over the counter.
There are prescription medications, including an anticholinergic medication called glycopyrrolate, although this may have to be started by a specialist.
Sometimes we can use something called iontophoresis, where small electric currents are used to temporarily shut down the sweat glands in the affected area.
Botulinum toxin injections are also available on the NHS to switch off sweat production. These are very effective but need to be repeated every few months.
Occasionally, we need to perform surgery to remove the sweat glands or cut the nerves supplying the glands.
Author
Dr Dawn Harper - MBBS MRCP DCH DFFP
NHS GP and TV Personality
