Breaking a sweat on a hot day or during a hardcore workout is nothing a quick shower can’t fix. But sometimes those beads of perspiration aren’t heat- or exercise-related. What if you sweat so much — and so often — you need to take a fresh shirt wherever you go and dread a simple handshake?
As many as 900,000 Canadians have hyperhidrosis, a form of excessive sweating; approximately 300,000 of them have a severe form of it, but few ever seek treatment. “It’s important to know that this is a common condition and help is out there,” says Nowell Solish, a cosmetic dermatologist in Toronto. So if you’ve ever reluctantly pinned menstrual pads into the underarms of your shirt, here’s the skinny on hyperhidrosis.
How much is too much?
Perspiration is simply the body’s way of cooling off. But frequent, excessive sweating that disrupts your day-to-day activities isn’t normal. People with hyperhidrosis may sweat four or five times more than an average person. There are two types of hyperhidrosis that can affect both men and women at any age, but usually occur from the early teen years to early 40s.
Focal hyperhidrosis is the most common type. It usually affects the underarms, hands, feet or face and may be inherited, although no one knows what causes it.
Generalized hyperhidrosis is rarer and involves sweating over the entire body. It’s often a symptom of another issue, such as a thyroid condition, or a side effect of medication.
Excessive sweating can have a huge impact on your quality of life. “Most people seek treatment because of social embarrassment,” says Marlene Dytoc, an Edmonton dermatologist and associate clinical professor of medicine at the University of Alberta. “It can affect your work, how you function socially, as well as your overall confidence.” Hyperhidrosis sufferers constantly worry about sweating and the fact other people might notice, adds Solish. “They plan their lives around it and often feel anxious and depressed.”
If you have generalized hyperhidrosis, your doctor will usually do a physical exam to find the underlying problem. But if your doctor can’t find a cause, you may be given a prescription for a pill that simply shuts down your sweating, says Solish. Because these meds can come with unpleasant side effects, such as dry mouth and constipation, they’re usually taken on an as-needed basis, for example, before a wedding or other important social event. If your problem is more localized, there are several treatments you can try:
Over-the-counter antiperspirants can help mild cases of underarm hyperhidrosis, says Solish. “When you’re buying regular antiperspirants, look for ones that say ‘extra-strength,’ ‘longer lasting’ or ‘clinical strength,’” he says. If those don’t work for you, ask your pharmacist for an antiperspirant with a stronger concentration, such as Drysol, which contains a higher concentration of aluminum chloride. “These stronger applications come in liquid form and can be a little irritating, so most people put them on at night,” says Solish. They can also take a little while to work and are absorbed better at night when your underarms are dry, he adds. (Some people cover their underarms with plastic wrap to help with absorption, although this can increase the risk of irritation.)
A relatively new hyperhidrosis treatment, Botox blocks the nerves that trigger sweat glands and is most often used on the underarms, hands, feet, forehead and groin. The procedure usually takes five minutes and starts to work within a couple of weeks. “You can see up to a 99 percent improvement with Botox treatments,” says Dytoc. “But it’s not permanent, so you usually need to be treated once or twice a year.” Most drug plans cover the cost of these injections — unlike the Botox treatments that fix your frown lines and crow’s feet.
Another option to temporarily stop sweating in your hands and feet is to immerse them in an iontophoresis machine, which sends an electrical current through water to block the sweat glands. You may feel a slight stinging sensation during the treatment, which usually takes about 20 to 40 minutes, and needs to be repeated once or twice a week, depending on how much you sweat. You can find iontophoresis machines at some dermatologists’ offices or even invest in your own as the treatment is safe enough to do at home.
If you’ve tried everything and your sweating problem remains unsolved, you may opt to have your sweat-controlling nerves severed via endoscopic transthoracic sympathectomy (ETS) surgery. Unfortunately, one of the side effects is that it may cause more sweating in other areas, such as the backs of your legs, as your body tries to compensate for decreased sweating in the treated area. Another surgical option that is usually used as a last resort is the removal of the sweat glands in the affected area.
If the very thought of all these treatments makes you sweat, consider the naturopathic route. “Most patients who come to see me are concerned about being able to carry on with day-to-day activities and many have already tried some kind of conventional treatment,” says Toronto naturopathic doctor Sherry Chen.
Chen uses traditional Chinese herbs and acupuncture to treat excessive sweating and helps patients eliminate foods that might increase sweating, including stimulants such as coffee, colas and teas. She also recommends relaxation techniques, such as yoga or tai chi, to help reduce anxiety. “Alternative treatments have a high success rate, but are very much based on patient compliance,” she says.
The bottom line? With proper treatment, hyperhidrosis can go from ruling your life to all but disappearing — just like those pesky pit stains.