Whilst not the most pleasant of bodily functions, sweating is an important part of our temperature control system. For most of us, a quick shower and a little antiperspirant will be enough to counter any unsightly patches and eliminate that sticky feeling. But for sufferers of excessive sweating - or hyperhidrosis - more extreme measures are needed to keep sweating at bay.
As sweating is a normal bodily function, it can be easy to write off hyperhidrosis or imagine that it's not a serious problem; however, the condition can cause misery for sufferers.
"Everyone sweats," explains dermatologist Dr Anton Alexandroff, spokesperson for the . "But if a child at school cannot hold their pen due to excess sweating, or if a person has to change their clothing several times a day it can have a significant impact on their quality of life."
How much is too much?
Whilst hyperhidrosis is a recognised medical condition, there is no actual measure of how much sweat constitutes a diagnosis.
"Increased sweating is a normal response to a rise in body temperature, and to emotions such as anxiety. The amount of sweat considered to be normal is quite variable. People may sweat less than a litre, or up to several litres a day, based on what they're doing and the ambient temperature," explains dermatologist Dr Daniel Glass of in London.
The real measure of whether you are suffering is the impact your sweating has on your life.
"Sweating is, by definition, excessive if it is problematic for you; if your life is significantly affected by the problem," explains Glass.
Why do some people sweat too much?
Frustratingly, the cause of primary hyperhidrosis - excessive sweating without additional symptoms - is not yet known. However, if your hyperhidrosis is accompanied by other symptoms, you may be suffering from what’s known as 'secondary hyperhidrosis'.
"However, the majority of people who have hyperhidrosis do not have an underlying problem."
Whilst it's important to seek proper medical advice, primary hyperhidrosis has some unique symptoms that set it apart from other conditions.
"Primary hyperhidrosis only happens when we're awake, and never when we're asleep," explains Alexandroff. "It's also bilateral - meaning patients experience the problem from sites on both sides of the body."
"The palms, soles, underarm skin, face and scalp tend to be the most common areas," adds Glass.
What are the treatments?
There are several different treatments for hyperhidrosis, and the treatment prescribed will depend on the severity of your symptoms, how you react to the different treatments and whether an underlying cause is discovered.
However, as with many conditions, the first call for sufferers should usually be the GP.
"Your GP will ask questions to identify whether there might be an underlying cause, and if necessary carry out tests, prescribe treatment or refer to a dermatologist," explains Alexandroff.
As well as seeking medical advice, it's worth reviewing changes you can make to your lifestyle to minimise the problem. For example, some patients have found limiting their intake of certain foods to be helpful.
"Some people find that spicy foods are a particular trigger for their sweating. Alcohol and caffeine can also be triggers," advises Glass.
It's also worth looking at your clothing to see whether you can alleviate the symptoms by keeping your body temperature stable.
"For example, wearing breathable fabrics, such as cotton and linen, can help to keep you cooler by absorbing the excess moisture, which in turn reduces sweating. Clothing with modern fabric technology such as sweat wicking is also a good option as they have been designed to help people keep cool and draw moisture away from the body to allow it to evaporate quickly and easily. Absorbent under-layers can also help to minimise the outward symptoms of hyperhidrosis," says Glass.
Finally, as many people find this condition is worsened or triggered by stress and anxiety, it's worth looking into strategies to keep these to a minimum.
"Stress or worry about this condition can cause you to start sweating profusely and the fear of excessive sweating itself can also be a trigger, resulting in a vicious circle. Being aware of this can help you find ways to identify and cope with your anxiety before it triggers the excessive sweating cycle," explains Glass.
So, once hyperhidrosis is diagnosed, what treatments are sufferers offered?
"The first treatment is medical-grade antiperspirant, containing a higher dose of aluminium chloride than standard antiperspirants," explains Alexandroff. "This can be prescribed by your GP."
Iontophoresis is a treatment which involves passing an electric current through the affected areas, whilst they are immersed in water.
"Usually hospitals will allow patients to try this treatment, and if they find it helpful, there is a system that can be bought for use in the home," says Alexandroff. "It's safe and can be used continuously."
You probably associate this type of treatment as one that is injected into the face, rather than under the armpits or elsewhere; however, botulinum toxin, or Botox®, has been proven to be very effective for those suffering from hyperhidrosis.
"This form of treatment can be injected into the skin to block the action of the nerves which activate the sweat glands. Patients often need multiple injections in the affected area and each treatment can last up to six months. This type of treatment is most commonly used for underarm sweating," explains Glass.
If the sweating you are experiencing is more generalised then the above methods may prove ineffective. However, there are medications that can be taken to counter hyperhidrosis for patients with more widespread sweating.
"Prescription medicine such as propantheline can be useful to help reduce excessive generalised sweating," explains Glass. "However, there is a careful balance in using these types of drugs, as side effects may outweigh the benefits. These side effects include dry mouth, blurred vision, urinary retention and constipation."
Hope for the future
Thankfully, those who continue to suffer may be able to take advantage of a new - permanent - treatment for their condition, known as . This involves electromagnetic energy which destroys sweat glands in targeted areas.
"It appears to be a permanent solution to the problem," says Alexandroff. "It's currently available privately in the UK, but the National Institute for Health and Care Excellence (NICE) is looking into the possibility of making it available on the NHS."
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