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The EV guide to Hyperhidrosis

Everything you need to know about this excess sweating condition and the treatment options available to keep it at bay

If you’re worried that your sweating exceeds what you consider to be normal, and want to know if it tips into a condition called hyperhidrosis, where sweating isn’t prompted by exercise or to regulate body temperature but rather occurs excessively and on occasion at random, you’re in the right place.

Here’s your guide to where it occurs, why it can crop up, how it affects sufferers emotionally, and what can be done about it.

What’s the difference between 'normal' perspiration and hyperhidrosis?

Sweat is secreted by the eccrine glands in the skin primarily in order to cool the body – the liquid, which evaporates, takes heat with it. These glands occur all over skin but are highly concentrated on the palms, soles, forehead, and armpits, which is why sweat tends to be most noticeable in these areas.

There are also larger sweat-producing apocrine glands that populate the groin, nipple, and armpit, though rather than the watery sweat of the eccrine glands (which is salty owing to a blend of salt, protein, ammonia, and urea), apocrine gland sweat tends to be more lipid-rich, carrying pheromones. This can be the cause of body odour when it has a chance to mix with the bacteria that lives on our skin.

The apocrine glands are generally associated with sweating for reasons other than temperature regulation i.e. when anxious or preparing for a challenging situation, when eating spicy food or those one is intolerant to, when hormones are shifting, and when excited – though the interplay between both and which precise role they play is down to the individual.

The difference between the sweat that is considered to be part of daily function and hyperhidrosis, is both the amount of sweat itself and the lack of a clear reason such as keeping body temperature stable when it’s, say, hot outside. As yet, scientists don’t really know what causes hyperhidrosis, and are looking into whether genetics play a role, and if other factors come into it.

So what do we know about hyperhidrosis?

Although relatively little is still known about hyperhidrosis, the presence of increased sweating without said reason classifies the condition. However, doctors do know that when it comes to hyperhydrosis, sweat originates from the eccrine glands.

The symptom of sweating aside, it varies from case to case – some people are born with hyperhidrosis, and for some it appears later in life, some people have generalised hyperhidrosis, where it appears all over the body, and some more localised, where it focusses on an area or areas such as the palms, face, underarms, or soles of the feet.

While the sweating isn’t related to usual causes, it can be prompted by them. Anxiety, for example, can exacerbate the condition, but equally so can foods commonly associated with sweating such as chilli or caffeine. There is a further relationship with food, whereby what is consumed affects metabolism and hormones, which have both been proven to have a connection with hyperhidrosis.

The emotional effect of hyperhidrosis

Many with hyperhidrosis are affected not only by the sweating and rituals surrounding that, but also by the prospect of sweating to excess in social situations. This can be challenging and some sufferers can find being around people tricky; this may have a knock on effect on their work life as well as their social life, and by extension their wellbeing.

How can you treat hyperhidrosis?

In the first instance, it’s worth exploring ways to manage hyperhidrosis. This could include wearing loose-fitting clothing, switching to a stronger antiperspirant, trying sweat shields in areas where it is most pronounced, or using powders to absorb excess sweat. Some experts suggest looking at limiting any foods or substances such as nicotine, which sufferers suspect may act as a trigger.

If, however, it continues to present problems, there are further measures. GPs can recommend tablets to reduce sweating (these work by limiting sweating overall by preventing the stimulation of sweat glands), or muscle relaxing injections which can be effective at treating areas of excessive sweat by blocking the nerve signals responsible for sweating. Electric current administered by a doctor, which will similarly disrupt the nerve transmission signals, can also be an option, as well as surgery to remove or reduce sweat glands.

MiraDry is another much loved in-clinic treatment and permanent solution to underarm sweating. It works by delivering thermal energy into the sweat-producing glands, thereby safely eliminating them. One or two sessions delivers a significant reduction in sweating – on average, patients reported to seeing an 82 per cent decrease. The treatment doesn’t inhabit your body’s ability to regulate temperature as a minimal number of sweat glands are located under the arms, leaving the others free to do their job.

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