What is Hyperhidrosis?

Dr Nazim MahmoodClinic update

Hyperhidrosis is the medical term for frequent or excessive sweating. Sweating is the body’s natural cooling mechanism, but when the body produces more sweat than is necessary to cool the body, this is known as hyperhidrosis. Excessive sweating is most common on the palms of the hands, the soles of the feet, the face and the underarms.

The excessive sweating can disrupt everyday life. Someone suffering with this condition may refrain from taking part in sport or other recreational activities. Severe sweating can cause severe social anxiety can be embarrassing. There are three types of this condition.

Primary focal hyperhidrosis

Primary focal hyperhidrosis affects three per cent of people and is where there is excessive sweating that affects one or more of the following parts of the body, including palms of the hands, the soles of feet, the underarms and the face or scalp. The rest of the body however sweats normally.

There may be certain triggers to the sweating such as stress, anxiety, emotion, heat and spicy foods. The condition usually begins in early adulthood. There is no real known cause of this, it is believed the sweat glands in these areas are just more sensitive than normal and there is evidence that it may be partly genetic and run in families.

It can be an embarrassing problem forcing people to change their clothes frequently, avoid social situations and can affect their confidence and performance at work. The constant wet patches can also cause soreness and irritation to the skin. This type of excessive sweating can be easily and effectively treated with Botox® injections.

Secondary focal hyperhidrosis

This is a rare type of hyperhidrosis where excessive sweating occurs in one particular place and there is a known cause. For example someone with a rare spinal or nerve problem may find their leg sweats excessively.

Generalised hyperhidrosis

This is the term used for a person who sweats excessively all over their body. This too is not as common as primary hyperhidrosis and is often a symptom of another medical problem such as infection, an overactive thyroid gland, side effect to a certain drug or anxiety. Having a blood test via your General Practitioner can help diagnose this type of hyperhidrosis.

How Can I Reduce Sweating?

First and foremost there are several non medical lifestyle changes that can help.

  • Avoid excessively hot or spicy foods as this can be trigger for hyperhidrosis.
  • Some people find that soaps can irritate the skin, if this is the case use a soap substitute to wash, such as Aqueous cream or other moisturisers.
  • Use antiperspirants instead of deodorants. Deodorants simply mask smells whereas antiperspirants reduce the amount of sweat produced.
  • Wear black and white clothes which don’t show up sweat marks easily compared to coloured clothes.
  • Wear loose fitting clothing under the arms.
  • Avoid man made fabrics such as nylon, polyester or Lycra, which do not allow the skin to “breathe” and may trigger hyperhidrosis. Choose fabrics like cotton or silk instead.
  • “Dress shields” or “sweat shields” are available for purchase online. These can help protect clothing against sweat by absorbing excess amounts.
  • Socks should be changed at least once, if not twice a day.
  • An absorbent foot powder should be placed in shoes everyday.
  • Different shoes should be worn on consecutive days so that they can dry out fully before being worn again.
  • Sports shoes or boots should be avoided as they do not allow the feet “breathe”.

Are there Medical Options?

If these measures are insufficient, you may want to consider medical options. Most hyperhidrosis sufferers have tried normal antiperspirants and found them to be ineffective, if this is the case, you can ask your General Practitioner (GP) to prescribe a stronger antiperspirant called Aluminium Chloride.

These stronger antiperspirants work best for excessive underarm sweating by blocking the pores of the sweat glands. These strong antiperspirants may also be available over the counter at your local pharmacy, some well known brands include, Anhydrol Forte® which is available as a roll-on, Driclor® and ZeaSORB® which is available as a powder.

It can take a few weeks before you notice sweat reduction from Aluminium Chloride antiperspirants and they can often cause irritation of the skin.

It is quite unusual that medications are prescribed by a doctor for excessive sweating, this is because these drugs often do not work well and it is very common to experience unwanted side effects from these drugs such as dry mouth and blurring of the vision.

Iontophoresis uses electrical stimulation to treat excessive sweating, more recently this treatment has become less available due to the increasing popularity and effectiveness of Botox injections. Iontophoresis works by using an electrical current to block the sweat glands. The downside of this treatment is that it requires around eight sessions lasting thirty minutes each before you will notice sweat reduction and after this you will need regular maintenance sessions every four weeks to maintain the effect. The treatment is also not always successful and may cause short lived side effects such as a dryness and soreness in the mouth and throat.

Is Surgery an Option?

This is often a last resort for sufferers of excessive sweating, where they have tried other treatments and they have not worked or have caused many side effects. For excessive underarm sweating the sweat glands can be removed surgically by making an incision in the armpit.

The obvious downside of surgical treatment is that is has an increased risk of surgical complications such as scarring, bleeding, including risks from having an anaesthetic and rarely reduced function of the treated arm.

What can Botox do and what can Face Clinic London offer to help with this problem?

Following a consultation with one of our doctors it might be suggested that Botox treatment would be a good option for you. This is often an effective and hassle free treatment for facial and underarm sweating. Botox treatment can be performed at Face Clinic London and takes around twenty minutes and involves having small injections just under the skin of each underarm or the forehead.

The injections are relatively painless and can feel like a small sting. Botox injections work by blocking the nerves in the underarm that control sweat glands. The main benefit of this treatment compared to the alternatives is that the treatment is very straightforward and there are relatively few side effects which commonly may include a little temporary soreness and redness in the area treated.

The treatment is very effective, usually resulting in a 90% reduction in underarm sweating that  can last for up to six months from just one treatment session.

What do our Doctors Say About Botox Treatment?

“After 17 years of being a GP and finding very limited treatment choices for this common and embarrassing problem- finally something that works very effectively, is safe and non destructive! The injections paralyze the tiny muscles just under the skin which squeeze the sweat out from the sweat glands, up the sweat duct and out through the pores to the surface of the skin.

It is very useful for facial and underarm sweating and the results last 4-6 months. This is the most commonly used treatment for hyperhydrosis now, but availability is limited on the NHS and more patients are electing to pay for this treatment privately.

It is amazing to me as a doctor how it can transform a patient’s life, confidence, clothing choice etc. By the time the client walks through our door they have usually tried various anti perspirants, beta blocker tablets or even scarring and destructive surgery which have been unhelpful or resulted in side effects.

I have not known any clients who have been unhappy with the effectivity of the treatment and most will return 2-3 times per year to have the treatment repeated.”


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