When perspiration becomes excessive
It is a visible and stigmatizing condition that can have a strong impact on quality of life. Hyperhidrosis affects between 0.6 and 2.8 %1 of the population, which is a lot of people.
What is excessive perspiration?
There are two types of hyperhidrosis:
- When the causes of excessive perspiration are not identified, we call this “primary” hyperhidrosis. It concerns 90%2 of cases. It is usually genetic and can begin in childhood or adolescence. Although its causes are not identified, primary hyperhidrosis can become worse under the influence of various factors, including stress. -
- We use the term “secondary” hyperhidrosis when it is induced by a disease or on taking certain medicinal treatments. If excessive perspiration begins suddenly and lasts several days it is best to consult a doctor, in order to determine the cause.
There are no precise criteria for defining hyperhidrosis because oversweating has not been linked with a specific quantity of sweat. Sweating is therefore considered excessive when it poses a problem in everyday life.
The role of sweat glands
When exercising, and when it’s hot, these glands produce even more sweat to help the body cool down.
Hyperhidrosis: embarrassing symptoms
Excessive perspiration of the handsFor example, excessive perspiration of the hands can pose a problem in daily work, when handling objects, tools or documents, carrying out certain activities or simply shaking hands.
Excessive perspiration of the feet
Excessive perspiration of the feet can cause bad smells and discomfort. In addition, heat and humidity are conditions that encourage the development of bacteria and fungi.
Body odorIn addition to having to cope with excessive quantities of sweat, bad smells can also pose a problem for people suffering from hyperhidrosis, and for the people around them. These unpleasant smells are caused by the bacteria found naturally on our skin surface. When in contact with sweat, they degrade certain components and produce molecules that give off a smell. Hyperhidrosis can therefore have a serious impact on the personal and/or professional lives of those suffering from it, causing distress and even a career change, social isolation, anxiety and depression.
What solutions to reduce perspiration?
First up, antiperspirant active ingredientsAntiperspirants are commonly used as a first-line treatment for localized oversweating in order to prevent hyperhidrosis.
Unlike deodorants, which simply mask odors, antiperspirants contain aluminium salts which will effectively control the amount of sweat produced.
Aluminium salts react with sweat and form a small plug at the orifices of the sweat glands on the skin surface. The more they are used, the more this mechanism will cause the sweat glands to rest, thus reducing the oversweating phenomenon.
Other therapeutic alternativesWhen use of antiperspirants does not give satisfactory results or is not suitable given the severity of hyperhidrosis, other solutions may be proposed:
- Iontophoresis: this method can be proposed for people suffering from excessive perspiration of the hands or feet. It consists of soaking the hands or feet in a basin filled with water through which a weak electric current is circulating, which causes small plugs to form at the orifices of the sweat glands. It is a protocol that can people can follow at home. It takes 10 to 30 minutes and must be repeated regularly to be effective.
- Botulinum toxin injections: these can be proposed as a 2nd or 3rd line treatment for excessive armpit sweating when use of antiperspirants fails. The doctor will establish which areas are affected by excessive perspiration, then inject the product locally to block the sweat glands. It is a technique that gives very good results but is effective only temporarily, meaning the injections must be repeated every 4 to 6 months. And it is not reimbursed.
- Medicinal treatments: these can be used for extensive hyperhidrosis. “Anticholinergic” drugs can be prescribed orally. They can reduce production of sweat but have contraindications, and can sometimes have many side effects (dry mouth, visual disorders, constipation, tachycardia, etc.).
- Surgery: this may be proposed as a very last option in most severe cases, when previous treatments prove ineffective. The procedure is called “sympathectomy” and consists of cutting a nerve that regulates the activity of sweat glands. Cutting the nerve like this completely stops sweating on the upper part of the body. The main side effect is frequent occurrence of a “compensatory” hyperhidrosis in another part of the body, which can even be more serious and more embarrassing than that experienced before the operation.
(1) Stolman LP. Treatment of hyperhidrosis. Dermatol Clin 1998;16:863-9
(2) Münchau A, Bhatia KP. Uses of botulinum toxin injection in medicine today. BMJ 2000;320:161-5