Hyperhidrosis, or excessive sweating, is quite a common condition which is often underestimated by both medical professionals and patients alike.

In studies carried abroad, sufferers find it difficult to present such a condition to their family doctor and usually present late when their daily routines and social lives are affected by the excessive sweating.

People with this condition end up having to change clothing more often due to soiling, avoid sports or even handshakes to avoid embarrassment and some even complain about finding it difficult to engage into intimate situations. Some of those suffering with this condition present signs of depression, especially those with frequent and high amounts of sweating.

But, first of all, how and why do we sweat?

On average, every person has around two to four million sweat glands. Sweating is essential for temperature control and it’s controlled through a certain area of the brain known as the hypothalamus.

Hyperhidrosis is defined as a disorder of excessive sweating beyond what is necessary for heat control.

Sufferers find it difficult to present such a condition to their family doctor and usually present late when their daily routines and social lives are affected by the excessive sweating

Eccrine glands, which are the sweat glands responsible for this condition, are densely found at the soles of the feet, forehead, palms and cheeks and these are therefore the areas mainly affected by this condition.

Hyperhidrosis can be generalised, that is, excessive sweating occurs from several body parts at the same time, or localised, that is, a specific part sweats excessively, most commonly the armpits or the palms.

Laser treatment may be suggested to treat hyperhidrosis.

When the condition is generalised, it is usually secondary to other conditions such as diabetes – especially when blood sugars are low or even due to the thyroid releasing too much hormones in a condition known as hyperthyroidism. It could also be due to anxiety or due to certain medications such as certain anti-depressants and even insulin taken by certain diabetics.

If such sweating occurs at night – which might even wake the patient up – one should speak to a doctor as soon as possible as this could be a sign of an underlying serious condition. Generalised hyperhidrosis is mainly treated by treating the underlying cause.

On the other hand, focal hyperhidrosis, or sweating reserved to a single body part, is usually due to nerves controlling sweating in the particular body part that is being overworked.

In these cases, usually no actual cause is found unless it occurs in the face after surgical removal of the parotid gland which is the gland responsible for saliva production in the cheeks.

Sweating in such areas can be controlled using specific anti-perspirants containing aluminium chloride hexahydrate.

This helps to kill some of the sweat glands in the affected area, thus reducing sweating.

Treatment needs to be repeated every so often according to instructions given by your doctor or pharmacist.

If sweating is more severe or if these anti-perspirants are not effective, other treatments such as botox and laser can be suggested. Surgery for this condition is not usually recommended and is reserved for cases that remained unresolved with the other treatments mentioned.

If you are suffering from this condition, speak to your doctor for advice. Although this condition is not usually a sign of serious medical conditions especially if focal, it is very debilitating and lowers the sufferer’s quality of life.

Leonard Callus has co-written a scientific paper on the use of botox for hyperhidrosis that was published on the Malta Medical Journal. It is available online.