Hyperhidrosis is the medical term for abnormal sweating. Sweating is a normal function of our body. It helps to regulate our body temperature to cool our body and a certain amount of sweat on our hands and feet actually helps our skin grip better. However, for some people, the sweating can be so excessive that it impacts on their daily lives. Many people suffering hyperhidrosis feel embarrassed and isolated, and find it difficult to perform at school, at work or at play. Many people try to hide their sweating problems from others and often carrying the burden of excessive sweating for many years. It can develop in childhood or adulthood. When is sweating excessive or abnormal? The answer is when it is having a negative impact on your life.
Where do we sweat?
Sweat is produced in tiny glands found over most parts of our skin. In typically “sweaty” areas, there are larger numbers of sweat glands. Abnormal sweating or hyperhidrosis can affect different people in different parts of the body but usually in those body sites where there are more sweat glands. It can be limited to one body part such as under the arms, or it may be more generalised over larger or multiple parts of the body. Common sites of excessive sweating include:
- Under arms – axillary hyperhidrosis
- Hands or feet – palmar or plantar hyperhidrosis
- Head or face – craniofacial hyperhidrosis
What causes excessive sweating?
The causes of hyperhidrosis are not fully understood but the good news is that we can help control many cases of severe sweating. The normal sweat response is controlled by a special part of our nervous system called the sympathetic nervous system. It has often been claimed that abnormal sweating is a result of anxiety or stress. These factors can be a trigger but in many cases normal activity of the brain and nervous system, for example while studying, talking, concentrating or working, can initiate the abnormal sweating process. Some medications, hot environments, clothing types and activity levels can all effect how much we sweat. In some cases an underlying medical problem may be at fault. It is important to talk with your dermatologist to identify whether there is any underlying medical cause for the abnormal sweating.
Excessive sweating generally fits into two specific types
This is by far the most common form of excessive sweating. It is often an inherited or genetic problem meaning a member of the family also has the condition but it is not caused by medications or underlying medical problems. Often patients experience abnormal sweating of the hands and/or feet or under the arms with primary hyperhidrosis but it can affect other body parts. Patients often notice that this type of sweating is only a problem when they are awake. This form is more common in children and teenagers.
This condition is much less common than primary hyperhidrosis. It is often seen when an underlying medical condition such as an infection or hormonal or metabolic problem is present. Very rarely, some cancers can be a cause. Some medications and drugs can also cause secondary hyperhidrosis. Rather than being localised to certain body parts such as the hands, this condition often affects the body as a whole.
It is important to discuss your condition with your dermatologist to rule out any underlying problems that may be causing the sweating problems.
What treatments are available for excessive sweating?
Our dermatologist is accredited with the Australasian College of Dermatologists and recognised by Medicare to provide PBS-subsidised injection treatments for excessive underarm sweating (axillary Hyperhidrosis).
Injections of botulinum toxin (BOTOX)
Injection of bolulinum toxin (BOTOX), a muscle relaxant, into the skin of the armpits has become one of the most effective treatments for axillary hyperhidrosis. Treatment is carried out by our specialist dermatologist, and is quick and tolerated well by most patients. There is no downtime and patients can return to normal work and social activities immediately after treatment. Treatments can often be performed at the time of your consultation with our dermatologist.
Results are usually excellent, benefitting over 90% of patients. While expectations are for the effects of the treatment to last around 4 months, many patients find they are relatively sweat-free for much longer (sometimes up to 12 months!).
The treatment is simple. A series of small injections using a tiny needle are placed into the skin of the armpit. A small stinging sensation is usually felt. Treatment is completed within minutes and any discomfort usually goes away immediately.
When performed by a dermatologist, patients with axillary hyperhidrosis (excessive underarm sweating) are entitled to a substantial Medicare rebate under the PBS. This makes these injections much less expensive than when provided by non-dermatologists. At Central Dermatology Clinic our dermatologist is very experienced in providing these injections and we use only the safest forms of botulinum toxin available.
This treatment has minimal side effects. Some patients however, may not be suitable for this treatment, and your dermatologist will be best to advise you.