Why We Sweat
Everybody sweats, even on a cold, inactive day. And from time to time—such as when exercising—everybody sweats excessively. Sweating is the way our body regulates its temperature and keeps itself from overheating. As our sweat evaporates, it draws heat from the body. That process ensures our internal temperature stays at a relatively cool 98.6° Fahrenheit (37° Celsius). If we couldn’t sweat, we might experience heatstroke.
Overactive Sweat Glands
Although everybody sweats, some do so excessively. They produce four or five times as much sweat as other people do—and at inappropriate times. Even when sitting quietly in a cool environment, their hands may become so clammy, they have difficulty grasping a pen, a car steering wheel, or other object. Or their underarms may become so wet, their clothes become visibly stained.
This condition, called hyperhidrosis, is triggered by overactive sweat glands. In some cases, it’s the result of an underlying medical problem, but it also occurs in otherwise healthy people.
Both Physical and Emotional Effects
Hyperhidrosis can cause considerable physical and emotional discomfort and distress. In addition to being physically uncomfortable, hyperhidrosis can lead to dehydration and, in some cases, fungal or bacterial skin infections. People with hyperhidrosis are also more prone to eczema and other skin rashes.
The emotional consequences of the condition can be even more debilitating. Individuals may feel embarrassed and worry about the social impression they’re making, such as when shaking hands. Many people with the condition find that it interferes greatly with their daily activities. They also begin to limit their contacts with other people, including intimate relationships.
Focal Hyperhidrosis
Doctors have divided hyperhidrosis into two main types. Focal hyperhidrosis, affects the palms of the hands, the bottom of the feet, the face, or the armpits. According to a 2004 survey of 150,000 households, about 2.8 percent of Americans (8 million individuals) have focal hyperhidrosis. Another survey found that one-third of people with the condition describe their sweating as either intolerable or barely tolerable and as frequently or always interfering with their daily life.
Focal hyperhidrosis usually begins in childhood or adolescence, and may be inherited. It can be intensified by heat and strong emotions, but it’s not a psychological disorder. It’s a physiological condition, caused by a sympathetic nervous system that has gone awry and pushed the sweat glands into overdrive.
Secondary Hyperhidrosis
The other type of excessive sweating is known as secondary hyperhidrosis. It typically affects the entire body and is usually caused by an underlying medical condition, such as hyperhyroidism (overactive thyroid) or hypoglycemia (low blood sugar). The sweating, therefore, is often accompanied by other symptoms, including pain, fever, heart palpitations, or weight loss or gain. Some medications can also cause secondary hyperhidrosis.
One interesting difference between focal and secondary hyperhidrosis is that individuals with focal hyperhidrosis do not usually sweat while sleeping. Those with secondary hyperhidrosis, however, often experience “night sweats.”
How It’s Diagnosed
You should see a doctor if you are experiencing excessive sweating. Your doctor will take your medical history and perform a physical exam. He or she may also order blood or urine tests to determine if the sweating is a side effect of another medical condition. The doctor may also give you a thermoregulatory sweat test. For this test, a moisture-sensitive powder and a heating device will be used to detect the severity of the excess sweating.
Highly Treatable
Although almost 3 percent of Americans, mostly people between the ages of 25 and 64, have hyperhidrosis, few seek a physician’s help for the condition. That’s unfortunate, for treatments are effective—up to 95 percent effective in some cases. The early detection and management of hyperhidrosis can greatly improve an individual’s quality of life.