Fact: Every human being walking this earth sweats sometimes.
A trickle down the back of your leg standing on the train. In the crease of your elbow after holding your handbag for a really long time. Under and between your boobs most of the time.
And just about everywhere – pits, lower back, under your eyes, between your thighs – on a hot day.
Sure, it’s annoying and makes you feel self-conscious and damp, but a good 20 minutes in front of a fan or some paper towel in the bathroom normally does the trick.
But what about when sweating, and trying not to sweat, consumes your day, everyday? When long after your co-workers have dried off from their commute, you’re sitting at your desk feeling like you’ve run a marathon when you definitely haven’t?
That kind of sweating can be classified as a genuine medical condition called hyperhidrosis, otherwise known as excessive sweating. And it’s treatable.
So how do you find out if you’re ‘just a sweaty person’, or have this medical condition?
Because the idea of talking about your sweating is a bit embarrassing, we asked experts to explain everything you need to know if you think you might have hyperhidrosis.
What is hyperhidrosis?
Hyperhidrosis is the medical term for excessive sweating. It occurs when overactive sweat glands release a volume of sweat that is significantly more than your body’s normal requirements for cooling.
Specialist consultant dermatologist Dr Mei-Heng Tan said this occurs when the sweat glands of certain pre-disposed individuals “can’t really stop producing sweat”.
“Hyperhidrosis is an excessive production of sweat that can be triggered by anxiety, stress, heat or on its own, or it can be secondary to an underlying medical condition or medication,” she told Mamamia.
“If you suffer from pre-disposed hyperhidrosis, you may start [experiencing symptoms] in childhood or adolescence. Up to two-thirds of people with this condition have a family history of it and there’s often hereditary predisposition to it, but not always or in all cases. If you have excessive sweating due to an underlying medical condition or medication, this will develop later on in adulthood.”
There are also different types of hyperhidrosis.
- Axillary Hyperhidrosis - most common form of excessive sweating of the underarms
- Palmar Hyperhidrosis - excessive sweating of the palms of your hands
- Plantar Hyperhidrosis - excessive sweating of the soles of your feet
- Craniofacial Hyperhidrosis - excessive sweating of the face and crown of your head
- Inguinal Hyperhidrosis - excessive sweating of the groin area
While axillary hyperhidrosis is the most common area people experience excessive sweating, it's possible to suffer from hyperhidrosis in more than one or all of these areas.
What's the difference between being sweaty and excessive sweating?
Everyone sweats and some people are just sweatier than others, but there's a line at which 'being sweaty' crosses over from being an occasional annoyance to a debilitating medical condition.
Physically, the difference between feeling damp walking to the train on a warm day and experiencing excessive sweating is in the sympathetic nervous system, Dr Tan explained.
"No one actually knows the exact mechanism that causes hyperhidrosis, it's not totally understood in the medical profession. Put simply, you lose the ability to regulate and 'turn off' sweating, your sweat glands just keep on producing sweat and there's no 'turn off' mechanism."
"Normally it's a finite thing and your sympathetic nervous system can tell your body when it's time to stop sweating - your body can say, OK you're cool enough now. But patients with hyperhidrosis don't have the ability to regulate that."
More important than the physical discomfort is the way this condition makes you feel, and stops you from living your life.
For people who suffer from hyperhidrosis, the condition affects their interactions with others everyday. From avoiding hugs and handshakes to worrying about whether people can smell them, the anxiety and embarrassment associated with this condition is real and legitimate.
"It's debilitating and anxiety-provoking, it can affect your confidence to have sweat dripping from your hands if you need to shake hands. This condition has an impact on a person's quality of life," Dr Tan said.
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Negative emotional and psychological side effects include:
Difficulty meeting people and developing meaningful relationships, the ability to perform at work, a struggle to build intimacy in personal relationships, time spent changing clothes multiple times a day and avoiding certain colours and materials (grey marle t-shirts, anyone?), and money and energy spent on maintaining an unrealistic level of personal hygiene.
"That's when we turn to look at this as a medical condition rather than asking, are you just a bit sweaty in the hot weather?"
If you can relate to any of these struggles, please know you're not overreacting and you don't just have to deal with it.
You have options.
How is hyperhidrosis diagnosed?
Treat Hyperhidrosis says hyperhidrosis is usually diagnosed when a person has experienced at least six months of excessive sweating with no known cause and two or more of the following characteristics:
Both underarms are affected, daily activities are impaired, family history of excessive sweating, the sweating does not occur while sleeping, or the first experience occurred under the age of 25.
Dr Tan also said it comes down to speaking to the patient about how their sweating is affecting their day-to-day life in conjunction with the physical symptoms.
"I sit down and ask them a few questions about how often they're experiencing this condition, which for some can be several times per week, and how it is impacting on their quality of life. We would go through - how is their sweating affecting their work, how frequently it's happening, what they've tried in the past, and how is it impacting their confidence," she said.
"We also ask patients about their medical history to rule out any other underlying medical conditions like diabetes, thyroid problems, types of conditions that can cause excessive sweating, and if any medications they're taking could be a contributing factor.
"If the patient identifies with these, we'd classify that as hyperhidrosis."
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How to treat hyperhidrosis
If you're experiencing any of the above symptoms or feel like your sweating impacts negatively on your quality of life, it's important to know there are treatments available to you.
Talk to your GP about your concerns. They will be able to steer you in the right direction for the best treatment option for you.
Below are some of the treatments your GP, dermatologist or specialist might recommend:
Over the counter antiperspirants
Dr Tan said the 'first line of defence' is an over the counter antiperspirant like Rexona or Dove.
These products contain metallic salts, which have been found to block sweat ducts, reducing the amount of sweat that reaches the skin (and soaks through your shirt).
If your sweating is bothering you, it's likely a regular antiperspirant won't be enough to give you the comfort and peace of mind you're looking for.
Next is a clinical strength antiperspirant, otherwise known as aluminium chloride treatment.
"Aluminium chloride antiperspirants are more effective [than regular ones] and you don't need a prescription," Dr Tan said.
"These products do work well, but for some they can be quite irritating to the skin."
Clinical strength antiperspirants are more expensive than the standard ones (between $10-15) and often have a cream or gel formula. Rexona Gentle Dry Antiperspirant (pictured below), 2pk for $19.98, Dove Clinical Protection Antiperspirant, $14.79 and Mitchum Women Clinical Powder Fresh, $9.06 are all great options.
Each is slightly different, the best way to figure out which one you'll like is to road test a few.
Failing clinical strength antiperspirants, oral medications are an option.
"Oral medications can help regulate the part of the nervous system that controls your sweat production, by essentially helping your body determine when you no longer need to sweat," Dr Tan explained.
Injectables are the most common, and in Dr Tan's opinion, effective treatment option for patients who aren't responding to less invasive treatment options.
"The next line is seeing your GP and getting a referral to a dermatologist and then they would go through medical procedures and forms of management which would include injectables," she said.
"Injectables have been proven to reduce hyperhidrosis by 80 - 90 per cent, and involves a fast, in-office treatment."
Dr Tan explained injectable treatments for hyperhidrosis works by blocking the release of a substance called acetylcholine to the nerves that stimulate your sweat glands, reducing severe sweating significantly. In layman's terms, the injectables intercept your body's signal to your sweat glands to produce sweat.
The procedure is most commonly applied to the underarms and involves around 15 injections made over the course of 10-15 minutes. These injections are a temporary solution (so the patient will need to maintain the treatments for extended results) and only work on the treated area.
"Because of the advancement of injectables in the last few years, we very rarely refer someone for a more surgical procedure," Dr Tan added, saying surgery or a medical procedure is the last option.
"Very rarely people may consider surgical procedures, I've never had to recommend a surgical procedure for a patient, because at this point in time the injectables do work really well," Dr Tan said of the surgical treatments for hyperhidrosis.
"This is because surgery is not without risk."
Surgical treatment options include: Excision, or removal, of the sweat glands, destroying the sweat glands using a carbon dioxide laser or through liposuction, and endoscopic thoracic sympathectomy.
Endoscopic thoracic sympathectomy works by cutting the nerve signals between the spinal column and the sweat glands in the affected area.
These surgical options come with increased side effects and must not be undertaken without seeking advice from your specialist or dermatologist.
Identifying your triggers
It's also important to look at the condition from a lifestyle perspective and isolate what your 'triggers' are.
For some, anxiety can be a trigger, as can heat, stress or strong emotions. If you're able to pin point your particular triggers (if you have any), you can make adjustments to avoid those types of emotions where possible.
Above all else, the message dermatologists like Dr Tan, and Treat Hyperhidrosis, want people to takeaway is:
Excessive sweating is not dirty, nor something to be ashamed of.
It's a medical condition that comes with treatment options, but only if you speak up about your concerns.
"It's important to be aware that this is a condition that's more common than you might think," Dr Tan said.
"Yes, it's a really embarrassing thing to talk about, but if we don't talk about it or speak up, we can't normalise what is a medical condition that can be treated."
This article is not to be substituted for personalised medical advice. If you or someone you know is experiencing any of the listed symptoms or is self-conscious about their sweating, please seek professional medical advice from a GP, dermatologist or specialist. You can also find more information about hyperhidrosis on the Treat Hyperhidrosis website.
If you or someone you know is struggling with their mental health, contact Lifeline on 13 11 14. If you're in immediate danger, call 000.