By Dr. Youwen Zhou, MD, Ph.D.

Why Do I Sweat So Much? - Identifying Hyperhidrosis

Did you know that you have between 2 and 4 million sweat glands? They are present under the lower part of the skin. Their function is to control your body temperature by emitting a watery secretion which in turn evaporates and cools your body. Sweat is actually water and salts such as sodium, chloride, potassium, urea, bicarbonate, and calcium as well as other excretions from the body such as amino acids. You can learn more about sweating on Sweating .CA.

There are two types of sweat glands; eccrine sweat glands and apocrine sweat glands. Both types of glands are controlled by the sympathetic nervous system, which controls many of our involuntary actions such as breathing, heartbeat and sweating.

Excess Sweating

Maybe you know someone who always seems to be sweating - whether it's their hands or their face? Maybe it's you? Excess sweating, known as hyperhidrosis, is a medical condition that affects almost one million Canadian. The most common form, primary focal hyperhidrosis (PFHH) , is defined as excessive sweating, not caused by physical activity that appears symmetrical in a localized fashion. It may be an inherited condition that usually appears in adolescence, but it can also begin in childhood or even in infancy.
This type of hyperhidrosis is caused by an overactive 'sympathetic nervous system'.

In another form of excessive sweating, called generalized or secondary hyperhidrosis, there is increased sweat production in the entire body. The cause of this sweating is different than primary hyperhidrosis as it is related to menopause, infection or a neurological or metabolic disorder.

Treatment Options

This condition (PFHH) can be difficult for people socially and psychologically; for some, even having a debilitating impact on their daily life. Interestingly most people do not seek medical treatment for this condition.
The most common ways to treat hyperhidrosis are:

  • Neuromuscular Blocking Agents: Botulinum toxin (Botox®) is injected under the skin and produces a sustained, localized decrease in sweating. It may be used to treat underarm, palm and sole hyperhidrosis. These agents block acetylcholine and inhibit the transmission of nerve impulses that trigger sweating.. Botox® was approved for use under the arm in September 2001. Learn more on www.BotoxFacts.ca.

  • Topical Treatments: Aluminum salt solutions are the most common antiperspirants in use today. Aluminum chloride is the partially neutralized form that is used in cosmetic antiperspirants, while aluminum chloride hexahydrate is the widely used effective antiperspirant and is available in products such as Drysol®.

  • Tap-Water Iontophoresis (TWI): In cases where antiperspirants are not effective, a physician may recommend Tap Water Iontophoresis for the treatment of palm or foot hyperhidrosis. In medical terms, iontophoresis is the topical introduction of ionized drugs into the skin using direct current (DC).

  • Oral Medications: There are a number of options with varying degrees of effects and side-effects.

  • Surgical Treatments: There are different types of surgery available including sweat gland excision (Surgical removal of the subcutaneous tissue and the sweat glands), Sympathectomy (Cutting or removing nerves from within the chest cavity to block the communication with the sweat glands.) and other types of major surgery. Like all surgeries, there is some risk involved with these procedures.

Learn more about treatment options on www.sweating.ca/hyperhidrosis_treatment.html.


About the author:

Dr Youwen Zhou specializes in the treatment of pigmentation, skin cancers, hyperhidrosis, rosacea, and psoriasis. He is assistant professor at the Department of Dermatology and Skin Sciences at University of British Columbia where he heads a research laboratory studying skin cancers, pigmentation disorders and rosacea as well as psoriasis.


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