Overview of Hyperhidrosis – Dr. Barankin

What is it?

dr-benjamin-barankin
Dr. Benjamin Barankin Dermatologist, Medical Director and Founder, Toronto Dermatology Centre

Hyperhidrosis (also referred to as HH) is defined as excessive sweating, which can affect any part of the body. “In fact, I see many patients in my practice with this condition.”

It is a disorder of excessive sweating due to the over-stimulation of cholinergic receptors on eccrine (sweat) glands.

Hyperhidrosis is inappropriate sweating, so sweating while reading or watching TV, as opposed to appropriate sweating when we’re nervous or exercising.

For many patients, it can be embarrassing, frustrating, even debilitating and impairs social interactions. In fact, it has been shown to have a significant impact on patients’ quality of life, resulting in social and work impairment and emotional distress.

Where does it occur?

The most commonly affected areas are the armpits/underarms as well as the palms and the bottom of feet. Excessive sweating can also occur in other areas of the body as well.

full-body-sweat

Who is affected?

sweat-hands

Hyperhidrosis affects approximately 3% of the population – that’s almost 1 million Canadians – of whom 300,000 have the severe form of the disorder.

It primarily affects those between 13-60 years of age (the average age of onset is 25). After age 50, sweating severity appears to decline. Armpits (axillae) are affected in approximately 51% of people, feet in 29%, palms in 25% and face in 20%.

It has also been shown that ONLY 38% of people living with hyperhidrosis talk to a health care professional about their condition. People seldom seek help because many are unaware that excessive sweating is a treatable condition.

The science behind sweating – why does it occur?

science-behind-sweatingWe sweat partly to cool our body and partly to obtain a good grip function.

These functions are controlled from different parts of the “old” part of the brain: grip function from the cortex and the limbic system, thermoregulation from nuclei in the hypothalamus.

Since the hypothalamus is also a nucleus of the limbic system, factors such as stress also usually draw sweat from the whole of the body, and heat/exertion can make hand and foot sweating worse. What may be physiological can transform into pathological in about 3% who are genetically predisposed.

Skin conditions and consequences of severe hyperhidrosis

Hyperhidrosis can lead to minor skin conditions such as:consequences-of-hyperhidrosis

  • Athlete’s foot
  • Jock itch (Tinea cruris)
  • Warts
  • Foul-smelling body odour (bromhidrosis)Other infections triggered by untreated excessive sweating
  • Fungal infections affecting skin, hair and nails (dermatophytosis)
  • Bacterial infection affecting soles of the feet and/or palms of the hands (pitted keratolysis)
  • Plantar warts (verruca plantaris)
  • Ingrown toenails

Summary – what do you do next?

There are treatment options available that can help treat excessive sweating, including topical clinical strength antiperspirants such as DrysolTM (mild, regular & extra strength), which is available over-the-counter.

“All patients with hyperhidrosis, whichever body part is affected, should first try a topical aluminum chloride product such as DrysolTM first, based on the years of usage, safety and efficacy.”

DrysolTM passed the Human Repeat Insult Patch Test (HRIPT) and met the Canadian Dermatology Association’s Skin criteria Health Program.

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