Your body regulates your temperature by activating the sweat glands when necessary. Most of these glands are located in your palms, but there are many in the soles of the feet, the armpits and the face as well. These glands are under the control of the autonomic nervous system over which we have no control (unlike the voluntary nervous system, which we can direct to move our limbs and do anything else we want). So, sweating is normal when we’re too hot, nervous, fearful, stressed or embarrassed. Such emotional sweating usually stops when you’re sleeping.
What is hyperhidrosis (excessive sweating)?
Profuse, ongoing, abnormal sweating (doctors call it hyperhidrosis)— more than the body needs to keep cool—can occur under two circumstances. In the first, called “primary hyperhidrosis,” the sweat glands are overstimulated by specific areas in the brain for no apparent reason. In other words, the sympathetic nervous system (part of the autonomic system) goes wacky. The other category is “secondary hyperhidrosis,” in which another well-defined disorder is responsible, according to the International Hyperhidrosis Society. Roughly one in 20 people in the U.S. have hyperhidrosis, and although those suffering from excessive sweating experience night sweats, “It’s not only happening at night, though,” according to Peter Bidey, vice chair of the Department of Family Medicine and assistant professor of family medicine at the Philadelphia College of Osteopathic Medicine.. “They’re overproducing sweat in certain areas of their body, sometimes their whole body. It happens during the day, too,” he says.
Causes of excessive sweating
The most common causes are:
an overactive thyroid. (That’s the first thing to have checked.)any infection, especially one accompanied by fever.a malignancy, of which you may or may not be aware.obesity. Overweight people tend to sweat too much.menopause. The decline in estrogen production often results in hot flashes accompanied by sweating.diabetes. When not well controlled, sugar levels that are too high or too low can result in abnormal perspiration.abnormalities of the immune system. Some diseases, such as lupus, can cause excessive perspiration.
Treatment of hyperhidrosis depends on the cause. Obviously, the first step is to determine whether you have any of the secondary causes and then treat them.
Treating hyperhidrosis
In primary hyperhidrosis, for which there’s no apparent cause, treatment is directed at controlling the sweating. This can be done by medications, antiperspirants (prescription-strength, if necessary), Botox injections, iontophoresis and, when all else fails, an operation on the nerves of the sympathetic nervous system. The most common oral medications are:
tranquilizers.anticholinergic drugs, of which there are many, belong to the atropine family and act on the nervous system to reduce symptoms. However, this medication is not free of side effects, especially in elderly people.NSAIDS (nonsteroidal anti-inflammatory drugs), such as ibuprofen, often curb excessive sweating. calcium channel blockers (such as verapamil), normally used to control blood pressure.a drug called catapres (clonidine), also used to lower blood pressure.
One popular option is injections of botulinum toxin (Botox) directly into the sweat glands every few months, which can reduce gland activity. Botox and most other treatments are temporary, so those seeking a permanent solution may opt to have the sweat glands removed surgically. Iontophoresis delivers a low electrical current to the areas that perspire most to disrupt sweat production. It is usually done while the skin is submerged in water. (Pregnant women or anyone with a pacemaker should not use this therapy.) Sympathectomy, cutting the nerves that transmit the messages to the glands that trigger sweat, should be considered only as a last resort. Read more about how to stop stress sweating.
