HYPERHIDROSIS 101: Understanding Excessive Sweat

Hyperhidrosis is a medical condition in which excessive sweating occurs beyond what is needed to maintain normal body temperature.1,2 Excessive sweating can occur in the hands, feet, underarms or face, and it often interferes with everyday activities.1

Understanding Sweat Sweat glands are small tubular structures in the skin that secrete sweat onto the skin via a duct.3 Eccrine sweat glands are distributed throughout almost the entire human body and they secrete directly onto the surface of the skin.3 Apocrine sweat glands are ten times larger than eccrine sweat glands.3 They are localized in the axilla (underarms) and perianal areas.3 Rather than directly opening onto the skin surface, these glands secrete sweat into the pilary canal of the hair follicle.3

What is Hyperhidrosis? We all sweat. It’s the body’s way of cooling itself and preventing 1 ourselves from overheating. People living with hyperhidrosis, What Causes Us to Sweat? however, sweat when the body doesn’t necessarily need cooling.1 Their sweat is excessive, often visible to others and usually occurs The main reason we sweat is to control without physical exertion or extreme heat. our body temperature.2

There are two different types of hyperhidrosis - primary (also known as focal Here’s how it works: Sensors in our skin can detect changes in temperature hyperhidrosis) and secondary hyperhidrosis.6 Primary hyperhidrosis often begins and relay signals to our brain when we in childhood or adolescence and affects localized areas of the body, including the exercise or when it is hot outside.4 In hands, feet, underarms or face.6 The condition may be inherited and many members turn, our brain signals the sweat glands 7 of the same family may suffer from hyperhidrosis. Sometimes excessive sweating that it’s time to start producing sweat. As can be caused by another medical condition or is a side effect of a medication, so it’s sweat evaporates from the skin, it has a 6 important to speak to a dermatologist to understand the symptoms and causes. cooling effect on the body. In people with hyperhidrosis, it is Secondary hyperhidrosis is a type of excessive sweating that is caused by another believed that overstimulation of nerve medical condition or is a side effect of a medication.7 Secondary hyperhidrosis fibers in sweat glands causes excessive begins in adulthood, often can affect the entire body (vs. localized areas) and present sweating.5 symptoms during sleep.7

Anxiety and Embarrassment Associated with Hyperhidrosis Did You Know? Research shows that hyperhidrosis is associated with increased prevalence of anxiety and depression.8,9 Understandably, excessive While many people don’t initially talk to sweating can be embarrassing and interfere with every day activities their doctor about excessive sweating, at school, work and other social situations.2 People who suffer from more than 15 million people in the excessive sweating constantly worry about how much their sweating United States have hyperhidrosis.2 and spend hours each day dealing with sweat.10, 11 Those affected with hyperhidrosis worry about over-sweating, causing them to often:10, 11

Frequently Freshen up with Place tissues Hide under change clothes wipes or extra under their arms dark-colored, throughout showers or stick panty bulky clothing the day liners in their shirts

Hyperhidrosis Treatment Options There are many different ways to treat hyperhidrosis. Treatments can include:12

A solid, gel or spray substance that is applied to the underarms, hands, feet or hairline. Antiperspirants Antiperspirants form a gel plug, which will block the duct of a sweat gland, preventing sweat from reaching the surface of the skin. Antiperspirants, available in regular, clinical and prescription strength, are usually a dermatologist’s first treatment recommendation.

Thermolysis Using targeted microwaves or lasers, this treatment causes the destruction of sweat glands through localized heating.

A medical device that sends an electric current through water to disrupt the activity of sweat Iontophoresis glands in the hands or feet. The at-home device requires the hands or feet to be immersed in a shallow pan of tap water while a low-voltage current runs through the water.

Prescription medications look to inhibit the signaling pathway of sweat glands and block the Prescription body’s ability to produce sweat in localized areas or temporarily block the chemical signaling that Medications stimulates sweat glands. These take many forms including topical products, a series of multiple injections or shots of medication and oral medications.

An operation to surgically remove the sweat glands from the underarms or palms of the hands. Surgical Because surgery is permanent and carries risks, it is usually only considered when other Procedures treatments fail to bring relief to excessive sweating.

Talk to your dermatologist about hyperhidrosis. To learn more about hyperhidrosis, visit https://dermira.com/our-focus/hyperhidrosis/

References: 1. American Academy of Dermatology. Hyperhidrosis: Overview. Accessed October 04, 2017, from https://www.aad.org/public/diseases/dry-sweaty-skin/hyperhidrosis. 2. Doolittle, J., Walker, P., Mills, T., & Thurston, J. (October 15, 2016). Hyperhidrosis: an update on prevalence and severity in the United States. Accessed October 04, 2017, from https://link.springer.com/ content/pdf/10.1007%2Fs00403-016-1697-9.pdf. 3. Wilke, K., Martin, A., Terstegen, L., & Biel, S. S. (2007). A short history of sweat gland biology. International Journal of Cosmetic Science, 29(3), 169–179. 4. International Hyperhidrosis Society (IHHS). (2016). Understanding Sweating. Accessed March 20, 2017, from http://www.sweathelp.org/home/understanding-hyperhidrosis.html. 5. Solish, N., Benohanian, A., & Jonathan, W. K. (2005). Prospective open-label study of botulinum toxin type A in patients with axillary hyperhidrosis: effects on functional impairment and quality of life. Dermatologic Surgery, 31(4), 405–413. 6. American Academy of Dermatology. Hyperhidrosis: Signs and Symptoms. Accessed October 04, 2017 from https://www.aad.org/public/diseases/dry-sweaty-skin/hyperhidrosis#symptoms. 7. International Hyperhidrosis Society (IHHS). (2016). Two Types of Hyperhidrosis. Accessed October 04. 2017 from https://www.sweathelp.org/home/types-of-hyperhidrosis.html. 8. Bahar, Rayeheh, et al. The prevalence of anxiety and depression in patients with or without hyperhidrosis (HH). Journal of the American Academy of Dermatology, vol. 75, no. 6, 2016, pp. 1126–1133., doi:10.1016/j.jaad.2016.07.001. 9. Bragança, G. M. G., Lima, S. O., Pinto Neto, A. F., Marques, L. M., Melo, E. V. de, & Reis, F. P. (2014). Evaluation of anxiety and depression prevalence in patients with primary severe hyperhidrosis. Anais Brasileiros de Dermatologia, 89(2), 230 -235. https://doi.org/10.1590/abd1806-4841.20142189 10. International Hyperhidrosis Society. (2016). Diagnosing Hyperhidrosis. Accessed October 04, 2017 from https://www.sweathelp.org/home/diagnosing-hyperhidrosis.html. 11. Kamudoni, P., Mueller, B., Halford, J., Schouveller, A., Stacey, B., & Salek, M. S. (2017). The impact of hyperhidrosis on patients’ daily life and quality of life: a qualitative investigation. Health and Quality of Life Outcomes, 15(1). Accessed on February 28, 2018, from https://doi.org/10.1186/s12955-017-0693-x. 12. American Academy of Dermatology. Hyperhidrosis Diagnosis and Treatment. Accessed October 04, 2017 from https://www.aad.org/public/diseases/dry-sweaty-skin/hyperhidrosis#treatment.