We all sweat. It is an important aspect of the body’s cooling system.
However, approximately 1% of the population suffer with excessive sweating – hyperhydrosis.
Hyperhidrosis usually occurs on the hands, face, feet and under the arms. It can cause a great deal of embarrassment, particularly if you have a job where you are regularly meeting people and need to shake hands. Excess sweating of the feet can cause maceration of the tissues leading to a soggy appearance, bad smell and bacterial and fungal infections.
In most cases, there is no underlying cause, and the condition is then termed primary, or idiopathic hyperhidrosis. Rarely it is caused by an overactive thyroid, a rare tumour of the adrenal gland called a phaeochromocytoma, or the menopause. Obesity can also be a cause.
- Topical applications of aluminium chloride (20-25% in 70-90% alcohol). You can buy this from most chemists as Driclor or Anhydrol forte. Preparations are available in liquid formulations with roll on applicator. These should be applied to the affected areas at night, to dry skin and washed off the next morning. Try them daily at first and reduce the frequency as the sweating improves. If using in the underarm area do not apply after shaving or if the skin is broken in any of the areas you intend to treat. Irritation may occur. A dusting powder is also available called Zeasorb which may help people who suffer with sweaty feet. It can reduce the likelihood of infection.
- Iontophoresis. This is only suitable for hands and feet, as they have to be immersed in an electrolyte solution through which an electrical current is passed. The disadvantage of this treatment is that it is time consuming and costly and may not be available everywhere.
- Botulinum A neurotoxin (Botox) injections. These seem to be effective but there are risks, including pain at the injection site and muscle weakness
- Medication, eg beta blockers or probanthine
- Surgery. Sympathectomy is an operation in which certain nerve fibres, which supply the sweat glands in the affected areas, are destroyed. These are special nerves called the sympathetic nervous system. There has been a new interest in this operation as it can now be performed endoscopically making it safer, effective and minimally invasive. The operation can usually be performed as a day case, but again you may need to enquire whether it is available in your area.
This article published on
26 January 2006
Next review date 1/1/2013
Skin and hair
Skin and hair