Hyperhidrosis (excessive sweating)
Hyperhidrosis is the medical name given to excessive sweating. People suffering from hyperhidrosis, with the localised from armpits, hands, feet or face or generalised to be sweating from all over the body, can find it extremely socially debilitating. Hyperhidrosis can lead to constant anxiety, changes of behaviour as sufferers try to avoid situations where they may sweat more or indeed whether sweating maybe noticed, and can result in social isolation leading to failure to advance in relationships and careers.
Recent research has supported how severe the effects of hyperhidrosis on the individual can be.
Although some non-sufferers do not understand how awful hyperhidrosis can be, there has been some very good research looking at measurements of quality-of-life in people suffering from hyperhidrosis and comparing it with the quality-of-life of normal people and those with other chronic illnesses. Interestingly, the decrease in quality-of-life scores found in people with hyperhidrosis are very similar to the decreased quality-of-life scores found in chronic diseases such as multiple sclerosis.
As such, although people suffering from hyperhidrosis often feel stigmatised and young people are often teased and ridiculed, hyperhidrosis is a serious medical condition that needs to be addressed and expert help sought.
Unfortunately, there seem to be few experts that specialise in hyperhidrosis. Currently hyperhidrosis is often ignored by the medical profession and patients are often left to fend for themselves. If hyperhidrosis is diagnosed and a referral to an expert is made, which treatment is suggested often depends upon who the patient is referred to – whether they be endocrinologist, dermatologist, vascular surgeon, plastic surgeon or harassing surgeon. More worryingly, there has even been an explosion of cosmetic clinics and cosmetic doctors who only offer botulinum toxin injections to reduce underarm sweating rather than exploring the problems a whole and offering alternative treatments.
Our aim at The Whiteley Clinic is to treat each patient who comes to see us as an individual, to find out exactly what the cause of their hyperhidrosis is, and then to work through various options ranging from simple behavioural changes, simple treatments or medications, through to injections and eventually invasive surgery only if required.
Hyperhidrosis – Primary or secondary hyperhidrosis
Primary hyperhidrosis means that the sufferer has excessive sweating without any underlying cause. Primary hyperhidrosis usually starts off in the adolescent years, is localised to only a few places on the body (usually one or more of the following: armpits, hands, feet, face), and it runs in families.
Secondary hyperhidrosis means that the sufferer has hyperhidrosis secondary to another condition. As the commonest of these conditions is embarrassment or anxiety, it is clear that most people with primary hyperhidrosis will also have secondary hyperhidrosis when they get anxious that other people will notice their sweating!
However it is very important to understand the difference between primary and secondary hyperhidrosis as each are treated by different specialists. Secondary hyperhidrosis is usually generalised (ie: occurs all over the body) and, if not due to embarrassment and anxiety, can be due to a wide range of other conditions. Such conditions that cause secondary hyperhidrosis include some medical illnesses (ie: hyperthyroidism, diabetes, medullary carcinoma of the thyroid, phaeochromocytoma, carcinoid syndrome), can be a side-effect of some medications (especially antidepressants, opiate drugs such as morphine, cocaine, anabolic steroids) and also is often found when the sex hormones reduce (such as the hot flushes in menopause).
Localised or generalised hyperhidrosis
It follows from the discussion about primary and secondary hyperhidrosis above that people with primary hyperhidrosis almost always have localised areas of sweating and are therefore treatable by hyperhidrosis experts who have the whole range of treatment options available.
Patients suffering from sweating in one, two or even three different places, that has been going on for quite some years, are likely to be able to be improved or cured using some of the treatments that are now available (see www.sweating.co.uk for more information about available treatments).
People who suffer from hyperhidrosis all over the body are more likely to have secondary hyperhidrosis and therefore may well need to see an endocrinologist or physician to check for underlying disease before seeing an expert in hyperhidrosis treatments.
However, having said this, there are people who suffer from localised hyperhidrosis first who then get very embarrassed about this excessive sweating in one or two areas, resuolting in secondary and generalised hyperhidrosis because of this embarrassment.
It is essential to understand the difference between the localised and generalised hyperhidrosis and primary and secondary hyperhidrosis to make sure that anyone suffering from excessive sweating sees the right specialist and gets the appropriate treatment with the minimum of fuss, time and expense.
Who should you see?
Naturally, if you have any concerns about hyperhidrosis, you should see your general practitioner first.
If you have primary hyperhidrosis with localised sweating to just one, two or three areas, you should probably try antiperspirants or aluminium containing antiperspirants first. If these do not work, then you will probably need some of this specialist hyperhidrosis treatments available for your localised treatment and, although some general practitioners do offer some of the treatments, a referral to a specialist is probably necessary.
If you have secondary hyperhidrosis with generalised sweating, then you should discuss this with your general practitioner. In many people. It is merely that they are drinking too much water, caffeine or alcohol and simple measures can improve this. Following on from this, some simple blood tests and urine tests can also exclude other causes. If however causes not found easily, a referral to an endocrinologist or physician with a special interest in secondary hyperhidrosis is probably necessary.
Finally if sweating starts off as localised but provokes enough anxiety to become generalised, then these can often be treated as a primary hyperhidrosis.