Everyone normally sweats while exercising, in anxiety-provoking situations, in a hot room. But what if you were drenched all the time – even in a cold room? Would you like to shake hands with someone whose hands are soaking wet with sweat?
Sweating is a normal process by which the body is able to cool itself. For unknown reasons, the part of the nervous system responsible for controlling body temperature becomes dysfunctional and the result is exaggerated sweating (hyperhidrosis), at variable (and often inopportune) times during the day and on various parts of the body. It is the nervous system which stimulates the excessive sweating – the sweat glands themselves are absolutely normal.
About 3% of the world population suffers from this condition, called hyperhidrosis, or excessive sweating. It affects both men and women, all races and ethnicities, teens and adults. Even young children and infants can have hyperhidrosis. And it runs in families, too, although many family members may not share that information with each other. People with hyperhidrosis produce up to five times the amount of sweat required to regulate body temperature. And as an added insult, the excess sweat that is produced is frequently acted upon by the normal bacteria on the skin surface to produce bad body odor (bromhidrosis).
The presence of hyperhidrosis takes a toll on one’s everyday life – and it can ruin lives. One has to be ever vigilant, take several showers a day, remember to bring extra clothing in which to change during the course of a day, carry absorbent pads, etc. Clothing and shoes can be ruined; skin infections can occur; dry cleaning bills can skyrocket. Personal, social and business plans have to be very carefully arranged to accommodate potential problems. Indeed, hyperhidrosis can affect one’s emotional, psychological, financial, physical, social and even one’s professional life. It influences every decision and every moment. Hyperhidrosis is embarrassing and therefore no-one talks about it – they suffer in silence. And unfortunately, many times patients do not seek adequate treatment because they do not know that treatment options actually exist.
TELL ME ABOUT SWEAT GLANDS
There are approximately four million sweat glands on the body – three million eccrine glands and one million apocrine glands. Eccrine sweat glands are contained entirely within the skin itself and are responsible for normal, casual-type sweating. These glands are distributed over the entire body but are concentrated on the forehead and soles of the feet, followed by the palms and the cheeks. The sweat produced is a thin, clear, odorless fluid.
Apocrine sweat glands, parts of which extend beneath the skin into the underlying fat, are responsible for the sweating associated with anxiety and of hyperhidrosis. These glands are mainly located mainly in the hair-bearing areas of the armpits and the groin. They produce a thick, odorless sweat which is prone to rapid bacterial decomposition, which then leads to strong odors. It is the portions of these apocrine glands (the bulbs that produce the sweat itself) that extend into the fat beneath the skin that makes it possible for surgery to remove them. In the armpit areas, the ratio of eccrine to apocrine sweat glands is approximately one to one.
ARE THERE DIFFERENT TYPES OF HYPERHIDROSIS?
Primary (focal) hyperhidrosis, oftentimes starting around puberty, is excessive sweating which is not caused by another medical condition. Most commonly, the armpits (technically called the axillae), the hands, the feet, and the groin are involved. Occasionally, the face, back, and chest are also affected. The sweating is usually symmetric (ie. both sides equally affected) and rarely occurs while sleeping.
Secondary hyperhidrosis is excessive sweating as a side effect of another medical condition, such as menopause, cancer, diabetes or taking some medications. It often occurs while sleeping.