Excessive Sweating

Why do people sweat?

Sweat is produced by glands in the dermis layer of the skin and helps control body temperature by evaporating to keep the skin cool.

What is hyperhidrosis?

Hyperhidrosis is the medical term for sweating in excess of what would normally be expected. Whilst it is normal for people to sweat during certain everyday activities such as with exercise, in some people the sweating can be excessive and uncontrolled.

How common is hyperhidrosis?

It is relatively common affecting nearly 3% of the population making it a common condition affecting millions of people around the world. The highest prevalence is among adults aged 18 to 54 years old.

Why is it important?

Excessive sweating can not only make people feel uncomfortable but it can also be a source of great embarrassment. Sufferers of excessive sweating often go to a great extent to conceal their

condition. This can include multiple changes of clothing, avoidance of certain clothing such as white shirts, the need for frequent showers and much higher laundry and dry cleaning costs.

Where does it occur?

Uncontrolled sweating can occur in various parts of the body but especially the underarms, hands and feet.

What causes hyperhidrosis?

Although high temperatures or stress can increase perspiration they don’t cause hyperhidrosis. Instead, hyperhidrosis is probably an inherited trait. A positive family history has been found in some studies to be up to 65% of patients with hyperhidrosis that stops the body from properly regulating its temperature.

What can be done?

The first line of treatment for Hyperhidrosis is the use of strong antiperspirants notably DRICLOR that can be purchased from pharmacies. In situations where this is ineffective or not tolerated well because of skin irritation the use of injections can be considered. The product used to treat excessive sweating by injections is the same that is used for wrinkle injections on the face. The protein based product blocks the release of the chemical signal that triggers perspiration. The procedure is very straightforward and very effective but the main drawbacks are that it is temporary and quite expensive. Most people find inprovement for as long as 6-12 months (average 7.5 months), before needing further treatment. The procedure typically takes 15 minutes and involves a series of tiny injections into the skin. There is no downtime and people can continue their normal daily activities straightaway.

Are there any permanent treatments?

In the past surgical treatments have been tried including surgical removal of sweat glands (Retrodermal Curettage) and chest surgery to divide the nerve supply from the spinal column to the sweat glands (Endoscopic Transthoracic Sympathectomy). These procedures are rarely performed because of potential complications and are a last resort in extreme cases.
In the last few years the use of heat to try and destroy sweat glands non surgically has become increasingly used as a permanent option. The 2 main technologies are the use of microwave heat (MIRADRY) and the use of radiofrequency heat (INFINI). We use the INFINI device and typically 3 treatments are needed at 4 weeks apart to achieve an 80% plus reduction in sweating. It is a walk in walk out procedure with no downtime. Topical anaesthetic is needed and normal activities can be resumed immediately although some slight discomfort like a mild sunburn sensation can persist for a couple of days.

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