As the summer approaches and the Covid lockdown restrictions ease from 12 April our minds are turning to enjoying the sun, outside spaces and social gatherings. Fashion is playing its part too with many of the “fashion conscious” considering the latest styles and colours available and what will most suit them. It may be an exciting time for the majority but there are those who are unable to really appreciate the bright balmy days as they have a problem, it is not a common one, but this “affliction” makes them dread social gathering or even public outings. Hyperhidrosis!
Many will be completely unaware of this issue, but we all sometimes suffer from the heat and we sweat (for the male gender) perspiration for the female gender. It is embarrassing when we get those tell-tale wet patches under the arm but usually everyone else gets them too, so it is a shared problem. What if though you suffer with “excessive” sweating. This is completely different as individuals find themselves sweating from all parts of the body, not just under the arms.
Hyperhidrosis affects the palms of the hands, this may lead to an awkward meeting with friends or colleagues as the sufferer feels uncomfortable about shaking hands and if the party takes the initiative then they can be shocked by the rather “wet” palm they are shaking, result embarrassment and awkwardness on both sides. Taking part in active sports can be difficult and an individual may choose to avoid these. It also can create problems in an office environment – sweaty hands and keyboards do not make an ideal match, likewise with musical instruments. Writing and leisure activities are also impacted by this condition.
This is not limited to the hands though. It can affect the face, soles of the feet and the rest of the body. The cause is generally unknown but for many this only affects them in childhood and early adolescence and the “symptoms” may improve with age or gradually decrease over time. When it continues however it is referred too as “Generalised Hyperhidrosis” or secondary Hyperhidrosis. This can be caused by other factors which can result from infections, diabetes, an overactive thyroid, and the menopause. Prescribed medication may also induce excessive sweating and anxiety can have an effect although not common where it is experienced then it creates further anxiety for the sufferer.
There are 2 types of sweat glands APOCRINE, the sweat generated by these are oily and they excrete an odour which is unpleasant and ECCRINE, these produce water and are the cause of Hyperhidrosis. Although odourless it sometimes will generate an odour (particularly the feet) when harmless skin bacteria is more excessive than usual.
Is Hyperhidrosis hereditary – although it is not considered to be it has been established that 33% of those who experience Hyperhidrosis have family members who have suffered with the condition.
Diagnosis of Hyperhidrosis is usually confirmed after consulting your doctor. Having explained the symptoms, the doctor will decide whether a referral is required for specific tests. These will establish whether there is an underlying cause such as diabetes or an overactive thyroid or another possible cause.
If following the afore-mentioned testing procedure, a cause for the condition may be ascertained and the condition treated, then it is possible that a cure may be forthcoming. Sometimes a surgical procedure may be considered, (e.g., sympathectomy) however there can be significant side effects, so it generally not recommended. If no cure is available, then controlling the condition is the best possible procedure.
What can done to prevent or “cure” the condition? If the testing procedure confirms a particular cause, then treatment may be available. There is a surgical procedure that is available, sympathectomy, however due to the side effects associated with this it is not generally recommended. Controlling the condition is often thought the best way forward.
What about standard toiletries? We are familiar with deodorants and anti-perspirants and most of us spend a considerable amount on these products as they usually are sufficient to deal with our requirements. They are different however and that is seen in their description. A deodorant provides a more pleasing perfume to eliminate unpleasant odours caused by sweating. An Anti-perspirant is designed to limit the excess water so is more of a “keep dryer” option. There are some products that may provide both. In cases of Hyperhidrosis these are ineffective as they are not powerful enough to counter the effects of the condition.
There are some solutions to the condition and depending on the severity Hyperhidrosis will dictate as to the choice available.
In the case of Localised Hyperhidrosis there are commercial anti perspirants that contain aluminium chloride this is an active ingredient which may alleviate some symptoms and other stronger products also availbale. The advice offered with these is that they best used overnight (usually these are for feet) but there are also possible side effects, sore red skin and this is countered by applying hydrocortisone cream. With sensitive skin products containing Aloe Vera might be beneficial. On occasions a solution of the of the anticholinergic drug glycopyrrolate may affect and reduce excessive sweating in the scalp and forehead, this treatment however is not available in the UK through the NHS.
There is another form of treatment known as Lontophoresis this uses a small electric current through the skin while immersed in a dish of water. Regular treatments are required with each session lasting for 10-20 minutes. This can be completed as a “home” remedy, but equipment is expensive. The NHS may offer a referral in some instances but only if it is deemed suitable for an individual.
What about the Aesthetics Industry can they provide an alternative that is effective and safe? There may be salons / clinics available that can provide a service that will offer a solution but before rushing to find your local clinic make sure that you research the salon/clinic and practitioner to ensure they are fully qualified to administer the procedure.
Botox – which people generally think of as being associated with Aesthetic Beauty Treatments, (the product used is botulism toxin which is derived from bacteria), can be effectively used to treat this medical condition. It can only be used in the under-arm area (other areas affected by Hyperhidrosis are deemed to be too sensitive). It involves injecting the prepared site under the arm with small doses into the affected areas. Numbing can be applied (topical cream or ointment) but this is not usually required as the area is not particularly sensitive. The NHS may offer the treatment, but it is only available in a few places in the UK. The treatment may last between 6-12 months.
The other treatment that may be available is Miradry which uses microwave technology. The microwaves target the sweat glands and destroy them thus eliminating the need for surgery. The NHS does not currently offer this form of treatment.
Surgical procedures are available and sympathectomy has been mentioned and due to side effects is not advised. The under arm can also be treated by removing the area of skin containing the sweat glands or by scraping away the sweat glands from under the skin by creating a small hole and then repairing the area.
Finally, having considered all these there are some general “self-care” guidelines that will proved beneficial. Wear suitable clothing, Cotton, or absorbent materials (you may need to change during the day). Leather shoes or sandals will help combat excessive sweating. Cotton socks with regular changes will also help combat any odour. If you have a change of shoes / footwear this will allow any pair worn to dry out. Absorbent under-arm pads are available through the internet.
The avoidance of activity that may induce excessive sweating should be avoided where possible also if an individual knows of foods, (e.g., spicy) that may cause sweating or alcohol these should be avoided.
I hope this helps anyone that is subject to the condition or knows someone who might gain from the article will find a solution to their condition from the options available.