What to do when sweating becomes excessive

Walking up 10 flights of stairs and breaking out in a light sweat is one thing, but simply sitting at your desk and sweating through an undershirt, a dress shirt and suit jacket is another thing entirely.

Sweating is a key to human survival as it’s the mechanism that helps keep our bodies cool and prevents us from overheating. However, experts say that excessive sweating may be a sign of a larger health problem.

Excessive sweating, also called, hyperhidrosis is often “a symptom, not a disease,” says Dr. Prentiss Taylor, an internal medicine physician with Advocate Medical Group in Chicago.

Excessive sweating can be caused by a variety of things, all of which are normal, such as part of menopausal symptoms, overactive thyroid glands or even as a response in people who are overly anxious, which may indicate stress and anxiety, Dr. Taylor says.

But “occasionally, you have a person who, for unexplained reasons, gets unusual sweating in response to normal occurrences, such as heat or exercise,” he explains, almost as if sweat glands are stuck in the “on” position.

According to the International Hyperhidrosis Society (IHS), at least 3 percent of the world population suffers from excessive sweating—that’s more than 211 million children, teens and adults worldwide.

The IHS reports that there are two types of hyperhidrosis: primary and secondary. Primary hyperhidrosis affects one or more specific areas of the body such as palms, armpits or the soles of the feet. Secondary hyperhidrosis affects the entire body and may be caused by another condition such as prescription medication or diabetes.

Primary hyperhidrosis may be detected through a physical exam, which may include a thyroid test, known as a TSH (for thyroid stimulating hormone), and a blood count to make sure lymphomas or leukemia are not present, explains Dr. Taylor. And depending on the age of the patient, he adds, “I would consider an EKG or stress test if you have other risk factors such as heart disease or diabetes.”

Treatment options may include strong antiperspirants that plug sweat ducts, medication that prevents stimulation of sweat glands and an electrical procedure called iontophoresis, which temporarily shuts off sweat glands.

“Excessive sweating may also be treated by botulinum toxin, also known as Botox when other treatments don’t improve the condition,” Dr. Taylor says. The botulinum toxin, which is approved by the U.S. Food and Drug Administration (FDA) for this purpose, is injected in the underarm to create a block to the nerves that stimulate sweating.

For those who suffer from hyperhidrosis, Dr. Taylor says he refers them to a plastic surgeon, neurologist or dermatologist for treatment.

The type of treatment a hyperhidrosis patient receives depends on the patient’s history and physical exam, which is where everything should start, Dr. Taylor says.

He adds that if patients are bothered by excessive sweating, it’s important to talk with their primary care physician about their concerns.