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Excessive Sweating (Hyperhidrosis)

Definition: A phenomenon occurs when the amount of sweat exceeds the volume required by the body for thermoregulation (> 0.5 L of sweat per day), explained by an exaggerated activity of the sweat glands. This could be due to an overactive nervous system or genetic factors. The intensity and duration vary among individuals. Moreover, it can be diffuse or localised, hence the distinction of two types of hyperhidrosis: localised hyperhidrosis (90% of cases) which manifests on certain body areas (armpits, palms of hands, soles of feet, and sometimes forehead, nose, chest, back and groin areas), and occurs bilaterally (symmetrically). This type of hyperhidrosis usually appears during childhood, intensifies during puberty and tends to regress after 40 years. However, it can reappear during menopause; generalised hyperhidrosis (about 10% of cases) which manifests as perspiration emanating from the entire body, more diffuse. Excessive sweating occurs during the day and stops at night. However, when the feet, hands and armpits sweat excessively, skin problems can occur: it can lead to skin diseases such as fungal infections, warts and frostbite. Most cases of excessive sweating are harmless, but can however cause social discomfort.
Internal and external causes: Genetic factors, stress, strong emotions, physical exertion, consumption of spicy food and/or alcohol, menopause (hot flushes), anxiety, certain diseases (hyperthyroidism, Parkinson's disease, infectious diseases such as tuberculosis, lymphoma, etc...), hot weather, overweight/obesity, intake of certain medications (antidepressants, tamoxifen).
How to reduce or eliminate: Using an antiperspirant or deodorant based on metallic salts (aluminium or zirconium); administering subcutaneous injections of botulinum toxin (botox); performing a thoracic sympathectomy (permanent destruction of the sympathetic ganglia that innervate the sweat glands); excision of the sweat glands (if local complications occur); conducting iontophoresis; prescribing anticholinergic medications (glycopyrrolate, propantheline); prescribing tranquilisers, antidepressants or anxiolytics (if there is a psychological component).
Preventative steps to take: Practising relaxation techniques (such as yoga, meditation...); being mindful of alcohol and caffeine consumption; altering one's diet and avoiding spicy dishes.

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