Hyperhidrosis: when sweating (too much) becomes a problem

Wet hands when shaking hands with an acquaintance or sweaty clothes in areas where you are most perspiring: in some cases sweating can become embarrassing and does not always depend on the heat or momentary states of anxiety, but it could be a disease. Prof. Antonio Costanzo, head of Dermatology at Humanitas, spoke about it in an interview.

Hyperhidrosis: what it is and who suffers from it

About 2-3% of Italians suffer from hyperhidrosis; in about 3 cases out of 10 it is a hereditary disorder. We talk about primary hyperhidrosis when the palms of the hands and feet, the face or the armpits get too wet; while secondary hyperhidrosis when sweating is connected to other chronic diseases (heart, respiratory, diabetes, gout or in many cases hyperthyroidism). Taking certain medications may also be the cause of hyperhidrosis. “This problem is already perceived in adolescence, when there is excessive sweating in the hands,” explained Prof. Costanzo, “then comes the turn of the armpits, feet and face. “In order to identify the areas where the most sweat is produced, it is possible to proceed with a test that measures the amount of sweat on the hands: the areas concerned will appear dark”. In addition, the dermatologist can prescribe tests and blood tests to measure for example blood sugar, exclude diabetes and monitor thyroid function.

Causes

In addition to a physiological emotional reason – for example, when you are very excited, or anxious, you tend to sweat more – in those who suffer from hyperhidrosis the sweat glands (in our body are about 2 million) react more intensely to stimuli.
In many cases, this happens because of stress, creating a sort of vicious circle that increases sweating, while between 30-50% of cases the causes seem to be genetic and hereditary.

Cures and remedies

There is a tendency to use antiperspirant products and deodorants, which contain aluminium chloride, or astringents that dry the sweat glands, to remedy the discomforts caused by hyperhidrosis. “In the United States, the use of a towel that contains topical glycopyrrolate and acts on the nerve fibres of the epidermis has recently been approved.
If these initial solutions are not sufficient, the use of injections of botulinum toxin, which blocks the muscles of the sweat glands, is injected under the armpits, in the palms of hands and feet inhibiting the release of acetylcholine. The effect of botulinum toxin, which paralyzes the glands, lasts from 4-6 months.