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When excessive sweating becomes a medical condition: about hyperhidrosis

Click to play video: 'Some treatment options for excessive sweating when it’s a medical condition'
Some treatment options for excessive sweating when it’s a medical condition
WATCH: Treatment options for excessive sweating – Jul 4, 2018

As much of Canada continues to bake in the sun, it’s fair to say most Canadians are sweatier than usual.

But some people are dripping sweat no matter the situation, said Dr. Youwen Zhou, a dermatology professor at the University of British Columbia – even if they’re not hot, or nervous or in any of the usual sweat-inducing situations.

These people suffer from a condition called hyperhidrosis, where they produce more sweat than is necessary to keep themselves cool. The Canadian Dermatology Association estimates around three per cent of Canadians, or about 950,000 people have hyperhidrosis.

“Patients affected by this condition could just be sweating for no reason when other people in the same environment, same conditions, do not,” said Zhou, who founded a hyperhidrosis speciality clinic at the Vancouver General Hospital.

While it’s not dangerous, it’s definitely unpleasant and many patients feel embarrassed, he said.

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“They feel embarrassed. They feel embarrassed that when they interact with other people, that their shirt will be all wet. That sweat will drip down from their face, nose, and they feel the urge of constantly wiping off the sweat drops.”

Many sufferers will avoid social situations that could involve shaking hands, for fear that someone will feel their clammy palms, he said. It can even limit career choices – it’s tough to use a keyboard or operate machinery with extremely sweaty hands.

Zhou acknowledges that there is a spectrum of sweatiness – some people hardly sweat at all, and some people sweat so much that they have difficulty in social situations, with most people somewhere in between.

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But if you define hyperhidrosis as sweating so much that you feel your life is limited by sweating on half of all days, then about 10-15 per cent of the population reports suffering from the condition, according to his research. About five per cent could benefit from medical care, he thinks.

“Sweating by itself may or may not be a problem. But it is a problem if it becomes a limiting factor in people’s activities, in people’s lives.”

Dr. Anatoli Freiman, a certified dermatologist in Toronto, said that if people are sweating excessively, they should talk to their doctor. “It’s important to seek a doctor to make sure there’s no other reason for hyperhidrosis. A number of medical conditions, for example, thyroid disease, can cause hyperhidrosis. Some medications can do it. So it’s important that patients get evaluated to exclude other possibilities.”

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Treatments

If it turns out that there aren’t any underlying conditions causing sweating, there are treatments available.

Antiperspirants, even those available at the drugstore, can help with mild cases.

Botox on the affected area, like the armpits, can work very well, said Zhou. “If you inject right in the armpit where people sweat, the sweat stops.”

There are also some medications, though they come with side effects. He’s hopeful that newer medications applied topically, like a moist towelette just approved by the FDA in the U.S. to treat excessive sweating, will have fewer side effects because they stay on the affected area rather than being fully absorbed through the digestive system.

Surgery can disrupt the nerves that are triggering the excessive sweating – though in some cases, patients simply start sweating more elsewhere to compensate. And some patients benefit from an electrical therapy, immersing their hands or feet in water and receiving light shocks.

And don’t worry about overheating, said Zhou.

Sweat is a natural and necessary function to help cool you off, but treating excessive sweating shouldn’t impair that, he said. “If you stopped sweating in the entire body, yes, it would be dangerous,” but most treatments target a single area, like the armpits.

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“Heat regulation is not controlled by the armpit. Heat regulation is controlled by sweat glands on the body.”

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