The Effects on Patients' Lives: Physical Discomfort
Studies have shown that hyperhidrosis’ (Hh) impact on quality-of-life is equal to or greater than that of psoriasis, severe acne, Darier’s disease, Hailey-Hailey disease, vitiligo, and chronic pruritus.1a
Some of these quality-of-life impacts are certainly related to the physical ramifications of excessive sweating including wet/damp skin and clothing/shoes and feeling cold due to such wetness. Indeed, in a 2017 study, 40% of Hh sufferers reported some level of physical discomfort related to Hh.1f Seventeen percent of the individuals mentioned doing extra chores in order to stay “clean,” such as taking a shower several times a day, changing clothes or shoes often, and using strong antiperspirants. Individuals said they experienced discomfort in relation to “being in wet clothes day in, day out,” “having wet feet," and "sweat dripping into the eyes." Additionally, 17% of these Hh sufferers reported other skin problems that they attributed to constant dampness due to hyperhidrosis. The most common were sore and cracked skin.
In other research, Hh sufferers were found to have a 300% greater risk of skin infections.1d Skin maceration from constant wetness can lead to bacterial and fungal overgrowth. This overgrowth can then lead to intertrigo, bromhidrosis (foul-smelling sweat), pitted keratolysis (an infection of the plantar surface characterized by pits or craters), and/or gram-negative bacterial macerative infection. Beyond the skin, 60% of Hh sufferers have reported negative impacts on general health.1e
Safety can also be an issue as hyperhidrosis sufferers can drop objects and experience electric shocks 1b,1c or may slip and fall due to sweaty feet.
Excessive sweat can stain and eventually destroy clothing and shoes. Patients may spend thousands of dollars yearly on dry-cleaning and clothing/shoes replacement.
It can be argued that, in the past 10 years, the burden and impact of Hh has grown significantly in developed nations due to changes in culture and technology that make excessive sweating more visible and embarrassing as well as more of an impediment. Examples include:
- Security checkpoints at airports that require travelers to remove shoes and jackets and raise their arms in scanners (exposing sweating that might otherwise be hidden).
- Touchscreens like smartphones, tablets, and other devices in day-to-day life (banking, shopping, etc.) and touch identification that may not work with sweaty hands and that can be damaged due to wetness. According to one recent study, 20% of hyperhidrosis sufferers report problems using computer keyboards, a computer mouse, mobile phones, and touch screens.1f
1a. Swartling C, Naver H, Lindberg M. Botulinum A toxin improves life quality in severe primary focal hyperhidrosis. Eur Med J Neurol 2001;8:247-52.
1b. Adar R, Kurchin A, Zweig A, Mozes M. Palmar hyperhidrosis and its surgical treatment: a report of 100 cases. Ann Surg 1977;186:34-41
1c. Pariser DM, Ballard A, Topical Therapies in Hyperhidrosis Care. Dermatol Clin 2014;32(4):485-490.
1d. Walling HW. Primary hyperhidrosis increases the risk of cutaneous infection: a case-control study of 387 patients. J Am Acad Dermatol doi: 10.1016/j.jaad.2009.02.038.
1e. Doolittle J, Walker P, Mills T, Thurston J. Hyperhidrosis: an update on prevalence and severity in the United States. Archives of Dermatological Research. 2016;308(10):743-749. doi:10.1007/s00403-016-1697-9.
1f. Kamudoni P, Mueller B, Halford J, Schouveller A, Stacey B, Salek MS. The impact of hyperhidrosis on patients' daily life and quality of life: a qualitative investigation. Health and Quality of Life Outcomes. 2017 15:121.