Important Sweat Issues Explained by the International Hyperhidrosis Society
Center Valley, PA, Jan 30, 2020 -- Sweat is essential to human survival, but when sweating is "different," serious issues come up -- like health concerns, lack of awareness and understanding, embarrassment, and more. To help, International Hyperhidrosis Society experts are providing a key sweat-condition summary:
Anhidrosis = No Sweat
Sweat is essential to human survival because it's the body's coolant, getting rid of excess heat and protecting the body from overheating. With anhidrosis, a person does NOT sweat (or doesn't sweat enough). Without being able to cool themselves, people with severe anhidrosis can be in serious danger if they attempt strenuous activity in high temperatures. They are at high risk for heat-related illnesses, coma or death as a result.
Factors that may lead to anhidrosis include (but are not limited to):
- Certain Drugs/Medications: In particular, antipsychotic medications used to treat serious mental disorders may interfere with normal functioning of the sweat glands. Also, medications with anticholinergic properties and calcium-channel blockers may cause anhidrosis.
- An Inherited Condition: It's rare, but some people are born without sweat glands.
- Nerve Damage: Injuries to the nerves that help control some of the involuntary body functions can interfere with the activity of sweat glands. Such nerve damage may be caused by a number of medical problems including gout, B-vitamin deficiency, diabetes, and alcoholism.
- Clogged Ducts: Skin diseases and conditions that block or clog sweat ducts are the most common causes of anhidrosis.
- Skin Injuries: Injuries to the skin and sweat glands can also cause anhidrosis. Such injuries can occur due to third-degree burns from fire, chemicals or electricity, or from medication overdose or poisonings.
Treatment for anhidrosis depends on the cause. If someone develops a noticeable decrease in sweating, it's important for him or her to talk to a healthcare professional and discuss any medications they are taking. Anhidrosis over large portions of the body can dangerously limit the ability to keep cool. In such instances it's important to take steps to prevent heat exhaustion, heat stroke, and dehydration.
Bromhidrosis = Smelly Body Odor
Everyone gets stinky sometimes and that’s normal. But bromhidrosis becomes a medical issue when noticeable smell has a negative effect on self-esteem, social interactions or quality of life. In such instances, self-care and professional help may be needed. Management recommendations include:
- Keeping the impacted body area dry. Antiperspirants, powders and clothing changes can help. (Women, learn about potential risks of long-term use of talc-based powders in the genital region.)
- Washing smelly parts with antibacterial soap.
- Removing hair. Consider shaving, waxing or electrolysis of fuzzy spots that are also sites of odor. Hair can magnify odor.
- Using a deodorant. Most antiperspirants are also deodorants. Read labels to make sure a product is appropriate.
- Looking at diet. Limiting curry, garlic, onions, and alcohol. Medications can sometimes also cause bromhidrosis. Discuss medications and smell concerns with a doctor. NO ONE should stop taking a medication prescribed for him/her without consulting a physician.
- Still stinking? A medical professional may recommend miraDry or Botox injections.
Chromhidrosis = Colorful Sweat
Chromhidrosis manifests with colored sweat on the face, in the underarms, or on the areola of the breasts (the darker circle of skin around nipples). Sweat may be yellow, green, blue, brown, or black. Colors are due to a pigment in the sweat glands called lipofuscin. Lipofuscin is common in human cells, but some people have higher concentrations of lipofuscin or lipofuscin that is in a higher state of oxidation.
Possible reasons for colored sweat include: infection, blood in the sweat (hematidrosis, see below), excess bilirubin (a pigment formed in the liver), and/or poisoning. If anyone experiences sweating in an unusual hue, it's important to talk to a healthcare provider to rule out potentially serious medical conditions.
The medical journal Pediatrics says chromhidrosis can be treated with topical capsaicin cream 0.025%. Others have noted that Botox injections can treat chromhidrosis. The goal of treatment is to reduce symptoms in order to also reduce any related psychosocial impacts or stigma.
Hematidrosis = Sweating Blood
Hematidrosis or hematohidrosis is an extremely rare problem that causes a person to sweat blood, often on the face or forehead. Symptoms appear as blood droplets on the skin, bloody sweat or sweat with blood in it.
One theory behind hematidrosis is that it’s linked to the body’s “fight or flight” response; triggered by extreme fear, stress or physical exertion. The thought is that during high stress, tiny blood vessels in the body can rupture causing blood to seep into the sweat glands and then onto the skin. In other cases, hematidrosis may be a symptom of a medical condition like high blood pressure.
While hematidrosis is likely not serious, it should be discussed with a doctor. If stress is a potential trigger, addressing life situations will be important. For an ongoing hematidrosis problem, blood pressure medications, antidepressants, anti-anxiety medications, or meds that help control bleeding might be considered. Anxiety caused by seeing blood on the skin and related social issues should also be addressed.
Hyperhidrosis = Excessive Sweating
In people with hyperhidrosis (Hh or excessive, uncontrollable sweating), sweat glands are overactive; producing more sweat than is necessary as a reaction to temperature, exertion, stress, or simply living. Sweat may be four or five times more than "normal."
Research shows that 4.8% of the population is affected by Hh (~365 million people worldwide); this means that Hh is more common than autism, psoriasis and peanut allergies. Complications can include an increased (tripled) risk of skin infections and negatively impacted functionality at school, work and more. Some experts argue that Hh is perhaps the only chronic skin condition that directly affects people’s abilities to DO things.
There are two types of hyperhidrosis: primary vs. secondary. Secondary Hh is sweating that is caused by or is a symptom of another underlying medical condition or is a side effect of a medication. Ruling out or responding appropriately to secondary Hh is a crucial step because secondary Hh can be a symptom of another medical issue. If secondary Hh has been ruled out, healthcare providers solidify diagnosis of primary Hh by considering the following symptoms:
- A: Age of onset during childhood or adolescence (with facial sweating onset trending later).
B: Bilateral. Hh sufferers typically experience bilateral (on both sides of the body), symmetric involvement of palms, feet, face/scalp and/or underarms (or other body areas or combinations). For example, two feet with extreme sweating at the same time.
C: Cessation during sleep.
D: Duration. 2+ excessive sweating episodes per week for the past 6+ months.
E: Episodes of varying length/degree not related to hot conditions, exercise or stress. As stated above, 2+ excessive sweating episodes per week for the past 6+ months.
F: Family. 2/3rds of Hh sufferers indicate other family members have Hh, too.
G: Gets in the way. Hh gets in the way of sufferers’ abilities to function, work, develop relationships, and more.
Fortunately, there are treatment options to help control symptoms and sufferers can learn more about these on the IHhS website:
antiperspirants, iontophoresis, injections (Botox), microwave thermolysis (miraDry), topical anticholinergics (Qbrexza), oral anticholinergics, and surgical techniques.
The Hidrosis Family
Each “hidrosis” covered here has much in common: lack of awareness and understanding and potential embarrassment or anxiety. IHhS hopes that by getting all of these conditions out in the open, the organization can help sufferers to find ways to manage symptoms and feel better. IHhS wants to help more healthcare providers stay up-to-date on best practices in the full range of sweat-related diagnosis and care, too.
No matter the sweat issue, IHhS welcomes sufferers into its community. Check out IHhS' videos, podcasts, past blogs, and website for sweat-related news, research, and events. IHhS can also be found on social media:
Facebook @SweatingStopsHere, Twitter @WeKnowSweat, Instagram @WeKnowSweat.
About the International Hyperhidrosis Society
The International Hyperhidrosis Society (IHhS) was founded in 2003 by a team of dedicated advocates working alongside physicians respected worldwide for achievements in hyperhidrosis research and treatment. Today, IHhS remains the only independent, non-profit, global organization striving to improve quality of life among those affected by excessive sweating (as well as helping those with other sweat disorders.) IHhS’ mission focuses on reducing the symptoms, anxiety and social stigma associated with sweating problems. Its programs aim to improve hyperhidrosis and sweat awareness, education, research, and advocacy. Visit SweatHelp.org to learn more, to stay up-to-date with related news via the IHhS blog, to search a sweating-focused Physician Finder, and access related podcasts and videos. Connect on Facebook @SweatingStopsHere, Twitter @WeKnowSweat and Instagram @WeKnowSweat. You can also find the International Hyperhidrosis Society on YouTube and wherever you enjoy podcasts.
Angela Ballard, RN
International Hyperhidrosis Society