Do you sweat on large areas of your body? Like your chest or back or buttocks and thighs? Are you "sweating everywhere"? Rest assured, you're not alone. We hear about this problem A LOT and we want to help you find treatment and relief.
The first step is to determine whether an underlying medical condition or a medication may be causing your sweating, in which case it would be called secondary hyperhidrosis because it is secondary to something else.
As with any type of sweating problem, it is important to find a knowledgeable physician to talk to about your all-over or large-area sweating. A physician, can look at your medical history, provide an examination, run necessary tests, consider medications you may be taking (tell your doctor about all medications you're using – including over-the-counter and herbal/natural products) and provide other professional insights.
To help you and your physician investigate your sweating problem, we've compiled lists of medications that can cause secondary hyperhidrosis as a side effect, and a list of diseases and conditions that can cause secondary hyperhidrosis. Of course, not everyone who takes one of these medications or who suffers from one of these conditions will experience excessive sweating and the lists are not exhaustive. They are provided as a starting point for a discussion with a physician. We encourage you to print them out and use them as part of a thorough investigation into what may be causing a your sweating problem. If a medication or another medical condition is causing excessive sweating, you and your doctor can discuss ways to treat the problem or mitigate the side effect.
So, how do you know which type of hyperhidrosis (primary or secondary) you have? And how do you know where to turn for help?
"It's actually pretty easy to figure out," says Toronto dermatologist and IHHS Board Member Dr. Nowell Solish, co-author of "Focal Hyperhidrosis: Diagnosis and Management" (Canadian Medical Association Journal, Jan. 4, 2005.) "With secondary hyperhidrosis, the onset is sudden."
Unlike secondary hyperhidrosis, primary hyperhidrosis tends to be a longstanding medical condition that usually begins before age 25. Primary hyperhidrosis can affect one or more body areas, most often the palms (called palmar hyperhidrosis), armpits (called axillary hyperhidrosis), soles of the feet (called plantar hyperhidrosis) or face (called craniofacial hyperhidrosis) and sometimes the back, chest, groin, and under the breasts in men and women. Secondary hyperhidrosis, on the other hand, is typically generalized, involving the whole body. This type of excess sweat may seem to come on for no apparent reason – although a closer look will usually reveal a root problem.
"Someone comes in and says, 'I'm 52 years old, and I just got it.' I'm a little more suspicious than if someone comes in and says, 'I'm 12 years old, and I've got it under my arms and nowhere else.' That fits the classic build, and I don't worry," says Solish, who treats hundreds of patients at his Sweat Clinics of Canada where he specializes in Botox injections for hyperhidrosis.
Tyring to figure out if you have primary or secondary hyperhidrosis? Ask yourself a few questions as outlined by St. Louis dermatologist Dr. Dee Anna Glaser (and published in the Journal of the American Academy of Dermatology, 2004, Vol. 51, P. 274-86). Dr. Glaser is one of the founders of the International Hyperhidrosis Society and an internationally recognized expert in hyperhidrosis.
First, says Glaser, ask yourself if you have been experiencing episodes of focal, visible, excessive sweating for at least six months without apparent cause. (Focal sweating is sweating at specific body areas - like on the hands, or feet, or in the armpits.)
If the answer is "yes," then the next step is determining whether you meet TWO or more of the following criteria:
- Your sweat is bilateral and relatively symmetrical (you sweat the approximately same amount on both sides of your body. )
- Your excess sweat impairs your daily activities.
- You experience at least one excessive sweating episode a week.
- The onset of your excessive sweating was earlier than age 25.
- You have a positive family history (other members of your family suffer from similar sweating problems.)
- You stop sweating when you're sleeping.
If you meet at least two of the above criteria, chances are you have primary hyperhidrosis, and you should make an appointment with a medical professional familiar with treatment options for people with hyperhidrosis. Some dermatologists believe more than 90% of people who present with excessive sweating will be diagnosed with primary hyperhidrosis.
"Certainly we know that hyperhidrosis seems to affect at least 3% of the population, if not more, depending on which research is looked at," says Dr. Glaser. "That's pretty consistent around the globe. For the dermatological community, most patients that we see are more likely to be in that primary category."
If you don't meet the criteria for primary hyperhidrosis, then it gets a little more complicated, as your doctor may end up needing to do a complete workup to determine why you are sweating excessively. The cause may be as simple as a new medication you've been taking. Or, you might be suffering from one of a range of medical conditions – most commonly an infective or malignant disease or another medical disorder such as cancer, diabetes or gout. A hormonal imbalance related to pregnancy or menopause could be another potential root cause. For a list of medications and diseases that can cause excess sweat, click here. Keep in mind that no such list is exhaustive.
A person who thinks he or she is suffering from secondary hyperhidrosis should seek help from a general practitioner, ideally an internal medicine specialist. It's important to find the right doctor (see our section on choosing the right doctor) who will delve deep enough to find the cause of the excessive sweating.
"Generalized excessive sweating can occur in response to so many different medical conditions, disease states and medication treatments," says Dr. Glaser. "It's kind of a moving target depending on what kinds of medications are being used for different problems."
If you see one physician and don't get the sense that the answer given is sufficient or satisfying, you may need to seek out a second opinion. Sometimes that first response is: 'Don't worry about it. It's not going to kill you.' If you get an answer like that, and it's not satisfying to you, go ahead and seek out another opinion.
Whatever the reason for your excessive sweating, there are people in the medical community who want to help. Finding a physician sympathetic to and experienced in treating patients with hyperhidrosis may be as simple as going to our physician finder and, within seconds, you will have the names and phone numbers of physicians in your region. The "IHHS Educated" notation means the physician is not only familiar with treatment options for hyperhidrosis, but also that he or she has attended at least one of our educational events.
If medications and medical conditions have been ruled out, we encourage you to learn more about treatments for different body areas and consider a combination of treatments for the most troublesome body areas. For instance we have sections on: sweaty underarms, sweaty hands or sweaty palms, sweaty feet, sweaty face and even information for those who experience excessive sweating in other areas like groin, the breasts, and back.
This site also provides an extensive collection of insurance and reimbursement tools, including downloadable forms that can help you work with your physician and health insurance plan to get coverage for necessary hyperhidrosis treatments.
Don't let fear or embarrassment keep you from seeking out the attention you need and deserve. Remember you are not alone. We are here to serve and help you on your path to care and relief!
For updates about new hyperhidrosis research, the latest treatments, and daily management tips, sign-up for our news blog. We also have an extensive library of hyperhidrosis research articles from peer-reviewed medical journals, so you can see and share reliable medical data with your physician.
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