Excessive Sweating

Woman with excessive sweating

Excessive sweating is a condition which can be extremely embarrassing.  Thankfully there are treatment options that really work.

Excessive sweating is also known as hyperhidrosis.  Other terms used include excessive perspiration or diaphoresis.

The purpose of our sweat glands is to provide temperature regulation when we are exposed to hot temperatures or during exercise.

Hyperhidrosis occurs when our sweat glands produce sweat beyond what is required by our body to regulate our temperature.

Diaphoresis can be categorized as primary or secondary.  Primary, or essential, hyperhidrosis is when the condition is not caused by a medical condition or medications.  Secondary hyperhidrosis is defined as hyperhidrosis caused by secondary causes such as a medical condition or medications.

Primary diaphoresis usually affects the hands and feet and can also sometimes include the armpits.  Approximately, 0.6% to 1% of the population are affected by this issue.  Heat and emotional stimulus are the triggers for primary excessive perspiration.  Emotional stimulation is the major factor influencing increased sweating in these cases.

Excessive sweating can further be categorized as generalized or localized (also known as focal).  Examples, of localized hyperhidrosis are axillary (armpit) diaphoresis or plantar (foot) diaphoresis.  Generalized excessive perspiration means that a person sweats all over their body.

Generalized excessive sweating usually begins in adolescence.

Sweating is an activity regulated by the sympathetic nervous system.  The nerves of the sweat glands are sympathetic postganglionic fibers.  The major neurotransmitter controlling signals to these nerve fibers in the sweat glands is acetylcholine.

Due to their effects on acetylcholine levels, drugs that can increase sweating include cholinesterase inhibitors, opioids, selective serotonin reuptake inhibitors (SSRIs) and paradoxically tricyclic antidepressants (this is paradoxical becauses they block the effects of acetylcholine).

There are also drugs which can decrease effects of acetylcholine on sweat glands and therefore lead to reduced sweating and poor heat regulation.  These drugs include antimuscarinic anticholinergic agents, carbonic anhydrase inhibitors and tricyclic antidepressants.  Dry mouth often accompanies the decrease in perspiration experienced with these drugs.

Treatments for diaphoresis include antiperspirants and Botox treatments.

You may also wish to learn about body odor.