Hi, I'm Cathy with Level Up RN. In this episode of Ask a Nurse, I'll be answering your questions about hyperhidrosis, or excessive sweating, such as what causes hyperhidrosis and how is hyperhidrosis diagnosed and treated? Hyperhidrosis is excessive sweating, and this condition affects approximately 3% of the US population. So sweating is definitely important for temperature regulation in the body. It helps to cool the body off when it gets too hot. However, with hyperhidrosis, the nerves that control the sweat glands in your body are overstimulated, which results in excessive sweating. Hyperhidrosis is classified as primary or secondary. So primary hyperhidrosis typically occurs earlier in life and affects the armpits, palms, soles of the feet, and/or face. There is no known medical cause for primary hyperhidrosis, but genetic factors are believed to play a role in its development, so it tends to run in families.
Secondary hyperhidrosis typically occurs later in life and causes sweating that affects the entire body. So secondary hyperhidrosis is typically caused by a medical condition such as diabetes, hyperthyroidism, or an infection, for example. It can also be caused by certain medications such as antidepressants, diabetes medications, and pain relievers. In terms of diagnosis, your provider will review your medical history and your symptoms. And if secondary hyperhidrosis is suspected, then your provider may order blood and/or urine tests to identify any underlying medical disorders. And then a test called an iodine starch test may be used to assess the severity of your sweating and the specific areas affected.
Treatment of hyperhidrosis typically follows a stepwise approach. First-line therapy often includes prescription or over-the-counter aluminum chloride-based antiperspirants. In addition, prescription cloth wipes that contain glycopyrronium tosylate are also available to help reduce sweating. A common side effect with all of these topical agents is skin irritation. If topical treatments are ineffective at controlling sweating, then an oral medication can be prescribed. This may include an anticholinergic medication such as oxybutynin, which works by blocking stimulation of the sweat glands. So oxybutynin and other anticholinergic medications do carry side effects such as dry eyes, dry mouth, urinary retention, and constipation.
If topical and oral therapy are ineffective, there are other options to treat hyperhidrosis. One is something called iontophoresis. This is a therapy that can be performed at home where you place your hands or feet in water, and a device emits a mild electrical current to block the nerves that control sweating. So treatment sessions typically last between 20 and 40 minutes, and 6 to 10 sessions are typically required. Botulinum toxin A, or Botox injections, can also be used to treat hyperhidrosis. These injections work by blocking the nerves that control sweating, which can decrease sweating for about four to six months. However, it's important to note that Botox injections can be expensive, and repeat treatments are required. Other available and emerging treatment options for hyperhidrosis include microwave therapy, laser therapy, fractional microneedle radiofrequency, and ultrasound therapy.
For persistent and severe symptoms that are resistant to treatment, there are surgical options available. This includes surgery to remove the sweat glands from the armpits, as well as a procedure called a sympathectomy, which involves disconnecting the nerves that control sweating. So these surgical procedures do carry risks and have the potential for very serious side effects. So it's important to get detailed information about these procedures from your provider. Okay. That is it for this episode of Ask a Nurse. If you have any health concerns or questions you would like me to address in a future episode of Ask a Nurse, then definitely leave those in the comments. Stay informed and stay well.
