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Alternative Names: Hyperhidrosis.
Excessive or profuse sweating is a medical condition with many possible causes. Because it is not a disease, it can be a symptom of another medical condition such as a disorder of the nerves.
Sweating is a normal bodily function that serves to cool off and lubricate the skin, especially in areas that may rub against other areas of skin, such as under the arms, under the breasts, and between the legs. Special microscopic glands (sweat glands) in the deep layer of the skin (the dermis) produce sweat by filtering fluid and salts out of the blood and secreting this fluid through small tubes in the skin (sweat ducts) that empty out into small pores at the top layer of the skin (the stratum corneum).
Some areas of the skin have many sweat glands, while other areas have relatively few; they are present in the highest concentration in the palms of the hands and soles of the feet. In addition to sweat glands, skin also has oil glands that surround almost every hair root (the sebaceous glands). Finally, in some areas such as the underarm and the groin, there is found a special sweat gland called the apocrine gland, which secretes a very thick type of sweat that has a large amount of fatty chemicals in it. These chemicals can be broken down by bacteria on the surface of the skin to create the smelly chemicals that are mostly responsible for body odor.
Two different sets of nerves supply these many glands: the sympathetic nerves, which tend to increase sweating when one is excited, nervous, or afraid (the "fight or flight response"), and the parasympathetic nerves, which tend to decrease sweating of the skin. At the ends of these nerves, the body releases special chemicals called neurotransmitters, which carry the electrical signal from the nerves onto the cells near the nerve endings. For the sweat glands, the chemical at the tips of the sympathetic nerves is acetylcholine; too much of this chemical present next to the sweat glands stimulates them to produce large amounts of fluid. Many doctors feel that one of the biggest problems in people with idiopathic hyperhidrosis (excessive sweating due to unknown cause) is the fact that the sympathetic nerves are over stimulated, making the neurotransmitters "go haywire" at the nerve endings. Many activities that stimulate the nervous system, such as strong smells, spicy foods, increased air temperatures, exercise, high emotional excitement, stress or nervousness may cause attacks of excessive sweating through sympathetic nerve over activity.
Causes & Development
For some people, there may be no detectable cause for their excessive sweating, and they may be considered to have a medical condition known as essential (idiopathic or primary) hyperhidrosis. This may be due to over activity of the nerves that send signals to the sweat glands in the skin, the sympathetic nervous system. Sometimes this idiopathic form of hyperhidrosis can be genetically transmitted, and it often runs in families; this form may first show up in early childhood.
Other people may have sweating as a symptom of known medical conditions, such as:Many people who have hyperhidrosis may also have reddening of the skin, which is most noticeable in the face as blushing, due to the same nerve over-activity. Some medications may by themselves cause excessive sweating, such as the medications often used for prostate cancer, AIDS, or pyridostigmine (Mestinon™) used for the condition myasthenia gravis. Obesity and exercise are other obvious causes.
Treatment & Prevention
Sweaty palms (Palmar Hyperhydrosis) in a tense or high-anxiety moment is perfectly normal and will ease up once the moment has passed.
In order to decrease general sweating, one has to either cut down the nerve impulses to the sweat glands, cut down on the acetylcholine, destroy the glands, or block off their ducts, so that the sweat cannot flow out onto the skin. One of the main ways to cut down sweating is to use a medicine on the surface of the skin to cause the sweat to thicken and plug up the ducts, which is how the antiperspirants that are often used under the arms to decrease underarm sweat and odor work. These usually contain aluminum metal salts, such as aluminum chloride, which have to be frequently reapplied, or else the clumps in the ducts will get dissolved, unblocking the ducts and permitting sweating.
The sweat glands themselves can be destroyed, but since they are so small and numerous, and are located deep in the skin, methods such as electrolysis (which uses electric currents to destroy the hair roots) are not very practical. If only a particular area of the skin, such as the underarms, is causing sweating problems, there have been some reports on the use of liposuction to remove the apocrine sweat glands there [Rowland Payne C & Doe PT, Liposuction for axillary hyperhidrosis, Clinical and Experimental Dermatology 1998, 23: pp.9-10].
Electric currents through the skin - called iontophoresis - may disrupt the function of the sweat glands, preventing them from working for a long time. With the use of a home operated device, a small electric current is sent through the skin from one area to another. The electric current "shocks" the sweat glands, and they stop making sweat until they recover. By using this machine a few times per week, dryness in the area of treatment can be obtained that can last for weeks. This may work well if only a few small areas of skin have the excessive sweating problem, but requires frequent treatments.
The nervous supply to the sweat glands can be interrupted by cutting or destroying the sympathetic nerves. Since these nerves are extremely small, they are usually reached at areas near the spinal cord, where many nerves run together into structures known as sympathetic ganglia, before they spread out throughout the body. This produces one of the most effective treatments against sweating - thoracic nerve snipping surgery, which has permanent effect. Once the nerves are cut or destroyed, the sweat glands that are supplied by those nerves stop secreting sweat; in addition, other parts of the skin also lose their sympathetic nerve supply, so the skin may lose its ability to control its temperature and blood flow. This may lead to paleness and coldness of the skin where its nerve supply has been disrupted. People who suffer from blushing may find this side-effect desirable, as they will lose the ability to blush in those areas affected by the surgery.
Medication may be taken internally that works to block the neurotransmitter, acetylcholine, from stimulating the sweat glands. Some of the more useful medications include the anticholinergics (such as glycopyrrolate or atropine), some antihistamines, some antidepressants, and some of the tranquilizers. However, these medications will also affect other parts of the body, and may have side-effects, including dry mouth, drying of other secretions or constipation.
One new approach that may work on small areas of skin that have excessive sweating is to inject botulinum toxin (Botox®) into small areas of the skin (such as the underarms), which blocks the acetylcholine for up to 12 months before it wears off.
Home remedy for sweaty hands or feet: Boil five tea bags in a quart of water for five minutes. When the solution cools, soak your hands or feet for twenty to thirty minutes nightly. Tea contains tannic acid, which is also found in commercial products such as Zilactol, and Zilactin. The astringent properties of tannic acid are thought to be partly responsible for its antiperspirant action.
Complications
The apocrine glands can occasionally get diseased or infected, and may lead to a condition known as hidradenitis suppurativa, which is a serious medical condition that may require antibiotics or surgery to cure the disorder.
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Signs, symptoms & indicators of Excessive Sweating:
Risk factors for Excessive Sweating:
Recommendations and treatments for Excessive Sweating: | | | | | Diet |  Caffeine/Coffee Avoidance | Caffeine and medications may be the cause of excess sweating. Reduce your caffeine intake and note if there are changes when you stop taking medication. |
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Drug |
 Conventional Drug Avoidance| | Medications may be the cause of excess sweating. Note if there are changes when you stop taking medication (only do so under the supervision of your doctor.) |
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KEY | | Weak or unproven link |  | | Strong or generally accepted link |  | | Proven definite or direct link | | | May do some good | | | Likely to help |
GLOSSARY
Acetylcholine
A neurotransmitter widely distributed in body tissues with a primary function of mediating synaptic activity of the nervous system and skeletal muscles.
AIDS
Acquired Immune Deficiency Syndrome. An immune system deficiency disorder that suddenly alters the body's ability to defend itself. The AIDS virus invades the T4 helper/inducer lymphocytes and multiplies, causing a breakdown in the body's immune system, eventually leading to overwhelming infection and/or cancer, with ultimate death.
Antidepressant (Antidepressants)
Literally, substances meant to oppose depressions or sadness, and generally heterocyclic types such as Elavil, MAO inhibitors like phenelzine, or lithium carbonate. This category of substances formerly included stuff like amphetamines and other stimulants. Botanical examples include Hypericum, Peganum and Oplopanax.
Anxiety
Apprehension of danger, or dread, accompanied by nervous restlessness, tension, increased heart rate, and shortness of breath unrelated to a clearly identifiable stimulus.
Apocrine
Secretory glands, especially found in the armpit and groin, that secrete oily sweat derived from shed cell cytoplasm, and which contain aromatic compounds that possess emotional information for those nearby. Examples: The smell of fear; the scent released after orgasm.
Astringent
Agent causing contraction, especially after topical application.
Axillary
Pertaining to the region of the armpits.
Bacteria (Bacterial, Bacterium)
Microscopic germs. Some bacteria are "harmful" and can cause disease, while other "friendly" bacteria protect the body from harmful invading organisms.
Boil (Abscess, Abscesses, Boils, Carbuncle, Carbuncles, Cystic Acne, Furuncle, Furuncles, Hidradenitis Suppurativa, Pilonidal Cyst, Pilonidal Cysts)
A localized infection deep in the skin. A boil generally starts as a reddened, tender area. Over time, the area becomes firm and hard. Eventually, the center of the abscess softens and becomes filled with white cells that the body sends to fight the infection (pus). Finally, the pus forms a "head" and drains out through the skin. A furuncle or carbuncle is an abscess in the skin caused by the bacteria Staphylococcus aureus. It can have one or more openings onto the skin and may be associated with a fever or chills. Cystic acne is a type of abscess formed when oil ducts become clogged and infected. Cystic acne is most common in the teenage years. Hidradenitis suppurativa is an illness in which there are multiple abscesses that form under the arm pits and in the groin area. These areas are a result of local inflammation of the sweat glands. A pilonidal cyst is a special kind of abscess that occurs in the crease of the buttocks. These frequently form after long trips that involve sitting.
Cancer
Refers to the various types of malignant neoplasms that contain cells growing out of control and invading adjacent tissues, which may metastasize to distant tissues.
Constipation (Constipated)
Difficult, incomplete, or infrequent evacuation of dry, hardened feces from the bowels.
Diabetes Mellitus (Diabetes, Diabetic, Diabetics)
A disease with increased blood glucose levels due to lack or ineffectiveness of insulin. Diabetes is found in two forms; insulin-dependent diabetes (juvenile-onset) and non-insulin-dependent (adult-onset). Symptoms include increased thirst; increased urination; weight loss in spite of increased appetite; fatigue; nausea; vomiting; frequent infections including bladder, vaginal, and skin; blurred vision; impotence in men; bad breath; cessation of menses; diminished skin fullness. Other symptoms include bleeding gums; ear noise/buzzing; diarrhea; depression; confusion.
Ganglion (Ganglia)
A group of nerve cell bodies clustered together in a uniform mass outside of but often close to the brain or spinal chord. Nerves run to or from the ganglia in passage to or from the brain to specific sites on the body.
Gland (Glands)
The glandular system is one of the most important and complicated systems of the body. Gland tissue can be either an organ or general tissue that secretes chemicals and there are two types of gland: exocrine and endocrine. Those glands which secrete chemicals through tubules or ducts are called exocrine and include sweat, tear and salivary glands. Ductless glands - part of the endocrine system - secrete special chemicals (hormones) directly into the blood.
Gout
A disease characterized by an increased blood uric acid level and sudden onset of episodes of acute arthritis.
Hyperhidrosis
Excessive sweating.
Hyperthyroidism (Hyperthyroid)
An abnormal condition of the thyroid gland resulting in excessive secretion of thyroid hormones characterized by an increased metabolism and weight loss.
Hypoglycemia
A condition characterized by an abnormally low blood glucose level. Severe hypoglycemia is rare and dangerous. It can be caused by medications such as insulin (diabetics are prone to hypoglycemia), severe physical exhaustion, and some illnesses.
Idiopathic
Arising spontaneously or from an obscure or unknown cause.
Liver (Hepatic)
The largest and one of the most complex organs of the body, the liver is responsible for much of the metabolism of fats, proteins and carbohydrates. It is the site of much of the body's detoxification. It is connected very closely with digestion and the regulation of blood sugar, among many other functions. Found behind the ribs on the right side of the abdomen, it has many important functions such as removing harmful material from the blood, making enzymes and bile that help digest food, and converting food into substances needed for life and growth. Hepatic: Pertaining to the liver.
Lymphoma (Lymphomas)
Any tumor of the lymphatic tissues.
Menopause (Menopausal)
The cessation of menstruation (usually not official until 12 months have passed without periods), occurring at the average age of 52. As commonly used, the word denotes the time of a woman's life, usually between the ages of 45 and 54, when periods cease and any symptoms of low estrogen levels persist, including hot flashes, insomnia, anxiety, mood swings, loss of libido and vaginal dryness. When these early menopausal symptoms subside, a woman becomes postmenopausal.
Metabolism (Metabolic, Metabolize, Metabolizes, Metabolizing)
The chemical processes of living cells in which energy is produced in order to replace and repair tissues and maintain a healthy body. Responsible for the production of energy, biosynthesis of important substances, and degradation of various compounds. Also defined as the sum total of changes in an organism in order to achieve a balance (homeostasis): Catabolic burns up, anabolic stores and builds up; the sum of their work is metabolism.
Nervous System
A system in the body that is comprised of the brain, spinal cord, nerves, ganglia and parts of the receptor organs that receive and interpret stimuli and transmit impulses to effector organs.
Neurotransmitters (Neurotransmitter)
Chemicals in the brain that aid in the transmission of nerve impulses. Various Neurotransmitters are responsible for different functions including controlling mood and muscle movement and inhibiting or causing the sensation of pain.
Panic Attack (Panic Attacks)
A brief, irrational episode of fear that is perceived as so real that an individual may be driven to escape from the place or situation where it occurs. The attack is sudden and increases in severity until it leaves, usually within ten minutes. Panic attack symptoms are numerous and involve both mental and physical signs and symptoms. A panic attack can occur in other anxiety states such as agoraphobia and with certain activities and places. It may occur spontaneously without an apparent cause.
Parasite (Parasites, Parasitic, Parasitical)
An organism living in or on another organism.
Parasympathetic
Usually Parasympathetic nervous system: Portion of the autonomic nervous system that is generally associated with increasing digestion and intestinal muscle activity; decreasing blood circulation and respiration.
Prostate
The prostate gland in men that surrounds the neck of the bladder and the urethra and produces a secretion that liquefies coagulated semen.
Rheumatoid Arthritis
A long-term, destructive connective tissue disease that results from the body rejecting its own tissue cells (autoimmune reaction).
Sebaceous (Sebaceous Cyst)
Sebaceous Gland: Oil secreting glands, mostly clustered around hair follicles. The oil (sebum) is released into the oil glands from the disintegrated cytoplasm of shedding holocrine cells that line the alveolar surfaces. The nature of the secretion is often a direct reflection of the state of the body's lipid metabolism.
Sympathetic Nervous System
Portion of the autonomic nervous system that is generally associated with “flight or fight” reactions by increasing blood circulation and respiration and decreasing digestion.
Thyroid (Thyroid Gland)
The thyroid gland is an organ with many veins, anchored around the front of the throat near the voice box. It is essential to normal body growth in infancy and childhood. It absorbs iodine from the diet and releases thyroid hormones - iodine-containing compounds that help govern the rate of the body's metabolism (its total life processes), affecting body temperature, and regulating protein, fat and carbohydrate catabolism in all cells. They keep up growth hormone release, skeletal maturation, and heart rate, force, and output. They promote central nervous system growth, stimulate the making of many enzymes, and are necessary for muscle tone and vigor. To a high degree, metabolism is regulated by the hormone thyroxine, which can be made by the thyroid if enough organic iodine is available. An enlarged thyroid gland that is not cancer is sometimes called goitre.
Tuberculosis
Also known as TB, Consumption or "The White Plague", tuberculosis is an infectious disease caused by a bacterium called Mycobacterium tuberculosis, usually affecting the lungs but possibly also the brain, kidneys and bones. Patients may at first be symptom-free or experience a flu-like illness. In the secondary stage, there might be a slight fever, night sweats, weight loss, fatigue and various other symptoms, depending on the part of the body affected. Tuberculosis of the lung is usually associated with a dry cough that eventually leads to a productive cough with blood-stained sputum. There might also be chest pain and shortness of breath.
Last updated: Sep 28, 2008
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