How to Tell If Your Excessive Sweating Could Be Hyperhidrosis
Take it from this Italian girl, the fear of sweating too much at the wrong moment or while wearing the wrong outfit (hello, silk!), is a very real thing. But where do you draw the line between normal and excessive sweating? Are aluminum chloride deodorants safe to useevery single day? And, is it OK (re: not unhealthy) to get sweat-halting Botox injections before a big event such as your wedding? (Asking for a friend). As it turns out, hyperhidrosis, aka excess sweating, is more common — and relative — than you might think.
What exactly is hyperhidrosis?
Hyperhidrosis is "the excessive production of sweat" by the body, explains Lily Talakoub, a board-certified dermatologist at McLean Dermatology in Vermont.
There are two types of hyperhidrosis: primary and secondary. Primary hyperhidrosis, which is the most common type, has no known underlying physical cause. "Primary hyperhidrosis is due to overactive signaling of sweat glands to secrete sweat without stimuli," explains New York City-based dermatologist Dhaval Bhanusali.
In other words, your body starts sweating without any explicable reason (like feelings of anxiety, hot temperatures, or exercise). This kind of hyperhidrosis can occur at any given time or during any season of the year, even if the person is not physically warm or is completely at rest. "Primary hyperhidrosis is most commonly seen in the underarms, palms, and soles of the feet," says Bhanusali.
Other less-common areas can also include the head, back, and even face. So basically, it can pretty much happen anywhere on your body.
Secondary hyperhidrosis is excessive sweating that's caused by an external factor such as medication or illness, like a tumor, diabetes, or thyroid issues.
Of these two types, there are also different degrees of hyperhidrosis that experts differentiate between: mild, moderate, and severe. "If you sweat through a shirt when you are at rest in normal temperature, I would say that is moderate hyperhidrosis," Talakoub says. "If you have sweat dripping down your hands and through your socks [when you're] at rest with no [other] triggers, then that is severe hyperhidrosis."
How can you tell the difference between normal and excessive sweating?
Of course, the next question then becomes: What's the threshold between normal and worrisome sweat levels? Are there any other symptoms to look out for that don't involve perspiration?
"Excessive sweating, or how someone perceives it, is very personal in that what might be excessive to you is normal or not troubling to somebody else," explains Lyall Gorenstein, surgical director at Columbia University Hyperhidrosis Center.
Because sweat is not really a quantifiable thing, like blood pressure, it's really complicated to measure someone's sweat levels throughout any given day. With enough time and "sophisticated equipment," it is doable, but even so, "there's a big variability in how much people sweat under similar situations," Gorenstein says. "So, it's hard to define exactly what hyperhidrosis is, but it could be something along the lines of: increased amounts of sweating, which causes social or personal embarrassment, withdrawal and/or avoidance behavior." That "sophisticated equipment" is known as an evaporimeter, says Gorenstein, and it's a machine that measures the rate of water evaporation (aka sweat).
That is, hyperhidrosis is a relative disorder and most people diagnose themselves. For someone whose job depends on their physical appearance, like an actor or a performer, sweating too much would be a bigger deal than to, say, someone who works from home.
Is hyperhidrosis treatable?
Good news: Yes, there are many treatment options, including topical creams, injections, and oral medications. What your physician prescribes will likely depend on the area where you're experiencing the hyperhidrosis as well as the severity.
The first line of treatment is usually topical aluminum chloride, which is the same ingredient in antiperspirant deodorants, just in prescription-strength form. The effectiveness of this treatment varies, depending largely on the severity of the sweating — generally the more severe it is the less likely that aluminum chloride products will be effective. They will, however, work for mild hyperhidrosis, although the creams have to be applied to the affected areas every day.
Another longer-lasting treatment, which you've probably seen advertised on TV and in magazines, is Botox therapy. Yes, the very same injectable that you might get to prevent wrinkles between your brows can also help stop excessive sweating. Experts agree that it is most effective in the underarm area, where it can work for up to six months. On other areas of the body, however, such as the hands and feet, Botox isn't the best line of treatment because it's both painful and only lasts two to three months, Gorenstein explains.
Another option that's new to market is Qbrexza, which is a medicated cloth towelette that temporarily stops sweating when worn in your underarms. Other possible options include laser treatments (also most effective in the underarm area) and even oral drugs such as beta blockers and antidepressants, although the results here are mixed and, of course, they also present other unwanted side effects.
For really, really extreme cases of hyperhidrosis, there's an endoscopic thoracic sympathectomy: an outpatient surgical procedure where signals in the sympathetic nerve in the chest are permanently interrupted.
For the rest of us who are perhaps prone to over-sweating, yet not to the point of seeking medical help, there's always trusty over-the-counter antiperspirants, like Secret's Clinical Strength Soft Solid Antiperspirant and Deodorant. Next time you're in the deodorant aisle in the drugstore, just look for stick or spray options that are formulated with aluminum chloride.
But is it unhealthy to stop sweating in certain areas of your body?
This was my biggest question because sweating happens naturally for a physiological reason, right? So, is stopping your body from its natural sweating process unhealthy in the long-term?
"No, not really," Gorenstein says. "The function of sweating is to eliminate waste products [from the body], but minimally compared to the liver and kidneys," he says. "Sweating [also] allows you to cool yourself as the body heats, but you have sweat glands all over your body so even if you're not sweating in your underarms, you're not ever going to overheat."
That being said, no, it's not "unhealthy" to say, get a shot of Botox in your underarms before a big event, or even to continue the treatment indefinitely. However, if you do think you have hyperhidrosis, it's very important to consult a board-certified dermatologist who can rule out any underlying medical causes.
More on deodorant:
Allure Editors Say These Are the Natural Deodorants That Actually Work
Dove Launched Its First Aluminum-Free Deodorant, and It's Really Good
Now see how deodorant has evolved within the last 100 years:
