Excessive sweating is defined as excessive sweating for the needs of the body. It can cause significant discomfort on a daily basis. Treatments can provide relief by reducing sweat production.

Sweating is an essential mechanism for the proper functioning of the body. Sweat is produced by the body for the purposes of thermoregulation, that is, to balance body temperature at 37 ° C.

When the body temperature rises, the brain controls perspiration to remove heat from the body and cool it. Sweat also helps maintain skin hydration. It is produced by the sweat glands, found in the dermis, the deep layer of the skin. There are between two and four million in the body. Although present everywhere on the surface of the body, these glands are mainly present in the palms of the hands, the soles of the feet, the armpits, the genital area, the forehead and the cheeks. In the normal state, the body produces approximately 0,5 L of odorless sweat per day.

Excessive sweating is defined by sweating more than “normal”, that is to say more than what the body needs to regulate its temperature. Also called hyperhidrosis, it affects up to 3% of the population. In 90% of cases, it is localized to an area of ​​the body, most often the armpits, palms of the hands or the soles of the feet, but it can also be generalized. Excessive sweating can range from excessive sweating to runoff.

Sweating can be difficult to quantify. Here are some signs that can identify this symptom:

• excessive sweating making it necessary to shower and / or change clothes several times a day;
• hands that get wet easily, to the point of making it difficult to hold a steering wheel, work at a computer, use tools or shake hands with someone else;
• the body sweating so much that the affected person is afraid to play sports or dance with other people.

Excessive sweating is linked to hyperstimulation of the sweat glands. It can be primary or secondary.

Primary hyperhidrosis is the most common. Most often localized, it begins in childhood, is aggravated by puberty, tends to decrease after 40 years and can reappear during menopause. Episodes of excessive sweating are often triggered by certain factors such as:

• the stress ;
• strong emotion;
• great heat;
• consumption of alcohol or spicy food;
• physical effort.

Excessive sweating is the consequence of a disorder of the nervous system which causes the production of sweat while the body is at the right temperature. This disturbance has no known cause. In 25% of cases, there is a genetic character (another member of the family is affected).

Secondary hyperhidrosis is the consequence of another event in the body. It can result from:

• taking medication;
• menopause;
• overweight;
• anxiety disorders;
• hyperthyroidism;
• trauma;
• a tumor;
• or a genetic, metabolic, neurological or even endocrinological disease.

It is often due to a neurological lesion causing overactivation of the nervous system in charge of the sweat glands.

The excessive sweating is most often not serious. However, it can have a significant impact on the quality of life and can have a significant psychological impact. It can be at the origin of a withdrawal into oneself, which can lead to the possible appearance of anxiety or depression. Excessive sweating can result in sometimes very significant socio-professional discomfort.

Hyperhidrosis can also cause skin problems like nail and skin fungus or warts, especially if it affects the hands, feet or armpits.

In case of really heavy sweating, you have to be careful of the risk of dehydration. This is even more problematic in fragile people, such as children or the elderly or during periods of extreme heat or heatwave.

The first thing to do is to assess the impact of excessive sweating on the patient’s quality of life. Treatment will be implemented depending on the discomfort felt. The doctor has at his disposal questionnaires as well as objective tools to carry out this evaluation. He can then suggest a treatment:

• Antiperspirant or antiperspirant product. The sweat glands are blocked;
• Iontophoresis. The affected area is immersed in water through which an electric current of low intensity passes. The sessions last about twenty minutes and should be repeated three to six times a week. About ten sessions are generally necessary before obtaining a response;
• Botulinum toxin. This option is only used in the event of failure of the previous ones and a very significant impact of excessive sweating on the patient’s life. The toxin is injected into the affected area and stops the production of sweat;
• Sympathectomy. In cases where excessive sweating is really problematic and resistant to treatment, it is possible to consider surgery to cut the nerves that trigger sweating in the problematic areas. However, in 10-40% of cases, this procedure is followed by compensatory sweating in other parts of the body.

In the case of secondary sweating, treatment depends on the underlying cause.

If the sweating is considered to be too much and bothersome on a daily basis, it is important to consult the attending physician in order to be offered a solution.