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Hyperhidrosis is excessive sweating that occurs even when the temperature isn’t hot and you’re not exercising. In some people who have hyperhidrosis, the sweat literally drips off their hands. You sweat more than usual and you experience night sweats for no apparent reason.

Hyperhidrosis usually affects the palms of the hands, soles of the feet and underarms. Besides disrupting normal daily activities, hyperhidrosis can cause social anxiety or embarrassment.

One of the first options for treatment involves using prescription-strength antiperspirants on the affected areas. In severe cases, your doctor may suggest surgery either to remove the sweat glands or to disconnect the nerves responsible for the overproduction of sweat.

Symptoms

Most people sweat when they exercise or exert themselves, are in a hot environment, or are nervous, anxious or under stress. The excessive sweating experienced with hyperhidrosis far exceeds such normal sweating.

Hyperhidrosis usually affects the hands, feet, underarms and sometimes the face. Rarely, the entire body is affected. The excessive sweat may soak through clothes or drip off your hands. Episodes usually occur at least once a week without an obvious reason.

Causes of Hyperhidrosis

Sweating is your body’s mechanism to cool itself. Your nervous system automatically triggers your sweat glands when your body temperature rises. Sweating also normally occurs, especially on your palms, when you’re nervous.

In hyperhidrosis, the nerves responsible for triggering your sweat glands become overactive and call for more perspiration even when it’s not needed. The problem worsens if you’re under stress or nervous.

The type of hyperhidrosis that occurs primarily in your palms and soles may have a genetic component, because it sometimes clusters in families. If you have excessive sweating all over your body, it may be caused by an underlying health factor, such as:

Certain medications

Menopause

hot flashes

Low blood sugar

Overactive thyroid gland

Some types of cancer

Heart attack

Infectious disease

Complications of Hyperhidrosis

Infections. People who sweat profusely are more prone to skin infections. These infections can range from ringworm to warts.Other skin conditions. Certain skin conditions, such as eczema and skin rashes, occur more frequently in people with hyperhidrosis. Excessive sweating may worsen skin inflammation.

Social and emotional effects. Having clammy or dripping hands and perspiration-soaked clothes can be embarrassing. Palm sweat can soak into paperwork, affecting occupational and educational pursuits.

Tests and Diagnosis

During your appointment, your doctor will ask about your medical history and conduct a physical exam. If your symptoms are obvious, it may be relatively easy for your doctor to diagnose hyperhidrosis.

Lab tests
Your doctor may order blood or urine tests to determine if the excessive sweating is caused by another medical condition, such as an overactive thyroid (hyperthyroidism) or low blood sugar (hypoglycemia).

Thermoregulatory sweat test: During this test, your skin is coated with a powder that changes color when it gets wet. The test begins in a room heated to a comfortable temperature, and then you enter a heating cabinet that brings your core temperature up to 100.4 F (38 C). Most people who have hyperhidrosis sweat enough to make the powder turn purple before they go into the heating cabinet.

Treatment and Drugs

Hyperhidrosis treatment varies, depending on the severity of the problem. In most cases, your doctor will want to try conservative treatments before suggesting more-invasive options such as surgery.

Drugs used to treat hyperhidrosis may include:
Prescription antiperspirant. If over-the-counter antiperspirants don’t help, your doctor may prescribe stronger products to apply at bedtime. Prescription-strength antiperspirants can cause skin irritation, so wash the product off your body in the morning. If your skin becomes irritated, hydrocortisone cream might help.
Pills that block nerve communication. Some oral medications block the chemicals that permit certain nerves to communicate with each other. This can reduce sweating in some people, but can also cause dry mouth, blurred vision and bladder problems.
Botulinum toxin injections. Commonly used to help smooth facial wrinkles, botulinum toxin (Botox, Myobloc, others) can also block the nerves that trigger sweat glands. However, each affected area of your body will need several injections, which are painful and expensive. And the effects may last for only a few months.

Iontophoresis. In this procedure, a dermatologist uses a device to deliver a low level of electrical current to the hands or feet, and sometimes the armpits, while that part of the body is immersed in water. Treatments are often performed once a day for several weeks, followed by less frequent maintenance therapy.
Sweat gland removal. If excessive sweating occurs just in your armpits, removing the sweat glands there may help. This can be accomplished via liposuction through very small incisions.
Nerve surgery. In severe cases of hyperhidrosis, your doctor might suggest a procedure that cuts, burns or clamps the spinal nerves that control sweating in your hands. In some cases, this procedure triggers excessive sweating in other areas of your body

Eczema is a condition that makes your skin red and itchy. It’s common in children but can occur at any age. Atopic dermatitis is long lasting (chronic) and tends to flare periodically and then subside. It may be accompanied by asthma or hay fever.

No cure has been found for atopic dermatitis. But treatments and self-care measures can relieve itching and prevent new outbreaks. For example, it helps to avoid harsh soaps and other irritants, apply medicated creams or ointments, and moisturize your skin.

Symptoms Of Dermatitis

Atopic dermatitis (eczema) signs and symptoms vary widely from person to person and include:

Itching, which may be severe, especially at night

Red to brownish-gray patches, especially on the hands, feet, ankles, wrists, neck, upper chest, eyelids, inside the bend of the elbows and knees, and, in infants, the face and scalp

Small, raised bumps, which may leak fluid and crust over when scratched

Thickened, cracked, dry, scaly skin

Raw, sensitive, swollen skin from scratching

Atopic dermatitis most often begins before age 5 and may persist into adolescence and adulthood. For some people, it flares periodically and then clears up for a time, even for several years.

Factors that worsen atopic dermatitis

Most people with atopic dermatitis also have Staphylococcus aureus bacteria on their skin. The staph bacteria multiply rapidly when the skin barrier is broken and fluid is present on the skin. This in turn may worsen symptoms, particularly in young children.

Factors that can worsen atopic dermatitis signs and symptoms include:

Dry skin, which can result from long, hot baths or showers

Scratching, which causes further skin damage

Bacteria and viruses

Stress

Sweat

Changes in heat and humidity

Solvents, cleaners, soaps and detergents

Wool in clothing, blankets and carpets

Dust and pollen

Tobacco smoke and air pollution

Eggs, milk, peanuts, soybeans, fish and wheat, in infants and children

Atopic dermatitis is related to allergies. But eliminating allergens is rarely helpful in clearing the condition. Occasionally, items that trap dust — such as feather pillows, down comforters, mattresses, carpeting and drapes — can worsen the condition.

Causes of Dermatitis

The exact cause of atopic dermatitis (eczema) is unknown. Healthy skin helps retain moisture and protects you from bacteria, irritants and allergens. Eczema is likely related to a mix of factors:

Dry, irritable skin, which reduces the skin’s ability to be an effective barrier

A gene variation that affects the skin’s barrier function

Immune system dysfunction

Bacteria, such as Staphylococcus aureus, on the skin that creates a film that blocks sweat glands

Environmental conditions

Treatment and Drugs

Atopic dermatitis can be persistent. You may need to try various treatments over months or years to control it. And even if you respond to treatment, your signs and symptoms may return (flare).

It’s important to recognize the condition early so you can start treatment. If regular moisturizing and other self-care steps don’t help, your doctor may suggest the following treatments and drugs:

Medications

Creams that control itching and inflammation. Your doctor may prescribe a corticosteroid cream or ointment. Talk with your doctor before using any topical corticosteroid. Overuse of this drug may cause skin irritation or discoloration, thinning of the skin, infections, and stretch marks.

Creams that help repair the skin. Drugs called calcineurin inhibitors — such as tacrolimus (Protopic) and pimecrolimus (Elidel) — affect your immune system. Applied to the skin, they help maintain normal skin, control itching and reduce flares of atopic dermatitis. Due to possible side effects, these prescription-only drugs are used only when other treatments have failed or if someone can’t tolerate other treatments. They are approved for children older than 2 and for adults.

Drugs to fight infection. You may need antibiotics if you have a bacterial skin infection or an open sore or cracked skin caused by scratching. Your doctor may recommend taking oral antibiotics for a short time to treat an infection. Or he or she may suggest you take it for a longer time to reduce bacteria on your skin and to prevent another infection.

Oral anti-itch drugs. If itching is severe, oral antihistamines may help. Diphenhydramine (Benadryl, others) can make you sleepy and may be especially helpful at bedtime.

Oral or injected drugs that control inflammation. For more-severe cases, your doctor may prescribe oral corticosteroids — such as prednisone — or an injected corticosteroid. These drugs are effective but can’t be used long term because of potential serious side effects. Continue moisturizing and using other self-care remedies to prevent a flare-up after you stop taking the corticosteroids.