Generalised
Hyperhidrosis

Very rarely patients may present to the Sweat Free Clinic with sweating everywhere. This is called Generalised Hyperhidrosis. Many cases are unknown, however it is important to exclude secondary causes of hyperhidrosis. Certain medical conditions such as thyroid disease, infections, diabetes and drugs can cause secondary generalised hyperhidrosis. With this pattern of sweating, finding a physician to exclude potential underlying problems is very important.

  • This condition or pattern of excessive sweating is very rare
  • Generalised sweating can be due to thyroid disease, diabetes and other conditions
  • Drugs are a frequent cause of generalised sweating
  • Secondary causes of sweating has a sudden onset compared to primary sweating
  • Focus treatments on the sweaty areas which bother you the most, such as the armpits, hands and feet or face
  • Tablets provide the greatest over all benefit for all-over-sweating, but side effects are commonly encountered

BEST TREATMENTS FOR GENERALISED HYPERHIDROSIS:

Iontophoresis treatment for excessive sweating can be successful in up to 80% of cases.

Hyperhidrosis or excessive sweating of the armpits can be effectively treated with Sweatfree injections.

Several tablets are available to inhibit the transmission of chemical messengers that produce sweat.

Endoscopic thoracic sympathectomy is a surgical procedure to decrease sweat production by interrupting the nerves that cause excessive sweating.

COMMON QUESTIONS

The majority of patients who have sweating will exhibit primary essential hyperhidrosis- this means that there is no cause for excess sweating. Secondary hyperhidrosis can be due to drugs or diseases and present in a different way compared to essential sweating.

Primary Hyperhidrosis/ essential hyperhidrosis features

The onset of sweating is usually early, mostly in the teens

Sweating stops when you are sleeping

Your sweating is symmetrical, meaning you sweat equal amounts on   both sides of your body

There is no apparent cause for your sweating, and the onset is gradual

You may have a positive family history of sweating

Most often you sweat in localised areas such as the hands, feet, armpits of face

 Secondary hyperhidrosis / secondary sweating features

You sweat in your sleep, or wake up sweating

The onset is sudden

The onset of sweating is usually later in life

Sounds confusing? If in doubt our Sweat Free team will determine the differences for you and guide you to further treatments or investigations.

Many patients will have no cause of generalised sweating, and may sweat everywhere for no apparent reason, however it is very important to exclude disorders that may cause of worsen this condition.

Disorders implicated in generalised sweating include the following:

Thyroid disease

Diabetes

Obesity

Carcinoid syndrome

Infections

Lymphomas

Drugs can also worsen or cause excessive sweating: the most common drugs include Energy drinks and caffeine.

Patients who have generalised hyperhidrosis should see a GP for review. In some cases our Specialist at Sweat Free may consult with a General Physician for more investigations.

In some cases, a dietician can be of benefit. This is especially so for patients who have underlying diabetes or who maybe overweight. Eating a well balanced diet, with minimal caffeine intake can decrease sweating.

Ok, here is the truth- secondary generalised sweating is exceedingly rare, but it is vitally important to rule out causes. Most patients say they sweat everywhere, but in reality sweat more in areas like the hands, feet and armpits. Distinguishing primary essentially sweating in these areas compared to generalised secondary hyperhidrosis is important.

Your first port of call is your General Practitioner, your doctor can rule out the most common causes of secondary sweating such as drugs, infections, thyroid disease, and diabetes. More complicated cases can be investigated by a general physician.

Our team can guide your GP for further investigations prior to seeing us. We may suggest special tests, x-rays and review prior to treatments. As we are Specialist in the management of sweat disorders working with your GP for investigations and treatment will give patients best outcomes.

The very first step is to exclude potential causes of generalised sweating, including medical conditions and drugs. Decreasing caffeine intake is super important.

We can now concentrate on specific areas of sweating, and methods to decrease sweat production in these areas.

Sweaty armpits can be treated with Driclor, creams and sweat stopping treatments

Excessively sweaty hands and feet can be treated with iontophoresis.

Sweating of the head and neck can be treated with creams or ETS.

Tablets treatment of sweating with Propantheline Bromide can be successful, however side effects are seen in the majority of patients.

A useful approach is to minimise or decrease sweating in the areas which affect you the most- this maybe the hands or feet, face and neck area, or under the armpits. Targeting these areas will give the greatest benefit.

Dr Davin S. Lim

Consultant Dermatologist

Sweat Free Clinics

If you sweat everywhere, its called generalised hyperhidrosis. Most patients say they sweat in all places, but in reality they sweat more in places such as the hands, feet, face, and armpits. Secondary generalised hyperhidrosis is exceedingly rare and investigations are a must.

How I approach excessive sweating in many places is simple. I treat in accordance to the importance for the patient. Most patients choose to get their hands treated first, others prefer armpits. Listening to where patients prioritise their treatments is important. In widespread sweating, a combination of treatments will yield the best results, for example patient A may require iontophoresis for the hands and feet, sweat stopping treatments for the armpits, and forehead, whilst another patient maybe well controlled with compounded Glycopyrrolate wipes for the face and Driclor for the armpits. Individualizing treatments is the key for best outcomes.

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