Excessive sweating can occur on the hands, underarms, face, scalp, or other parts of the body. In some people only certain areas are affected, while in others the sweating may be more widespread.
When evaluating sweating, not only the amount is considered, but also where it occurs, when it began, whether it continues during sleep, how it affects daily life, and whether any other symptoms accompany it.
What Causes Excessive Sweating?
Excessive sweating can generally be classified as primary or secondary hyperhidrosis. In primary hyperhidrosis, no clear underlying disease or medication-related cause is found. It most often affects specific areas such as the hands, underarms, feet, face, and scalp, and may begin at a young age.Secondary hyperhidrosis, on the other hand, may be associated with certain diseases, hormonal or metabolic conditions, medications, or other medical causes. Investigating underlying causes is particularly important when sweating begins later in life or affects the whole body. The treatment approach is determined by the type, location, and severity of the sweating and the person’s clinical characteristics.
Hand Sweating
Hand sweating is called palmar hyperhidrosis and is characterized by more sweating than normal on the palms.
Significant hand sweating can affect daily activities such as writing, using electronic devices, holding objects, or social interaction. The degree of sweating and its impact on a person’s life vary from person to person.
When planning treatment, the severity of the sweating, previously tried methods, and the person’s clinical characteristics are evaluated together. A range of approaches may be considered, from topical treatments to various interventional options.
Underarm Sweating
Underarm sweating is called axillary hyperhidrosis. It occurs when the underarms sweat beyond normal physiological needs.
Heavy sweating can cause noticeable wetness on clothing and may affect daily life or social comfort.
The treatment methods that may be used for underarm sweating vary depending on the degree of sweating and the person’s characteristics. Local treatments and various medical procedures may be considered, while surgical methods may be considered in selected cases.
Facial and Scalp Sweating
Facial and scalp sweating (craniofacial hyperhidrosis) is characterized by noticeable sweating on the forehead, scalp, face, or neck.
While sweating in a hot environment or during physical activity is natural, sweating that is disproportionate to these triggers or that affects daily life may be considered hyperhidrosis.
When evaluating sweating of the face and scalp, the age of onset, the distribution of sweating, triggering factors, and accompanying symptoms are taken into account. Treatment is also individualized based on these characteristics.
Facial Blushing
Facial blushing is a temporary reddening of the skin caused by the widening of blood vessels in the face. It is not the same as sweating, but in some people it may occur together with facial sweating.
Excitement, stress, changes in temperature, or other physiological triggers can bring on facial blushing. In some people, blushing may be pronounced and recurrent.
During evaluation, when the blushing occurs, in which situations it increases, and whether it is accompanied by sweating or other symptoms are taken into account. The treatment approach varies depending on the underlying mechanism and the person’s clinical characteristics.
Compensatory Sweating
Compensatory sweating is increased sweating in other parts of the body, particularly after surgical procedures on the sympathetic nervous system performed for excessive sweating.
It may appear in areas that previously had no significant sweating, such as the chest, back, abdomen, lower back, or legs. The degree of sweating can vary from person to person.
Compensatory sweating is one of the possible outcomes that must be carefully considered when evaluating surgery for excessive sweating. When planning surgical treatment, this risk must be weighed alongside the potential benefits of the procedure.
How Is Treatment for Excessive Sweating Determined?
There is no single treatment for hyperhidrosis that works for everyone. The treatment plan is based on the area where the sweating occurs, its severity, its impact on daily life, and previous treatments.Approaches that may be considered include topical products, iontophoresis, certain medications, botulinum toxin injections, and, in selected cases, surgical methods.
In primary focal hyperhidrosis, endoscopic surgical methods targeting the sympathetic nervous system may be considered in certain patient groups. However, because of the permanent effects of surgery and possible outcomes such as compensatory sweating in particular, patient selection and preoperative evaluation are important. When secondary sweating is suspected, the underlying condition that may be causing the sweating should be investigated first.