Hyperhidrosis is a condition characterized by excess sweating beyond physiological need. Hyperhidrosis is most commonly experienced at the axilla (underarms), and less commonly on the forehead, the palms of the hands and the soles of the feet. Hyperhidrosis has been diagnosed in 4% of the population. However, up to 21% of the population are bothered by excess sweating and may have undiagnosed clinical hyperhidrosis.
The diagnosis criteria for Hyperhidrosis include:
- Bilateral presentation (i.e., both armpits)
- Greater than 1 episode per week of excess sweating
- Symptoms started at age 25 or younger
- Sweating impacts daily activity (such as the need to wear black clothing, so sweat is not visible as it is with colored clothing; white clothing turns yellow from sweat stains, etc.)
- Excess sweating ceases at night while sleeping
- Family History (ask your family members!)
Sweat production involves two types of glands: The Eccrine glands produce watery secretions and sit at the dermal-fat junction.The Apocrine glands attach to the hair follicles and create the sweaty odor.
There are several modalities to address Hyperhidrosis. Botulinum toxin (Dysport) injection at the axilla or forehead is a semi-permanent solution that lasts 6-9 months. This is the recommended solution for excess sweating on the forehead.
More permanent solutions for excess sweating at the axilla include Laser-Assisted Liposuction and Ultherapy (Ultrasound), both of which heat and damage the eccrine and apocrine glands of the armpits.
These treatments are usually a covered benefit of Healthcare Savings programs, which helps mitigate the cost of the procedures.