Hyperhidrosis is not harmful but it can affect the quality of life of the patient negatively. Excess sweating can cause:

• Uncomfortable soaking of the clothes
• Sweat beads on cheeks or forehead
• Damp hair and scalp
• Damp socks
• Slippery hands
• Itching and inflammation due to constant irritation by sweat-drenched clothes
• Body odour due to bacterial growth
• Noticeable white marks on clothes
• Skin discolouration
• Abnormal soft and disintegrating skin of soles of feet
• Dehydration

Excessive sweating can be controlled by:

• Lifestyle changes like using antiperspirants, bathing regularly, avoiding tight clothes and changing clothes daily.
• Medications like antidepressants and nerve blocking agents
• Botulinum toxin injections or botox to paralyse the nerves temporarily
• Microwave therapy is used to destroy sweat glands of the affected area with the help of a hand-held device.
• Surgical removal of sweat glands and cutting & clamping of the nerve responsible for sweating stimulation.

The starch-iodine test is used for locating the overactive sweating glands on the affected area. In this test, the affected area is dried and an iodine solution is applied. After drying, the starch powder is dusted all over the surface. Saturated iodine-starch paper is placed over this area. Sweat moisture changes the colour from brown to the blue of the applied solution marking the location of sweat glands on the affected area.

Microwave therapy and surgery are the permanent treatment options for hyperhidrosis. Microwave therapy destroys sweat glands permanently with the help of heat. Surgery helps in excessive sweating management by the surgical removal of the sweat glands. Surgery is also used to cut and clamp the sympathetic nerves responsible for the sweat gland stimulation.

Certain medical conditions can cause generalised or secondary excessive sweating affecting the whole body and are common in adults. These conditions are:

• Stress and anxiety
• Spinal cord injury
• Dysautonomia (autonomic dysfunction)
• Infections like tuberculosis.
• Cancer of the lymphatic system
• Menopause
• Metabolic disorders like hyperthyroidism, diabetes, gout, pituitary disease etc
• Drugs like antidepressants and insulins

Yes, botox or botulinum toxin injections are FDA approved treatment used for excessive sweating. This toxin is used to paralyse the nerves responsible for the stimulation of the sweat glands and the production of sweat. The results are safe without the downtime and can last up to or more than 4 months.

Surgical options for hyperhidrosis are:

• Sympathectomy: In this surgery, the sympathetic nerves responsible for the stimulation of sweat glands are cut and clamped permanently. This results in no sweating of the affected area.
• Sweat gland removal: In this surgery, sweat glands are permanently removed surgically. Sweat glands are removed by the procedure of surgical excision, liposuction, scrapping or the use of lasers.

Hyperhidrosis treatment is safe but there are some common complications that resolve in a couple of days like mild swelling, pain and redness. Other possible and rare complications requiring medical help include:

• Hematomas
• Ecchymosis
• Seromas
• Loss of local sensitivity
• Necrosis and infection
• Loss of hairs
• Fibrosis
• Scars
• Recurrence of hyperhidrosis