Sweat A Lot: What to Do and How to Treat Hyperhidrosis

It’s summer; it’s hot, and we all sweat. Some more than others, it’s true. “All people sweat to maintain their basal temperature,” explains Dr. Alfredo Daniel Agullo, dermatologist of the Ribera health group in the Denia Health Department. Although, he adds, “not all dissipate heat with the same efficiency, and not all have the same hypothalamic basal temperature, which may mean that some need to release more water to keep their temperature constant,” he says. 

However, there is a point where sweating is considered excessive, in some cases generalized, and others localized to certain areas of the body. It is known as hyperhidrosis.

“Hyperhidrosis is considered excessive localized or generalized sweating that escapes the usual control mechanisms,” explains Dr. Agullo. And it doesn’t have to be hot, or we are practicing any sport. It can also appear in cold environments and is widespread for excess heat to accentuate its symptoms.

The problem is not sweating. This physical reaction occurs excessively and without control because it can condition our daily activities and mental health. The Denia Health Department specialist in Dermatology assures that there are cases in which this excessive sweating “can seriously affect both the social and professional lives of those who suffer from it, limiting their interpersonal relationships and professional conditioning activities, with the consequent repercussion on the mood of the person and their mental health.

Why hyperhidrosis or excessive sweating occurs.

Our specialist explains that sweat secretion is controlled via nervous stimuli, whose main regulatory center is in the hypothalamus, “although stimuli from the cerebral cortex, spinal cord, and local skin receptors also collaborate.”

And the thing is, we have sweat glands all over our bodies. “Sweat is generated in eccrine glands, which are composed of an orifice independent of the pilosebaceous system. The eccrine glands are distributed practically throughout the body, with a special concentration in the palms of the hands and the soles of the feet, which is why it is the most frequently affected body region,” says Dr. Agullo, who adds that in the region axillary, the second in frequency in these cases, “we found a variant known as apocrine glands, which are considered responsible for axillary hyperhidrosis.”

How is excess sweat treated?

The dermatologist of the Ribera health group at the Denia Health Department explains that “normally we use topical treatments to start with, and if they don’t work, we consider iontophoresis, botulinum toxin infiltrations, completing with topical treatments if needed, and as a last option Surgery.”

Topical treatment is the least invasive. Dr. Agullo explains that aluminum salts are used that obstruct glandular secretion. In addition, he explains, “long-term use ends up producing glandular atrophy, which also helps control hyperhidrosis.”

Suppose this treatment does not work or does not give the desired results. In that case, it is passed to another level, in this case, iontophoresis, which consists of passing a low-intensity electric current through the hands, which acts by blocking the epithelial duct. There is a specific device for this treatment that generally requires 6 or 7 sessions just the first week and maintenance of 1 or 2 weekly sessions to maintain its effects.

The next level is botulinum toxin infiltration, which blocks the release of acetylcholine, explains Dr. Agullo, inhibiting myoepithelial cell contraction and thus blocking sweat outflow. “The effects appear from the first week, they achieve very high rates of reduction in sweating, and the effect is maintained for six months,” he assures. The use of surgery, he concludes, is reserved “as the last option due to its consequences: scars, motility alterations and contractures, among others.”