'Don't sweat it.' It's easier said than done for millions of Americans, Saint Louis U. study shows

July 31, 2003

ST. LOUIS - It's summertime, everybody sweats. But for people with hyperhidrosis-excessive or abnormal sweating-the perspiration never stops.

A new study by Saint Louis University researchers has found that approximately 7.8 million Americans are living with this condition, which sometimes results in anxiety, depression, isolation and a reduced quality of life.

The results are based on a survey of 150,000 households in the United States, making it the largest study of hyperhidrosis in this country.

"The fact that we had an incredibly large response rate to our survey (70%) tells us this is a not a mild nuisance experienced by a few people," said Dee Anna Glaser, M.D., an associate professor of dermatology at Saint Louis University School of Medicine. "This is a big problem that interests people. Frankly, I was a little surprised at the high percentage of those affected."

Sweating is necessary to control body temperature during exercise or in warm or hot surroundings. It is regulated by the sympathetic nervous system. In people with hyperhidrosis, this system is revved-up, causing sweating at inappropriate times in specific areas of the body, such as the scalp, face, hands, armpits, feet or trunk. The condition strikes men and women equally.

Glaser and her colleagues presented their study results at the American Academy of Dermatology meeting in San Francisco. She said their investigation had a dual purpose-1) determine the prevalence of hyperhidrosis and 2) determine its impact on the daily activities of sufferers. The study found that approximately 90 percent of those with the disease said the sweating interfered with their life, whether it was at work, socially or romantically.

The study took a special look at individuals with axillary (armpit) hyperhidrosis. Results show that more than half (54 percent) of the estimated 4 million Americans with axillary hyperhidrosis report they feel less confident as a result of their condition. A third become frustrated with daily activities. A fourth feel depressed and decrease the amount of time spent working or pursuing leisure activities.

"Imagine being a businessperson who has to give a presentation and you've soaked through the layers of clothing you've worn to hide the problem," Glaser said. "It definitely shakes your confidence and makes you think twice about offering to take the lead on a project or be the spokesperson.

"Sweating has a negative connotation in our society," Glaser continued. "We assume that if you're sweating then you must be nervous or you have something to hide. Your thoughts usually aren't positive if you shake hands with someone who has clammy palms. That's what sufferers are up against."

Glaser said hyperhidrosis usually surfaces in childhood or early adolescence but treatment rarely is sought at that age.

"Kids spend most of the time just trying to fit in," Glaser said. "They're not about to report something that might make them feel different-especially if it's something 'yucky' like excessive sweating."

Glaser said you or someone you know might suffer from hyperhidrosis if:

- You think you sweat more than normal
- You find yourself managing the problem by doing such things as carrying a handkerchief to wipe your hands or keeping an extra shirt in your office drawer
- People comment on your excessive sweating
- You sweat even in cool environments
- Your sweating waxes and wanes
- Your sweating is brought on by stress, such as making a presentation or meeting new people
- You sweat through multiple layers of clothing
- You change clothes several times a day because of sweating
- You frequently have to buy new clothing because sweat stains soil your wardrobe

Glaser said treatment options are available. Some medications are topical, some are oral and surgery is an option if all else fails. Botox® also is an effective treatment for hyperhidrosis. Glaser is a lead investigator in the clinical trials using the drug for hyperhidrosis.

Saint Louis University

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