Hyperhidrosis is excessive sweat production above the necessary levels to regulate body temperature. This sweating can affect various body parts, such as the hands, feet, armpits, and face.
Although many people may experience intense sweating, hyperhidrosis goes beyond the usual, affecting quality of life and self-esteem significantly. If you sweat profusely, you may be wondering if this is the case.
Detecting this condition is not always simple, and it must be evaluated and diagnosed correctly by healthcare professionals. What techniques can they use to detect hyperhidrosis or excessive sweating? Read on to find out more!
Differentiating between primary and secondary hyperhidrosis
There are two types of hyperhidrosis according to its causes:
- Primary hyperhidrosis. It has no known cause, it is idiopathic.
- Secondary hyperhidrosis. It is associated with an underlying pathology, such as an endocrine disorder, a side effect of medication, or a neurological disease.
When diagnosing excessive sweating, it is necessary to rule out secondary hyperhidrosis caused by another disease or the side effects of a medication. The clinical history is usually enough to distinguish between primary and secondary hyperhidrosis.
Healthcare professionals can ask several questions to help distinguish between the two types:
- Age of onset. Primary hyperhidrosis appears between the ages of 14 and 25, while secondary hyperhidrosis is usually diagnosed after the age of 25.
- Sweating pattern. Primary hyperhidrosis is characterized by the appearance of sweat equally on both sides of the body, known as bilateral symmetry. However, secondary hyperhidrosis is unilateral. It appears on one side of the body only and is not symmetrical.
- Interruption during sleep. Primary hyperhidrosis does not cause excessive sweating at night. If you sweat only during sleep, there may be a secondary cause.
- Duration. Sweating episodes should last at least 6 months and occur more than twice a week.
- Sweating episodes. Excessive sweating may not be continuous or constant if you suffer from primary hyperhidrosis. Sweating episodes vary in frequency and duration. It is important to keep track of the number of episodes and how they affect your daily life.
- Family history. It is common that members of the same family also suffer from excessive sweating.
- Effects on quality of life. Hyperhidrosis can affect our daily lives, both personally and professionally, and have a negative impact on mental health, especially among adolescents.
Laboratory tests are usually not required to diagnose primary hyperhidrosis. However, if the clinical history and physical examination raise suspicion of secondary hyperhidrosis, specific diagnostic tests may be necessary.
Quantitative tests: How much do you sweat?
Although not strictly necessary, some tests can help quantify the amount of sweating to determine its severity and guide treatment choice.
The most common is the Minor test or iodine-starch test. It consists of applying an iodine solution on the skin and once the iodine is dry, sprinkle corn starch on it. The sweat produced causes a chemical reaction between the iodine and the starch, resulting in a color change, typically to a dark purple or black shade in the areas where there is sweating.
This test is very useful in identifying the location and extent of the area where sweating occurs when planning to apply treatments such as Botox injections or surgery.
In addition to the Minor test, there are other tests such as gravimetry, which weighs the amount of sweat produced, or dynamic quantitative sudometry, which measures sweating over time using a chamber placed on the skin surface, through which dried gas is transmitted.
Qualitative tests: How does sweating affect your daily life?
In addition to these quantitative tests, there are complementary tests to assess the quality of life of people suffering from hyperhidrosis or excessive sweating.
The Hyperhidrosis Disease Severity Scale (HDSS) is a questionnaire that measures the influence of sweating on daily activities. The respondent selects which of the following statements best reflects the impact of excessive sweating on his or her daily life:
- My sweating is never noticeable and never interferes with my daily activities.
- My sweating is tolerable but sometimes interferes with my daily activities.
- My sweating is barely tolerable and frequently interferes with my daily activities.
- My sweating is intolerable and always interferes with my daily activities.
Each of these statements is related to a number from 1 to 4. A score of 1 or 2 indicates moderate hyperhidrosis, while a score of 3 or 4 indicates severe hyperhidrosis. After appropriate treatment, the questionnaire can be retaken to see if there is a change in the answer. A 1-point improvement in the HDSS score has been associated with a 50% reduction in sweat production and a 2-point improvement with an 80% reduction.
In addition to this scale, there are others such as the Dermatological Life Quality Index (DLQI) or the Hyperhidrosis Impact Questionnaire.
[H2] Ecrisens, the alternative to help control excessive sweating
At Prospera Biotech, we work to improve the quality of life of people with sensitive skin from an innovative approach, through neurodermatology.
Ecrisens® is a neurodermatological cream that helps control excessive sweating without affecting the body’s thermoregulatory needs, making the sweat glands less sensitive to heat and decreasing their activation.
In addition, it can be applied to any area, helping to treat palmar, plantar, axillary, or facial hyperhidrosis. Its gel-like texture and non-comedogenic composition make it suitable for application to the face.
Ecrisens® is not an antiperspirant, it does not block the pores.
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References
- International Hyperhidrosis Society. Diagnosing Hyperhidrosis [Internet]. [cited 9 Jul 2024]. Available at: https://sweathelp.org/home/diagnosing-hyperhidrosis.html
- Nawrocki S, Cha J. The etiology, diagnosis, and management of hyperhidrosis: A comprehensive review: Etiology and clinical work-up. J Am Acad Dermatol. 2019 Sep;81(3):657-666. doi: 10.1016/j.jaad.2018.12.071.
- Solish N, Bertucci V, Dansereau A, Hong HC, Lynde C, Lupin M, Smith KC, Storwick G; Canadian Hyperhidrosis Advisory Committee. A comprehensive approach to the recognition, diagnosis, and severity-based treatment of focal hyperhidrosis: recommendations of the Canadian Hyperhidrosis Advisory Committee. Dermatol Surg. 2007 Aug;33(8):908-23. doi: 10.1111/j.1524-4725.2007.33192.x.
