Dear Doctor, 

I sweat a lot even when I am not involved in a rigorous activity. Is this normal or it could be a sign of a medical condition I don’t know?

Amy, Rwamagana

Dear Amy

You are suffering from hyperhidrosis - a condition of excess sweating. It can be embarrassing for a person to the extent of affecting his/her quality of life. One may sweat excessively in localised areas like underarms, hands and or feet. Somebody may sweat all over the body.

Normally sweat is produced in the body by sweat glands for lubrication to prevent dryness. Excess sweating normally occurs in response to adrenergic stimuli, like stress, exposure to heat or fever. 1-3% of people can have excess sweating without any apparent reason and this starts from childhood or adolescence. Physical or mental stress can produce excess sweating occasionally in a person. But if it is persistent or repetitive, it is not normal. Anxiety also causes one to sweat much. One can have excess sweating due to hormonal disorders like diabetes or thyroid disorders. Low blood sugar is associated with excess sweating. Some cancers, chronic infections like tuberculosis, coronary artery disease are some serious diseases associated with excess sweating.

But here there would be other associated overlying features of the disease. Obesity increases susceptibility to profuse sweating. Women may have hyperhidrosis around menopause. Regular use of alcohol can cause excess sweating. It can be one of the manifestations of collagen vascular disorders like rheumatoid arthritis. Drugs like paracetamol, some antiviral drug, anti asthma drugs can cause excess sweating as adverse effect. Nylon or polyester clothes tend to aggravate sweating in susceptible persons.

If excess sweating is due to a known disease, treating it helps to control the troublesome sweating as well.

Healthy life style including regular physical exercise to prevent obesity is useful in controlling excess sweating.

One should try to use cotton clothes in a tropical climate.

Antiperspirants containing aluminium chloride help to reduce hyperhidrosis. Iontophoresis, a procedure of introducing ionic medicinal compounds into the body through the skin by applying a local electric current, can reduce excess sweating. Exact mechanism is not known but it is said to block sweat glands. Anticholinergic drugs help reduce excess sweating. But they have other troublesome side effects like blurred vision, dryness of mouth.

Local injection of botulinium toxin is also sometimes useful. Surgical intervention by cutting the sympathetic nerves supplying that area is also used to control hyperhidrosis.

Dr Rachna Pande  is a specialist in internal medicine at Ruhengeri Hospital