There are two different types of excessive sweating:

• Primary focal hyperhidrosis is the most common form and is characterized by overactive sweat glands that cause excessive sweating in specific areas of the body without an underlying medical condition. It is usually diagnosed when the affected person is a child or adolescent. Excessive sweating happens at least once a week but usually occurs more often.
• Secondary hyperhidrosis usually affects adults and is caused by an underlying medical condition, such as thyroid problems or menopause, or some medications and causes sweating all over the body, even during sleep.

Research also suggests that genetics play a role in developing excessive sweating. Certain medications and substances can also cause hyperhidrosis as a side effect such as antidepressants and anxiety medications, blood pressure drugs, and alcohol.

It is typically diagnosed based on the patient’s symptoms and a physical exam. During your appointment with Dr. Shagalov, she will ask questions about your medical history, including any underlying medical conditions, and when the excessive sweating occurs how it affects your life. She may order lab tests and imaging studies to identify a medical condition that may be the cause.

She may perform a test called the iodine-starch test. This simple non-invasive test is performed by applying a solution of iodine and starch to the affected areas and observing the area for discolorations caused by sweating. Another test is the use of a device called an electrodermal activity (EDA) device which is a non-invasive test that measures the electrical activity of the sweat glands.

Luckily, treatments exist. The best treatment depends on the cause. If a cause is identified, it may be treated with topical or oral medication, iontophoresis, botulinum toxin injections, and surgery, in addition to antiperspirants. If a cause cannot be found, it will be treated locally.

Antiperspirants are the most commonly used treatment and are available over-the-counter or by prescription. Qbrexzaâ (Gylcopyrromium) is a topical prescription in the form of a cloth that is used once daily to reduce sweating locally. Glycopyrrolate is an oral medication that can be used in more severe  cases.  Botulinum toxin injections, also known as Botoxâ, can be used to temporarily paralyze the sweat glands.  Iontophoresis is a procedure that uses electrical current to reduce sweating. Surgery, such as sympathectomy, is typically a last resort and is only recommended for severe cases that have not responded to other treatments.