The Silent Handicap

Focal hyperhidrosis or localized excessive sweating affects about 3% of the population. This type of hyperhidrosis is also known as primary hyperhidrosis since it is not caused by or is not secondary to another medical condition. It typically affects the facial area, the underarms, the soles of the feet and / or the palms of the hands. Its onset is usually at puberty or in early adulthood - a rather cruel period of time given that individuals tend to be sensitive from a social, psychological and physical perspective.

Although focal hyperhidrosis is not dangerous or doesn’t give rise to another more malicious condition, it does have significant impact on a person’s quality of life. It is a poorly understood condition given that very few truly know the extent to which it affects a person’s wellbeing. The condition suffers from a lack of public interest and gets very little attention from the media, not to mention the medical community in general. Physicians are trained to focus on conditions that have impact on a person’s physical health. Conditions that impact mental health often go unnoticed or seem less important. To make matters worse, many individuals that suffer from focal hyperhidrosis tend to think that their condition cannot be treated or that it is not worthy of a medical treatment.

Let me share a few statistics, many of which are quite shocking. One third of individuals with axillary (underarm) hyperhidrosis (0.5% of the US population or 1.3 million people) have sweating that is barely tolerable and frequently interferes with their daily activities, or is intolerable and always interferes with their daily activities.

Three quarters of people with hyperhidrosis feel less confident, half report being unhappy or depressed, about 45% change their leisure activities so that sweating plays a lesser role, one quarter reduce or miss outings that under normal circumstances would be attended, and one fifth decrease their leisure time due to their excessive sweating condition. Another study involving people with palmar (palms of hands) hyperhidrosis demonstrated that almost all (95%) reported that their condition interfered with daily tasks. Nine of ten reported social embarrassment and 40% had social difficulties.

Many individuals go to considerable lengths to conceal their condition. Many experience feelings of humiliation and embarrassment. Simple aspects of socialization such as shaking hands or hugging can become very awkward. In fact, physical intimacy often becomes problematic in fear of becoming less desirable due to excessive sweating.

Perhaps what is most disturbing is the fact that many individuals do not seek treatment and often end up suffering in silence. Many treatments are now available and range from topically applied products to surgery.  Treatment guidelines (for e.g. Canadian Hyperhidrosis Advisory Committee) recommend topical treatments as first line options. Individuals should make sure that they try high strength topical gels, beyond those found over the counter in pharmacies.