Prevalence and burden of hyperhidrosis

NewsBot · Oct 5, 2012

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Prevalence and burden of hyperhidrosis in the adult population
I Schäfer, MA Radtke, H Heigel, M Augustin
Dtsch med Wochenschr 2012; 137 - A292

Aims: Hyperhidrosis is a common and sometimes burdensome hyperfunction of the sweat glands and can be a result of many underlying conditions. Patients affected with hyperhidrosis suffer from social problems, restrictions in daily activities as well as emotional and physical impairments.

Objectives: To evaluate the epidemiology and the disease burden of hyperhidrosis in a representative sample of German adults. Methods: A cross-sectional study was conducted in 52 German companies from several branches. Employees underwent skin screenings with full body exams and structured interviews.

Results: A total of 14,336 persons were investigated (36% women, mean age 42 yrs). Overall prevalence of hyperhidrosis was 16.3% (n=2,340), including n=869 (6.1%) with frequent or continuous sweating. Hyperhidrosis was in almost every age group more prevalent in men (18.2%) than in women (13.4%). 68% of the 2,340 study-participants suffering from hyperhidrosis reported generalised sweating whereas 28% of all hyperhidrosis was focal with the following distribution: hands 23%, feet 29%, axillary area 44%, others 34%.30% of the patients with focal hyperhidrosis stated that they felt bothered by sweating frequently or constantly.Most pronounced difference in dermatological comorbidity of study participants with vs. without hyperhidrosis hyperhidrosis was psoriasis (3% in comparison to 2% in persons without hyperhidrosis and tinea pedum (6% with vs. 4% without hyperhidrosis). As indicated by actual drug intake persons with metabolic comorbidity (diabetes, hypertension) also were at increased risk. Only 27% of persons with focal hyperhidrosis had consulted a physician, and only 28% used medication or self-medication.

Conclusions: Hyperhidrosis is a frequent condition predicted by personal and medical factors. In spite of the disease burden, only few persons affected consult a physician.v
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Admin2 · Oct 6, 2012

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NewsBot · Aug 31, 2013

Prevalence and Disease Burden of Hyperhidrosis in the Adult Population
Augustin M. Radtke M.A. Herberger K. Kornek T. Heigel H. Schaefer I.
Dermatology (DOI: 10.1159/000351292)

Background: Although hyperhidrosis is a common and burdensome condition, little is known about the population-based prevalence. Objective: To evaluate the epidemiology, disease burden and medical care of hyperhidrosis in German adults.

Methods: Employees of fifty-two companies underwent skin screenings and interviews including hyperhidrosis questions.

Results: 14,336 individuals were investigated (36% women, mean age 42 years) of whom 2,340 (16.3%) reported hyperhidrosis, including 869 (6.1%) with frequent or continuous disturbing sweating. 28% showed focal hyperhidrosis, whilst 68% had a generalized condition. Predictors of hyperhidrosis were male gender and concomitant drug medication. Moreover, persons with psoriasis and with metabolic comorbidity were at increased risk. Only 27% of those with focal hyperhidrosis had consulted a physician, and only 28% used prescribed medication or self-medication.

Conclusion: Hyperhidrosis is a frequent skin condition predicted by medical and personal factors. In spite of the disease burden, few individuals utilize medical care. Affected individuals should be encouraged to refer to a dermatologist.
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NewsBot · Apr 8, 2014

Development, validation and clinical application of a patient-reported outcome measure in hyperhidrosis: The Hyperhidrosis Quality of Life Index (HidroQoL ©)
Kamudoni, Paul 2014.
PhD Thesis, Cardiff University.

Consideration of broader outcomes of disease, especially those exclusively experienced and reported by the patient, such as HRQOL, is not only consistent with the ‘whole person’ view of health contained in the 1948 WHO definition, but is also a prerequisite to building health-care systems that are responsive to the needs of the patients. For chronic skin diseases, such as hyperhidrosis, these provide a useful indicator of how a patient feels and functions disease for both practical and methodological reasons. The aims of this study therefore were to investigate the impact of hyperhidrosis on patients’ HRQoL using a mix of qualitative and quantitative methods. In addition, a further aim was to develop and validate a disease-specific instrument for assessing HRQoL in hyperhidrosis. In pursuing the above aims, the feasibility of applying online social networking sites for outcomes research in dermatology was assessed. Patients were recruited through online social networking communities related to hyperhidrosis for all stages of the study. Interviews, focus groups and surveys were used for collecting qualitative data from patients (n = 71) to understand quality of life issues of patients, and to provide the content of the new instrument. Dermatologists (n= 5) and patients (n=7) took part in the content validation of the HidroQoL©. Item reduction and the development of the scale’s structure was carried out through several field-testing studies (n: USA, 559; UK, 115), using the item response theory (IRT) Rasch model and factor analyses. Further psychometric testing was performed in a separate study (n = 241). Distribution-based methods were applied in establishing minimum clinically important difference (MCID). A thematic analysis of the qualitative data collected produced 29 quality of life themes and 102 sub-themes, forming the content for the initial 49-item HidroQoL©. The two expert panels judged the instrument as content valid, with a few suggestions. The Rasch analysis modelling led to the collapsing of response categories (from five to three) and the reduction in number of items (from 49 to 18), to ensure a perfect model fit. Factor analyses supported both a single- and a two-factor structure. In subsequent construct validation study the HidroQoL correlated with the DLQI (rs = 0.572, p < 0.01) and the Skindex-17 (rs = 0.551, p < 0.01). Reliability was high (Cronbach alpha = 0.9; test-retest ICC = 0.93). The scores were sensitive to change in patients’ disease severity (standard response mean = 0.8, 95% C.I: 0.34-1.27). The scale banding proposed for the HidroQoL score is as follows: 0 – 1, no effect at all; 2 – 11, small effect; 12 – 22, moderate effect; 23 – 32, large effect; 33 – 36, very large effect. The MCID values were 1.94 – 3.07, for generalised v hyperhidrosis, 2.16 – 4.36, for axillary hyperhidrosis, 2.15 – 3.39, for palmo-plantar hyperhidrosis. An MCID of three is currently being proposed for all types of hyperhidrosis. This study has provided the initial evidence supporting the appropriateness of the content of the HidroQoL and validity of inferences from its scores for assessing HRQoL in hyperhidrosis. In addition, the availability of MCID estimates for the HidroQoL will facilitate its clinical interpretation in both research and routine clinical practice. This study has also demonstrated how CTT and IRT can be integrated in the development and validation of a new generation of HRQoL instruments, using social network for patient recruitment.
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NewsBot · Dec 27, 2014

Hyperhidrosis and social anxiety disorder--the same old thing under a different cloak?
Nahaloni E, Iancu I.
Harefuah. 2014 Oct;153(10):595-9, 624

Hyperhidrosis is a reason for treatment by many specialists in medicine, such as dermatologists, family medicine doctors, surgeons and also psychiatrists. Hyperhidrosis causes considerable distress and disability. Despite the fact that the condition has been known for thousands of years, it is yet unclear whether excessive sweating derives from emotional" activation of the central nervous system, whether the emotional symptoms evolve due to local dysfunction of the sweat glands, or a combination of the two problems. In this article, we will present two conditions: hyperhidrosis and Social Anxiety Disorder, a mental condition with anxiety and avoidanrce in social settings that is frequently accompanied by sweating. We will discuss the similarities and differences between these disorders and the various treatments available for these conditions. Research shows that social anxiety does not explain hyperhidrosis, but that excessive sweating reduces the threshold for social anxiety. Among people with hyperhidrosis, the functional disability and the emotional problems are mediated by the social anxiety. We propose treating the symptoms of hyperhidrosis and social anxiety disorder in combination in order to achieve maximal improvement in these patients
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NewsBot · Jan 25, 2015

Distinguishing hyperhidrosis and normal physiological sweat production: new data and review of hyperhidrosis data for 1980–2013
Linnea Thorlacius MD, Mette Gyldenløve MD, Claus Zachariae MD, DMSc andBerit C. Carlsen MD, PhD
International Journal of Dermatology; Early View

Hyperhidrosis is a condition in which the production of sweat is abnormally increased. No objective criteria for the diagnosis of hyperhidrosis exist, mainly because reference intervals for normal physiological sweat production at rest are unknown.

Objective
The main objective of this study was to establish reference intervals for normal physiological axillary and palmar sweat production.

Methods
Gravimetric testing was performed in 75 healthy control subjects. Subsequently, these results were compared with findings in a cohort of patients with hyperhidrosis and with the results derived from a review of data on hyperhidrosis published between 1980 and 2013.

Results
Approximately 90% of the controls had axillary and palmar sweat production rates of below 100 mg/5 min. In all except one of the axillary and palmar hyperhidrosis studies reviewed, average sweat production exceeded 100 mg/5 min.

Conclusions
A sweat production rate of 100 mg/5 min as measured by gravimetric testing may be a reasonable cut-off value for distinguishing axillary and palmar hyperhidrosis from normal physiological sweat production.
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NewsBot · Jan 2, 2016

Idiopathic hyperhidrosis: Is response to parasympathetic function test altered?
G S Latha, Nagaraja Puranik.
Natl J Physiol Pharm Pharmacol. 2016; 6(1): 85-88doi: 10.5455/njppp.2015.5.1209201586

Background: Idiopathic hyperhidrosis is characterized by excessive sweating, especially of palms of the hands and soles of the feet. It is said to be owing to sympathetic overactivity. However, autonomic nervous system as a whole could be dysfunctional in this condition, rather than isolated sympathetic dysfunction.

Aims and Objective: We have undertaken this study to test and compare the autonomic function status in these patients with age- and sex-matched healthy individuals.

Materials and Methods: Twenty, normal subjects with no known autonomic dysfunction as controls and 20, known idiopathic hyperhidrosis patients as subjects were taken for this study. Autonomic function tests were performed in both these groups and the results were compared.

Result: Sympathetic function tests, which were performed, were within the normal range whereas parasympathetic tests were normal except for response to deep breathing test, which showed a significant increase (P < 0.01) in the hyperhidrosis patients, compared with the controls.

Conclusion: Response to deep breathing, a parasympathetic test, was significantly increased in the patients with hyperhidrosis compared with controls in this study; we will conclude this study with the findings that the idiopathic hyperhidrosis seems to be a complex dysfunction of autonomic nervous system, which involves autonomic pathways other than those related to excess sweating.
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NewsBot · Mar 9, 2016

Sweating on the palm and sole: physiological and clinical relevance.
Asahina M, Poudel A, Hirano S.
Clin Auton Res. 2015 Jun;25(3):153-9

In mammals, sweating is a multifunctional response that aids in locomotion, thermal regulation, self-protection, and communication of psychological state. Humans possess three types of sweat glands (apocrine, eccrine, and apoeccrine) that are differentially distributed on the body surface and make unique contributions to these distinct functions of the sweating response. In humans, eccrine glands, which are widely distributed on hairy skin, play an important role in thermoregulation. They are also found on the glabrous skin of the palm and sole, where they are not usually activated by heat, but rather by deep respiration, mental stress, and local tactile stimulation. Sweating on the palm and sole, so-called "emotional sweating", acts to prevent slippage while grasping or performing a delicate task using the fingertips. Although the central pathways of emotional sweating are not yet elucidated in detail, it is thought that the amygdala, cingulate cortex, and medulla participate via efferent fibers that descend through the spinal cord and connect to preganglionic sympathetic neurons in the nucleus intermediolateralis. The limbic system, including the amygdala and cingulate cortex, is critical for emotional processing and many cognitive functions. Thus, measurement of sweat output on the palm or sole is useful for evaluating sympathetic function and limbic activity in autonomic and psychiatric disorders.
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NewsBot · Oct 22, 2016

Hyperhidrosis: an update on prevalence and severity in the United States
Doolittle, J., Walker, P., Mills, T. et al.
Arch Dermatol Res (2016). doi:10.1007/s00403-016-1697-9

Current published estimates of the prevalence of hyperhidrosis in the United States are outdated and underestimate the true prevalence of the condition. The objectives of this study are to provide an updated estimate of the prevalence of hyperhidrosis in the US population and to further assess the severity and impact of sweating on those affected by the condition. For the purposes of obtaining prevalence, a nationally representative sample of 8160 individuals were selected using an online panel, and information as to whether or not they experience hyperhidrosis was obtained. The 393 individuals (210 female, 244 non-Hispanic white, 27 black, mean age 40.3, SE 0.64) who indicated that they have hyperhidrosis were asked further questions, including body areas impacted, severity of symptoms, age of onset, and socioemotional impact of the condition. Current results estimate the prevalence of hyperhidrosis at 4.8 %, which represents approximately 15.3 million people in the United States. Of these, 70 % report severe excessive sweating in at least one body area. In spite of this, only 51 % have discussed their excessive sweating with a healthcare professional. The main reasons are a belief that hyperhidrosis is not a medical condition and that no treatment options exist. The current study’s findings with regard to age of onset and prevalence by body area generally align with the previous research. However, current findings suggest that the severity and prevalence are both higher than previously thought, indicating a need for greater awareness of the condition and its associated treatment options among medical professionals
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NewsBot · Sep 27, 2018

Relationship between depression scores and degree of skin perspiration: A novel cross-sectional study.
López-López D et al
Int Wound J. 2018 Sep 24.

Primary hyperhidrosis (PH) is a common pathological condition related to excessive sweating. It may be associated with depression. Therefore, the main aim of this study was to analyse and compare depression scores between subjects without PH (degree-I) and patients with PH (degrees-II, -III, and -IV). The secondary aim was to describe and compare depression scores among subjects with different PH degrees (I-without perceptible perspiration, II-tolerable perspiration, III-hardly tolerable perspiration, and IV-intolerable perspiration). A sample of 100 subjects with a median age of 23.00 ± 6.00 years was recruited from an outpatient medical centre, where medical history data were registered. The degree of PH was determined using the Hyperhidrosis Disease Severity Scale from degrees I (mild) to IV (very severe). The depression scores were analysed using the Beck Depression Inventory (BDI). Statistically significant differences (P < 0.001) were observed for higher BDI scores in the patients with PH (degrees II, III, and IV) than in those without PH (degree-I). Kruskal-Wallis tests demonstrated statistically significant differences for BDI scores (P < 0.001), with higher values for degree-III with respect to degree-I and degree-IV with respect to degree-I. Patients with a greater degree (especially III/IV) of PH showed higher BDI scores compared with subjects without PH.
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NewsBot · Oct 16, 2018

Impacts of Foot and Body Odor on Quality of Life
Rujitharanawong C , Bunyaratavej S Mail, Leeyaphan C , Pattanaprichakul P , Kobwanthanakun W , Phaitoonwattanakij S , Ongsri P , Kulthanan K
J Med Assoc Thai 2018; 101 (10):1371-4

Background: Foot and body odor have been found in some dermatologic diseases such as foot odor in pitted keratosis [PK]. The studies about odors are limited, especially, their impacts on patients’ quality of life [QoL].

Objective: To demonstrate the effects of odor on patients’ QoL, focusing on foot odor and association between the severity of foot odor and PK.

Materials and Methods: Seven hundred eighty-eight Thai naval rating cadets enrolled in the study. Odor was assessed by questionnaires. The severity of foot odor was evaluated using visual analog scale [VAS] score by the participant’s self-determination. QoL was assessed by Dermatology Life Quality Index [DLQI] questionnaire. Physical examination was performed by dermatologists. The association among PK, DLQI total score, and odor were analyzed.

Results: Seven hundred twenty-nine participants (92.5%) completed the questionnaires and physical examination. Foot odor was reported in 309 (42.4%), whereas body odor was found in 140 (19.2%). The mean DLQI total score significantly increased in the participants who had foot or body odor; comparing with those without odor. The positive correlation between DLQI total score and the severity of odor was demonstrated (r = 0.4, p-value <0.001). Foot odor significantly affected on patients’ QoL defining as DLQI score greater than 6 (p-value 0.04), comparing with those reporting no foot odor. Moreover, PK was described in 125 (17.1%) cases in the present study. The median VAS score of foot odor was significantly different between the participants with and without PK (p-value 0.002).

Conclusion: The present study demonstrated that odor had significant impact on patients’ QoL, using statistical analysis. Severity of unpleasant foot odor was correlated with diagnosis of PK. Thus, physicians should pay attention to this problem and perform a proper management.
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NewsBot · Dec 29, 2018

Hyperhidrosis and its impact on those living with it.
Lenefsky M, Rice ZP
Am J Manag Care. 2018 Dec;24(23 Suppl):S491-S495.

Sweating plays a vital role for humans. However, excessive sweating, also called hyperhidrosis, is a condition resulting in sweating beyond what is physiologically necessary. The increased rate of sweating is not caused by external stimuli or temperature fluctuations, as with an individual without hyperhidrosis. Hyperhidrosis affects approximately 4.8% of Americans. Primary hyperhidrosis, a specific classification of the disease, primarily affects younger adults aged 18 to 39 years, and it often has a genetic component. Living with hyperhidrosis presents many challenges and impacts numerous aspects of daily life. Patients with hyperhidrosis are impacted in their social and professional lifestyles, as well as their mental and emotional health. These negative effects, which have been studied, lead to a lower quality of life (QOL) in this population. Additionally, constant moisture from sweating can lead to skin maceration. This increases the risk of skin conditions such as athlete's foot and more severe conditions such as bacterial infections or pitted keratolysis. Study results report a nearly 30% greater risk of skin infections in patients with hyperhidrosis compared with healthy controls. This section of the continuing education supplement will examine the pathophysiology and clinical severity of hyperhidrosis and identify the comorbidities and QOL challenges associated with this condition.
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NewsBot · Jun 16, 2019

Hyperhidrosis prevalence and its impact on population
Erica Nishida Hasimoto, Daniele Cristina Cataneo, Tarcisio Albertin dos Reis, Antonio José Maria Cataneo
Source

Hyperhidrosis is a disorder characterized by excessive sweating which beyond the physiological need for body thermoregulation. It brings about a deep social, psychic, professional and emotional constraint, compromising the quality of life of its patients. The prevalence data available in the literature are practically nonexistent up to the beginning of the 21st century. The objective of this present study is to review the literature as a quest for studies that evaluated the prevalence of hyperhidrosis and its impact on the quality of life of individuals. The bibliographic review was carried out by using the PubMed database. During the search 16 articles were found which evaluated the prevalence of hyperhidrosis and out of these, 5 evaluated the impact in the disorder as to the quality of life. The prevalence found in the articles varied from 0.072% to 16.3%. As to the impact on the quality of life, all articles have shown that such disorder affects in some way the life of the individuals. Although the methodology is quite different among the studies and though some prevalence data are questionable, the undertaking of this kind of study is important for the scaling of the problem and the establishment of measures that seek the improvement of the quality of life of its patients.
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NewsBot · Aug 26, 2019

Sweat distribution and perceived wetness across the human foot: the effect of shoes and exercise intensity.
West AM et al
Ergonomics. 2019 Aug 17:1-26

This study investigates foot sweat distribution with and without shoes and the relationship between foot sweat distribution and perceived wetness to enhance guidance for footwear design. Fourteen females performed low-intensity running with nude feet and low- and high-intensity running with shoes (55%VO2max and 75%VO2max, respectively) on separate occasions. Right foot sweat rates were measured at 14 regions using absorbent material applied during the last 5 minutes of each work intensity. Perceptual responses were recorded for the body, foot and four foot regions. Foot sweat production was 22% greater nude (p < 0.001) and with shoes did not increase with exercise intensity (p = 0.14). Highest sweat rates were observed at the medial ankle and dorsal regions; lowest sweat rates at the toes. Perceptions of wetness and foot discomfort did not correspond with regions of high sweat production or low skin temperature but rather seemed dominated by tactile interactions caused by foot movement within the shoe. Practitioner summary: This study provides a detailed view of foot sweat distribution for female runners with and without shoes, providing important guidance for sock and footwear design. Importantly, perceptions of wetness and foot discomfort did not correspond with areas of high sweat production. Instead tactile interactions between the foot, sock/shoe play an important role.
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NewsBot · Sep 19, 2023

Psychological impact of primary hyperhidrosis
Roger Jamil Zari Arévalo et al
Revista de Investigación en Salud

Primary hyperhidrosis is a common pathology that represents a common reason for dermatologic consultation, characterized by excessive sweating in axillary,
plantar, palmar or craniofacial regions that usually appears at puberty or adolescence, its carriers often develop psychological disability such as symptoms of depression,
anxiety and social self-isolation. Objective. To identify the impact of primary hyperhidrosis on the quality of life of patients, by analyzing the effectiveness of available
treatments for the improvement of symptoms generated before the condition. Methodology. In the systematic review, scientific information was collected in Pubmed,
Scopus and Taylor & Francis, the information obtained was from original articles and meta-analysis from January 2011 to December 2022, the search equation
"hyperhidrosis", "psychology", "mental health" and "quality of life". Results. We obtained 127 sources among PubMed, Scopus, Taylor & Francis, reviewed and eliminated
duplicates and articles lacking information of interest, selecting 41 articles, and then applied the inclusion and exclusion criteria to the remaining articles, finally obtaining
8 articles for analysis. Conclusion. The main psychological impact of primary hyperhidrosis is anxiety and depression, which are more prevalent in female patients, and
the main repercussion in daily life is social isolation, where the support of family members plays an important role in the patient's recovery, and the direct cause of the
disease is unknown, being its cause multifactorial.
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