Living with hyperhidrosis

Daniel Reast

Hyperhidrosis is excessive sweating but carries a heavy, invisible burden—it’s not just damp patches and deodorants, says Daniel Reast  

Like many children, I dreaded the weekly PE lessons at school. That hour of rushed dressing and undressing with aggressive, often much fitter classmates was never something to look forward to. It was made worse by my sweating. Although I wasn’t officially diagnosed with hyperhidrosis at the time, the signs were painfully obvious. Indeed, school laid foundations for a crippling low self-worth that persists to this day.

But I’m not alone. It’s estimated that at least 1-3 per cent of the UK population suffer with some form of hyperhidrosis. The majority of people with the condition experience localised hyperhidrosis, finding it in specific areas such as the hands, armpits and feet. Some, like me, find there’s not a place that goes unaffected. This is known as generalised hyperhidrosis and is much harder to treatif possible at all.

"At least 1-3 per cent of the UK population suffer from some form of hyperhidrosis"

Man sweating illustration

Both varieties of the condition cause considerable embarrassment, even shame for some. Aidan from Liverpool, who developed heavy sweating at age 13 and is now in his early 20s said, “It makes me anxious that it’s noticeable and self-conscious that people are looking or talking about it”. The physical effects are obvious, but it’s how damp patches and clammy handshakes affect our mental health which needs more attention.

For one business owner, 32-year-old Kay* with palmar hyperhidrosis (affecting the hands), their livelihood was directly affected. They said “It made me very self-conscious…I was meeting clients and I was always nervous to shake their hands. It got to the point where I would ensure my hands were fully dry before the meeting.”

"I was meeting clients and I was always nervous to shake their hands"

This experience highlights a deep problem with the perception of sweating, particularly at times of stress or intense pressure. We’ve all seen film and television comedies which exaggerate sweat to make us laugh, like the scene from Airplane! where Robert Hayes’s character has torrents of water pouring down him. This scene has become a popular meme with gifs of the scene evoking expressions of tension on social media. Such casual representation has made it difficult to see sweat as anything but a joke.

But for some, these moments are real and desperately difficult to manage. Aidan from Liverpool said that, “It’s incredibly frustrating at times. I’ve resorted to folding tissues and trying to use them to absorb it, shaving my arms, trying different diets and nothing really seems to help it”.

Treatment for hyperhidrosis is known to be more effective for people with the condition in specific areas. Antiperspirants, Botox injections and electric therapy known as iontophoresis can halt excessive sweat in particular places. But as one GP, Dr Gerald Jones* told me in confidence, “Patients with the condition all over will sometimes struggle to find a treatment which helps them.” Indeed, knowing this fact only adds to the sense of frustration and hopelessness from experiencing it.

Illustration of a man being stepped on

One of the biggest barriers to treatment and acceptance of the condition is the wider culture of embarrassment about sweating. It’s natural to sweat and it shouldn’t be seen in such unhappy terms. Maria Thomas, founder of the award-winning blog website My Life as a Puddle, told me “Many physicians brushoff hyperhidrosis as just an anxiety problem or tell their younger patients they will eventually outgrow it. The health care community needs to understand that we’re not sweating because we’re nervous, we’re nervous because we’re sweating.”

"It's natural to sweat and it shouldn't be seen in such unhappy terms"

This difficulty in seeking help for managing the condition extends further than just medical care. Sufferers often feel hopeless and trapped by their sweat patches, unable to see how their lives will ever get better. Maria explained to me how tackling this difficult philosophy is vital to accepting your sweaty self. “The important thing is to never give up hope while also being detached from the outcome of finding a cure or a treatment option that works for you. If you base your happiness or productivity in life on whether you sweat, you’ll consistently be disappointed.”

Like many chronic conditions, this positivity can feel very hard to find. Young people who have been diagnosed with hyperhidrosis are at particular risk of suffering mental health problems as a result of their condition. Anxiety, depression and even paranoia from the appearance of damp patches is a sad reality. Clive* told me how the condition crippled him, leaving him feeling suicidal and angry from his diagnosis at 17-years-old. Now at 37, his loved ones and use of coping mechanisms have helped him manage his symptoms. The futility mixed with the knowledge that such a condition has no cure makes young people’s outlook on diagnosis seem very grey.

Illustration of a woman holding umbrella under a rain storm

Another young man, 25-year-old Connor from London, told me that realising his sweating was a genuine problem took time and assistance from another. “I never really thought about it until I did some research and found out I had the condition. It never occurred to me before then I had it.” Connor also went on to explain how his localised version of hyperhidrosis has been successfully treated with Botox injections, though admitted to me “I am aware that most people who suffer with it do not get the treatment and I’m lucky to have had it.”

If young people with hyperhidrosis are unaware, embarrassed and suffering mental health problems as a result of their sweaty reality, how can they get better? Dr Shamali Hoque, consultant dermatologist for HCA, explained to me “Hyperhidrosis patients can have a very poor quality of life if treatments are not offered at an early stage…It is important for hyperhidrosis patients to seek advice early.”

But as the condition affects every corner of a person’s daily existence, it’s hard to feel like any treatment or medical approach will help. In social life, having close support and understanding from loved ones is crucial for developing that confidence which Maria Thomas eluded to. Family, friends and partners have big role to play in helping sweat-stricken relatives manage their condition. Aidan from Liverpool mentioned earlier, also described to me “my friends make me feel very comfortable with it and it really helps going out with them.”

Another sufferer, 29-year-old Simone, explained that “My thoughts were mostly based on the idea that I wouldn’t be able to be too close to people. I’m still pretty social, as well as outspoken about my condition. I just don’t like to be touched.” She then went on to say, “I find that I’m usually the only person bothered by it.”

Simone hits on the real difficulty of hyperhidrosis sufferers to perceive whether others notice or care about their sweat. In public spaces, a passing glance may seem like a stare to someone dripping down through a shopping centre. It establishes a mental barrier to regular living but also a repressive, regular physical routine of washing, cleaning and mopping up sweat. Dr Hoque explained “There is a lot of social stigma associated with this condition and it can exacerbate stress which in turn causes further sweating thus creating a vicious cycle.”

When hyperhidrosis causes such a dense block of anxiety for some, personal contact can be difficult especially for those more intimate moments. I asked Maria Thomas, who herself first noticed her hyperhidrosis at age 12, how those suffering can handle the worries in their sex lives: “Everyone has something they’re dealing with…if you can’t be open and honest with your sexual partner, then you should probably find a new partner! Sweaty people deserve love, too. It’s okay to make a few modifications in the bedroom to help yourself feel comfortable.”

Because hyperhidrosis is often undiagnosed and embarrassing, medical clinicians have struggled to find an effective way of building wider awareness of the condition. But in 2019, health researchers from De Montfort University Leicester carried out a survey of patients with the condition, with the sole purpose to improve treatment policy and raise its profile. The team lead Dr Louise Dunford wrote at the time, “Despite it being a common skin condition, hyperhidrosis is not widely known about, and research is very poorly funded. Raising awareness is key if people are to feel comfortable enough to come forward.” Through speaking to those with the condition, the researchers pushed forward the awareness of hyperhidrosis from a relatively unknown problem to a much-improved clinical pathway it has now developed. But more can always be done.

The estimations for the number of people with hyperhidrosis are vague; it’s not well-reported enough to make an accurate record. Dr Hoque said to me that “There is no doubt that there is a strong link between skin conditions and mental health…This is often underestimated and not addressed.” Addressing a problem is half the task. It takes enormous courage from sweatboxes like me to be confident in their lives, without shame and unburdened. We’re sweaty but we really can’t help it. With better empathy, and just a few blasts of talcum powder, perhaps our reality need not be so futile.

*Names have been changed to protect anonymity

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