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Craniofacial Hyperhidrosis: Causes and Treatment Options
Written by Katie Crissman
October 01 2020

Do you struggle with excessive facial sweat? You’re not alone! When someone sweats excessively from their face for no apparent reason it’s called craniofacial hyperhidrosis. This type of hyperhidrosis can cause the scalp, nose, chin, and cheeks to produce more sweat than they typically should.[1] Primary focal hyperhidrosis, a form of hyperhidrosis that has no apparent cause and affects people over a lifetime, is the most common reason that people develop excessive craniofacial sweating. About 3% of the population struggles with primary focal hyperhidrosis, and of those people, around one in five will develop symptoms of facial sweating.[4] That means that there are a lot of people with this problem! It also tends to affect men more frequently than women. Unfortunately, craniofacial hyperhidrosis can have a negative impact on a person’s quality of life if it’s left untreated.[4][1][4] For example, many women are unable to keep makeup on, and sufferers can become very self conscious about their appearance. Many with craniofacial hyperhidrosis go on to develop anxiety because the face is so integral to social interactions and excessive facial sweating leaves people feeling self conscious about one of their most prominent features. It’s a problem that needs to be taken seriously, and treated with respect. Luckily, there are treatments available that can lessen the burden of sweat, and reduce both a person’s sweating and anxiety.[1]

Causes

There are two main subtypes of hyperhidrosis that can cause excessive facial sweating: primary focal hyperhidrosis and secondary hyperhidrosis. It’s important that you know which type is causing your sweating because secondary hyperhidrosis is caused by specific underlying factors that can affect how your condition is treated.[1]

If your doctor determines that your craniofacial sweating is caused by primary hyperhidrosis then it means that your condition has no well understood cause. Doctors are unsure why, but primary focal hyperhidrosis causes eccrine (sweat) glands to be overactive. People with hyperhidrosis have sweat glands that look and function the same as normal sweat glands, but they produce much more sweat. It’s known that stress can cause sweating on the face and neck to worsen, as can heat. It’s also more likely to occur in men and typically begins in early adulthood.[1] While some triggers of facial sweating are understood the cause of primary focal hyperhidrosis is not.

If your doctor suspects that your craniofacial sweating is caused by secondary hyperhidrosis it means that there is an underlying problem causing you to sweat excessively. There are a host of conditions and diseases that cause secondary hyperhidrosis which may be responsible for facial, scalp, and neck sweating. These can include anything from infections, endocrine disorders, ,the use of some medications, and even very serious issues like cancers.[1] If you have secondary hyperhidrosis, don’t panic. In most cases your doctor can treat the underlying problem so that your symptoms improve. Even if it sounds scary, receiving the medical treatment you need is in your best interest. The most common cause of secondary hyperhidrosis is a medication side effect, so make sure you inform your doctor about all the medications and supplements you are currently taking[5]

Many people find that their facial sweating is worse during times of high anxiety.[3] Often those who experience craniofacial sweating also suffer from stress sweating. If this is the case, then measures to reduce anxiety may also help to reduce the amount of sweating you experience. However, it’s important to understand that hyperhidrosis is not typically caused by an anxiety disorder. Therefore, treatment of hyperhidrosis along with stress reduction techniques will be the most effective to minimize symptoms.

Treatments

The type of treatment each patient requires depends on the cause of their craniofacial sweating. For those with primary hyperhidrosis, the goal is to reduce facial sweating and manage their symptoms via treatment. If a patient has craniofacial sweating caused by secondary hyperhidrosis, then the goal is to eliminate the underlying issue, or to manage symptoms if the causative agent can’t be reversed.

Antiperspirants, Creams, and Oral Medications

The first line of treatment when attempting to stop facial sweating is to use topical antiperspirant creams. There are over-the-counter topical creams for hyperhidrosis that contain aluminum chloride, a substance that reduces the amount of sweat eccrine glands produce. If this does not work then patients can move on to the use of a prescription topical cream that contains an anticholinergic, usually glycopyrrolate. According to the most recent research 2% glycopyrrolate cream seems to be an effective treatment for excessive facial sweating.[4]

If topical creams do not work then doctors often move on to a type of oral medication called an anticholinergic. This type of medication works on the entire body to reduce sweat production by interfering with the binding ability of a neurotransmitter called acetylcholine. There are not many studies on the efficacy of this treatment specifically for craniofacial hyperhidrosis. However, the studies that do exist show that oral medication does tend to help, but can come with side effects. The main side effect that bothered patients in the studies available was dry mouth, although others can occur[4]

Botox

Botox injections are a third line treatment for craniofacial hyperhidrosis. This means that they are used after topical therapies and oral medications have failed to help someone. Botox injections are used for the treatment of axillary hyperhidrosis most frequently, but they are used for facial sweating on occasion. However, there is no current consensus on the amount and type of botulinum toxin that should be used. Issues can also occur regarding aesthetic concerns due to Botox injections causing facial asymmetry and brow ptosis (drooping).[2] When Botox injections have been studied for the treatment of craniofacial hyperhidrosis Botulinum toxin A was used and it was shown to be a relatively safe and effective treatment. More studies need to be performed to demonstrate the safety and effectiveness of this treatment over time, and in a larger group of people.[1]

Endoscopic Thoracic Sympathectomy

This is a type of surgery in which the nerves of the sympathetic ganglia are disconnected from eccrine sweat glands. The sympathetic ganglia is the part of the nervous system that connects to sweat glands to the rest of the nervous system and which is responsible for the flight or fight response. When these nerves are disconnected it prevents the body from being able to sweat in a particular area of the body because it can no longer communicate with the sweat glands in that location. This is a viable treatment option for those suffering from craniofacial hyperhidrosis. Usually, to get rid of sweating on the head and neck, a surgeon will have to work on the T2 or T3 area of the spine. The nerves can be blocked by various means including clipping, transection, ablation and clamping.[4] While ETS is very effective at stopping excessive sweating of the face, it can come with some serious side effects. ETS comes with a potential complication called compensatory sweating, in which the body sweats excessively in areas the surgery was not performed on. Compensatory sweating can be so distressing that some patients decide to have the surgery reversed. There is a type of surgery called a needlescopic thoracic sympathetic block which essentially does the same thing as ETS but the nerves are just clipped. This way, if a patient experiences compensatory sweating, the procedure can more easily be reversed.[3] Surgery should be reserved as a last resort for severe cases of craniofacial hyperhidrosis.

Excessive facial sweating can be an extremely burdensome form of hyperhidrosis. The good thing is that new treatments are being developed each year and many effective treatments are already available. If you are struggling with this, then please, don’t give up! Keep trying treatments to see what works for you - there is hope!

Sources
  1. Craniofacial hyperhidrosis can usually be managed pharmacologically, but surgery may sometimes be needed. (2016). . Drugs & Therapy Perspectives, 32(5), 191-194. doi:10.1007/s40267-016-0282-9
  2. Huddle, J. R. (2014). Hyperhidrosis: Causes, Treatment Options and Outcomes. New York, NY: Nova Science.
  3. Lin, T. S., & Chou, M. C. (2002). Needlescopic thoracic sympathetic block by clipping for craniofacial hyperhidrosis. . Surgical Endoscopy, 16(7). doi:10.1007/s00464-001-8231-6
  4. Nicholas, R., Quddus, A., & Baker, D. M. (2015). Treatment of Primary Craniofacial Hyperhidrosis: A Systematic Review. American Journal of Clinical Dermatology, 16(5), 361-370. doi:10.1007/s40257-015-0136-6
  5. Pariser, D. M. (2014). Hyperhidrosis (4th ed., Vol. 32). Philadelphia, PA: Elsevier.
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Body Areas Affected by Hyperhidrosis

9 Outrageous Things People Try to Avoid Excessive Armpit Sweating

By Daniel McCarthy /

9 Outrageous Things People Try to Avoid Excessive Armpit Sweating


On my first day of work a few years ago, I got dressed to impress and walked the 20 minutes to my new office to meet my new colleagues for the first time. Having just moved to the southern US, I’d been getting used to the unbearable humidity and its effects on my excessive armpit sweating. Luckily (I thought), the sun wasn’t out and the temps dropped below 80, so maybe my sweat glands wouldn’t take center stage! Well...I arrived to meet my colleagues looking like a wet bass in business clothes. Thank goodness I arrived 15 minutes early, which brings me to the first outrageous thing people try to avoid armpit sweating. 

  1. The Hand Dryer 

I anxiously scurried to the nearest bathroom, declothed, and put the hand dryer to good use on my shirt stains and sweat stains. More outrageously, I awkwardly hovered my sweaty extremities (including my sweaty underarms) over the hand dryer. Thankfully, I reapplied my antiperspirant and headed out to meet my colleagues a decently dry man. That was the day I knew I really needed clinical strength antiperspirant for my excessive armpit sweating (and a car). 


  1. Pantyliners


Many with excessive underarm sweating already know that underarm pads are one way to help with sweating armpits. But if you find yourself sans pad and worried about your excessive armpit sweating, you would not be the first person to try pantyliners. That’s right, pantyliners have been used in a pinch to help keep sweat stains at bay. 

  1. Give a shirt

In 2019, a reddit user posted that to combat his excessive armpit sweating, he skipped the typical clothing and made his own shirt. He posted asking others to try out his creation and received over 250 replies! By creating and giving others shirts, this innovative reddit user designed his way into the hearts of many with smelly armpits. 

  1. Get inked

If you’ve been debating whether to get a tasteful tattoo and you have hyperhidrosis, this finding may just help you make your decision. A 2017 study found that getting inked helped reduce sweat [1]! Now, I don’t recommend choosing a tattoo as a means of treatment for excessive armpit sweating (and maybe don’t tattoo your armpit), but the connection is a fun little fact nonetheless. 

  1. Become a naked mole rat

If you can’t pull the trigger on an armpit tattoo, another method some people have tried is hair removal. Yes, like Steve Carrell (who actually has hyperhidrosis himself) in the hit movie 40-year Old Virgin, removing hair can help reduce sweat buildup for you too. Many likely already “naturally” lose hair thanks to some sweat prevention products, but more natural hair removal may just be the trick to solving excessive sweating. 

  1. Armpit art

Even though we know most sweaty armpit causes, like too much caffeine or spicy foods, it’s no fun to cut these out completely. A more outrageous approach to excessive underarm sweating is actually turning sweating armpits into art. Multiple users of the Reddit community r/Hyperhidrosis have created shirts, sweatshirts, and other clothing that includes beautiful tie-dye in the armpits. Creative, fun, and beautiful, and even better when combined with sweat prevention like antiperspirant or carpe underarm. 

  1. Vinegar your armpit

You may already know how to get rid of pit stains with vinegar, but there are other interesting ways it can help with excessive armpit sweating. Splashing vinegar on your sweaty underarms  is one method many recommend. Those that swear by this method also recommend using deodorant or antiperspirant, too. 

While we don’t know how this was discovered, I like to think someone accidentally splashed vinegar on their pits hundreds of years ago and voila! Too bad the first person to splash his pits with vinegar didn’t also have access to the best antiperspirant for his excessive armpit sweating. 

  1. Baking soda your sweaty underarms

If you find deodorant or antiperspirant irritating, one creative way to help alleviate your excessive underarm sweating is baking soda. Many crafty people with hyperhidrosis swear that not only can baking soda help reduce sweat, but it can also help alleviate pesky underarm smell with some of the best sweat prevention. 

  1. Restart the plaid fad

Black t-shirt, black sweatshirt, black button down, black tank top. If this sounds like your closet, you’re clearly an expert on the hyperhidrosis wardrobe. But if you want some variety as you fight excessive armpit sweating, add some plaid, a trick many with hyperhidrosis use that you may not know. Hey, you just may be starting the resurgence of the plaid fad, and at worst, you’ll add some fun, lumberjack variety to your dark closet. 


Sources: 

[1] Luetkemeier, M. J., Hanisko, J. M., & Aho, K. M. (2017). Skin Tattoos Alter Sweat Rate and Na+ Concentration. Medicine and science in sports and exercise, 49(7), 1432–1436. https://doi.org/10.1249/MSS.0000000000001244
Body Areas Affected by Hyperhidrosis

How to Cure Sweaty Hands Permanently at Home

By Daniel McCarthy /

How to Cure Sweaty Hands Permanently at Home 

Scenario 1: You’re invited into the office, confident you will land the job. You’ve prepared, you’re highly qualified, you have absolutely nothing to worry about. You walk in and confidently reach out to shake the CEOs hand. But then, your confidence turns to dread as the CEO pulls her hand back, wet with your sweat. 

Scenario 2: You’re at home, playing video games with your friends and absolutely dominating. They get so upset, they tell you to take a break to let another friend play. But there’s another problem... nobody wants to use your controller after you finish. Despite your domination, your palmar hyperhidrosis (excessively sweaty hands) has taken center stage. 

Do these scenarios sound familiar? Wondering how to cure sweaty hands permanently? Although you may not have had these exact things happen to you, your sweaty hands likely have caused something similar and you’re looking for a home remedy. To stop sweating these situations, let’s talk about how to cure sweaty hands permanently at home. 

One of the best ways to cure sweaty hands at home is actually not related to the hands at all. Instead, working on reducing anxiety can have immensely positive results on how to cure sweaty hands permanently naturally. There are many root causes of anxiety, and some or many may be related to your hyperhidrosis. Likewise, it is easier said than done to reduce anxiety. But there are also many ways to work on reducing anxiety that are worth a try. One interesting way to reduce anxiety, and in turn, sweaty hands, is to be grateful. Specifically, Petrocchi and Couyoumdjian found that “grateful people experience less anxiety mostly because they are able to encourage and be compassionate and reassuring toward themselves when things go wrong in life” [1]. Other ways include stepping outside for a walk, drinking tea, or even distracting yourself. In general, starting with anxiety reduction not only can help with how to cure sweaty hands, but also your wellbeing in general. 

Another great way to cure sweaty hands at home permanently is to reduce consumption of coffee and alcohol. Now you may be reading this and thinking “Hey, those are all my favorite things! I’m done with this article!”. And while I wholeheartedly agree and enjoy coffee and alcohol myself, consumption in moderation is key, especially with hyperhidrosis. Caffeine, for example, activates part of the brain that is already a main part in causing hyperhidrosis symptoms. Instead of giving it up, try to reduce consumption to under 200 mg or add in decaf to your routine. Alcohol can affect hyperhidrosis in a similar manner, but like coffee, 1-2 glasses of alcohol may be okay. When figuring out how to cure sweaty hands permanently naturally, it is important to find a balance of coffee, alcohol, and managing your hyperhidrosis. And remember to always drink responsibly, in moderation. 

Tackling how to cure sweaty hands permanently, naturally, and at home may require more than behavioral changes we’ve talked about so far. Luckily, there are other great remedies you can try at home! First, finding the right antiperspirant is of paramount importance, especially appropriate antiperspirant for hands. Another possible over the counter option is anti-sweat wipes. If neither of these work for you, another option to cure your sweaty hands permanently is to buy your very own iontophoresis machine for at-home use. This machine delivers mild electrical currents to your hands (or other affected body part) while submerged in water. A combination of these treatments may have your hands feeling less clammy in no time! 

Ultimately, your palmar hyperhidrosis may not be treatable at home and permanently, but these recommendations may help alleviate some of your symptoms. If symptoms persist, consult a medical professional for further assistance with how to cure sweaty hands. 



Sources

Sources

1. Nicola Petrocchi & Alessandro Couyoumdjian (2016) The impact of gratitude on depression and anxiety: the mediating role of criticizing, attacking, and reassuring the self, Self and Identity, 15:2, 191-205, DOI: 10.1080/15298868.2015.1095794
Antiperspirant

8 Random & Interesting Facts about Excessive Armpit Sweating

By Daniel McCarthy /

8 Random & Interesting Facts about Excessive Armpit Sweating

Our worries about shirt stains, sweaty underarms, and smelly armpits may dominate how we think about excessive armpit sweating. Hey, we may even avoid thinking about these all together. But guess what? There are some random and interesting facts that just may change how you think about excessive underarm sweating! Let’s take a look: 

Fact number 1: Sweat by itself ISN’T smelly

Sweat is often associated with smelliness. But by itself, it doesn’t smell AT ALL. The reason sweat can smell (in places like your armpit) isn’t really about sweat. It’s about the sweat glands (and hair)! Apocrine glands are the biggest of sweat-producing glands and are usually located near hair. It’s this combo that leads to smelly armpits.

Fact number 2: Excessive armpit sweating is as old as cavemen

Hang with me here. Excessive underarm sweating is connected to the fight-or-flight response ingrained in even the most ancient of human predecessors. This excessive armpit sweating response has helped humans survive for millenia. And yep, it means our cavemen ancestors likely had sweating armpits, too. Even though they didn’t have to worry about shirt stains like us, we have the benefit of products like carpe underarm and antiperspirant in general to help with our excessive armpit sweating.  

Fact number 3: Famous people worry about excessive armpit sweating too

Michael Gary Scott, fearless and deliciously cringeworthy leader of Dunder Mifflin Scranton on the show The Office, is perfectly played by actor Steve Carell. Carell seemed to play the role with such ease, comfort, and confidence that nobody would ever know he was worried about excessive underarm sweating due to his hyperhidrosis. Co-star Rainn Wilson (Dwight Schrute on the show) even pointed out that the set temperature was a cool 64 degrees to keep Carell’s sweaty underarms from becoming the focus of the scene. 

Even though Carell’s excessive armpit sweating wasn’t part of the show, I like to think Michael’s approach to sweat stains could be summed up by his famous line:  “I knew exactly what to do. But in a much more real sense, I had no idea what to do.” 

Fact number 4: Other celebrities combat hyperhidrosis too

Steve Carell is not the only notable person looking for the best sweat prevention. As a longtime vampire and real-life human with hyperhidrosis, Robert Pattinson is another actor who combats hyperhidrosis (and werewolves) on the regular. 

Like Pattinson and Carell, Halle Berry also has hyperhidrosis. Famously, Berry confidently showed her sweat stains on the Ellen Show back in 2010. So when you’re feeling a little self-conscious about your own excessive underarm sweating, remember you too can confidently move through your day like Berry barring her pits for the world. 

Fact number 5: Ventilation over here please!

If you’re still worried about how to get rid of pit stains, some ventilation could provide a brief respite. Because we sometimes get pesky pit stains, it can feel like our excessive underarm sweating is due to our pits proclivity to produce the most amount of sweat. Yet, this annoying issue is more commonly attributed to a lack of ventilation, although sweaty armpit causes cannot be narrowed to one thing. Still, a little ventilation and clinical strength antiperspirant can go a long way in dealing with pesky pit stains and excessive armpit sweating. 

Fact number 6: An underappreciated aspect of a non-meat diet

Sometimes even the best antiperspirant and deodorant may not feel like enough to help with excessive armpit sweating and underarm smell. That’s okay though because there are other interesting ways to approach this issue. A 2006 study showed that women found mens’ armpit odor “more attractive, more pleasant, and less intense” when these men ate a non-meat diet [1]. If you haven’t already thought about eating less meat, the improved aroma of your pits (and the kitchen) may be another reason to eat a non-meat diet. 

Fact number 7: Fashion matters

Choosing clothes is a fashion statement for many. And while fashion may matter more to some than others, there’s one interesting reason we can all get behind to choose our clothes. Our clothing choices can help deal with excessive underarm sweating. That’s right, there are clothes, materials, styles, and pads that all can help with excessive armpit sweating as well as excessive sweating and shirt stains in general. 

Fact number 8: You aren’t alone

An estimated 2-3% of the US population suffers from axillary hyperhidrosis (excessive underarm sweating). Even though this percentage may seem small, 3% of the US population is right around 10 million people. That’s like all of NYC combating excessive armpit sweating at the same time. It can be easy to feel isolated in dealing with hyperhidrosis, but there’s some comfort in knowing many others are dealing with the same worries. 

Sources

 

  1. Havlicek, J., & Lenochova, P. (2006). The Effect of Meat Consumption on Body Odor Attractiveness. Retrieved from https://academic.oup.com/chemse/article/31/8/747/364338
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