Everyone experiences increased sweating when exposed to a stressful trigger at some point or another, so this is an important topic to understand. The definition of stress sweat is: increased sweating caused by a stressful psychological stimuli. This is different than a person experiencing increased sweating due to heat or intense exercise, as it involves only a psychological component as the sweat inducing trigger. Normally, sweat works with body temperature in a way that helps the body keep its internal temperature stable even in hot conditions, but stress can trigger the same type of physical reaction as heat. For people with hyperhidrosis, stress can be one of the primary culprits that cause their excessive sweating. There are specific reasons that cause the body to produce sweat during certain psychologically stressful situations and it is one of the reasons why humans sweat. However, for a person with hyperhidrosis this process can be extremely excessive and embarrassing on top of an already psychologically tough situation.[3]
Symptoms of Sweat Stress
Hyperhidrosis is not bad for someone's health, but the symptoms that arise from the stress it causes can be. Stress sweat can occur on specific areas of the body and, at times, it can be distressing. Precipitating an episode of stress induced sweat a person will typically feel nervousness, excitement, or anxiety. The following symptoms may then occur:
- Craniofacial sweating (beads of sweat on the forehead)
- Palmar sweating
- Plantar sweating
- Axillary sweating
- Groin sweating
- All over body sweating (may occur but it is usually localized)
- Offensive body odor
Not everyone will experience all of these symptoms of stress sweat, and many may only experience one or two. Stress sweating usually effects localized parts of the body but can occur all over, this varies between individuals. Some people experience clammy hands and feet when dealing with stress sweating, while others soak through there clothes. It does often involve apocrine sweat glands, which are most densely located in the axillary and groin regions. Unfortunately, apocrine sweat glands are responsible for the odor that is sometimes a particular symptoms of stress sweat.[1] This is because of what the sweat is made of, bacteria readily break down the type of sweat produced by apocrine glands and this creates a foul odor. There are two types of sweat glands stress can activate, eccrine, which are located all over the body, and apocrine, which are described above.[4]
The Physiological Reasons Stress Sweat Happens
Stress sweat occurs in both healthy individuals and those with hyperhidrosis. It is most likely to occur on the palms, soles, face and armpits.[1] In a typical individual, sweat happens as a result of a psychological stressor because it activates a part of the autonomic nervous system called the sympathetic nervous system, which in turn activates eccrine (sweat) glands through specific neurotransmitters. The autonomic nervous system is responsible for maintaining homeostasis and is made of up two parts, the sympathetic nervous system which excites the body, and the parasympathetic nervous system which calms it down. In people with hyperhidrosis, the sympathetic nervous system is thought to be overactive, which leads to overactive sweat glands and an overabundance of sweat. During a situation that would induce sweat stress in anyone, a person with hyperhidrosis will experience a much greater volume of sweat than a typical individual.[2]
While the exact cause of hyperhidrosis is currently unknown, there are some ideas about what may lead to stress sweating. Interestingly, it can be demonstrated that the sympathetic nervous system is related to the excessive sweat created in people with hyperhidrosis. Sometimes patients with hyperhidrosis will have a surgery called endoscopic thoracic sympathectomy (ETS) done as a treatment for sweaty hands. ETS is a surgery which destroys the nerves that activate the sweat glands in the palms. Once this is done, people with hyperhidrosis will no longer experience the effects of stress sweat in that area. However, they still experience the change in blood flow that occurs from temperature changes. This means that there is a specific nervous system response that activates sweat glands that does not affect surrounding blood vessels or skin tissues.[2] All of this indicates that a psychological response can cause a host of physiological processes to occur which increases sweat in normal individuals, and which may be a causative factor in the overproduction of sweat in those with hyperhidrosis. This is also the reason that hyperhidrosis and anxiety are so closely related.
Situations that Cause Stress Sweat
Any situation that can trigger a nervous or excited feeling has the ability to elicit stress sweat. However, there are common situations that are highly associated with potential increased sweating, including:
- Public speaking and its effect on hyperhidrosis
- Intimate relationships (especially in the beginning)
- Performing (playing sports with hyperhidrosis, debating, acting etc..)
- Sudden panic moments (forgetting an assignment, realizing you missed an important deadline etc…)
- Intense social engagement
These are all things that everyone will face at some point, and struggling with the fear of sweat stress can make that even harder for those with hyperhidrosis.[4] It is also important to note that hyperhidrosis can cause anxiety and that this can cause a host of other related issues.
Treatments for Stress Sweat
There are many potential treatments for stress sweat depending on the severity of the case. For example, if stress sweat is severe and usually caused by social or performance anxiety the use of the oral medication for hyperhidrosis called propranolol, a type of beta blocker, might be appropriate to use.[4] If sweat stress is less severe it may make more sense to take a more conservative approach to managing your sweat. These techniques can include the use of stronger antiperspirant, choosing clothes wisely, deep breathing techniques and finding methods to generally reduce your stress. There are anxiety reduction methods that can lessen excessive sweating, especially in those who are dealing with stress sweating. If symptoms are pervasive and persistent there are ways to manage your hyperhidrosis sweat with a doctor through the use of iontophoresis, botox injections, local permanent procedures, surgeries and other resources that are available.[4]
Due to the fact that stress sweat often involves the apocrine glands of the armpit and groin it can be particularly prevalent for it to produce a bad odor. If this is the case, there are ways to stop body odor. It would prudent to use strong antiperspirant, shower often, change clothes after sweaty situations and see a doctor if the problem is especially troubling. There are antiperspirants for the face and groin that are made for areas with sensitive skin.
Sweat stress can stink, but it’s important that people don’t let it’s effects stop them from doing the things they want, even if they are stressful.
Sources
- Harker, M. (2013). Psychological Sweating: A Systematic Review Focused on Aetiology and Cutaneous Response. . Skin Pharmacology and Physiology, 26(2), 92-100. doi:10.1159/000346930
- Huddle, J. R. (2014). Hyperhidrosis: Causes, Treatment Options and Outcomes. New York, NY: Nova Science.
- Macefield, V. G. (2009). Developments in autonomic research: A review of the latest literature. Clinical Autonomic Research, 19(3), 133-136. doi:10.1007/s10286-009-0016-3
- Pariser, D. M. (2014). Hyperhidrosis (4th ed., Vol. 32). Philadelphia, PA: Elsevier.