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Dermadry® BLOG

Sweat Disorders: What Can Your Sweat Say about You?

By Sam Nardi 2020 Feb 21st
Dermadry Team

Hidrosis: Sweat

Sweating is a necessary function of the human body that allows us to regulate body temperature, to keep us cool and prevent us from overheating. But how much sweat is too much sweat? Do you sweat enough? Does sweat smell? Why does sweat stain clothing? These are just some questions you may have asked yourself in the past (or right now, as you’re reading this).

Sweat is a colorless and odorless liquid that is triggered by environmental (heat) factors and emotional (stress) factors, however there are some exceptions. Below, you’ll find a breakdown of sweat disorders, because while everyone sweats, not everyone necessarily sweats the same.

Hyperhidrosis: Excessive Sweat

Hyper = increased | hidrosis = sweating

Hyperhidrosis is a medical condition characterized by sweating in excess of the body’s thermoregulation needs. It is, by far, the most common sweat disorder.

Those who suffer from hyperhidrosis will experience uncontrollable sweating that is not necessarily triggered by anything but could be aggravated by certain situations. Those who have hyperhidrosis generally sweat 4-5 times more than the average person. There are different types of excessive sweating, categorized by cause, trigger, and region(s) affected, which are listed below.

Primary Hyperhidrosis

  • Primary hyperhidrosis is the most common type of hyperhidrosis.
  • It is believed to affect at least 5% of the global population (1 in 20 people), but most likely affects a lot more due to a lack of awareness and diagnosis of the condition.
  • Primary hyperhidrosis has no known cause and no cure.
  • It is usually localized, meaning it affects targeted areas on the body (not the entire body).
  • The areas most commonly affected are the hands, feet, underarms, and face.
  • Primary hyperhidrosis is linked to decreased quality of life and increased risk of anxiety and depression.
  • Effective treatment exists to manage its symptoms and keep sweating under control.

Secondary Hyperhidrosis

  • Secondary hyperhidrosis is excessive sweating as a side-effect of another medical condition or medication.
  • It is typically generalized, meaning it affects the entire body (larger areas) not just certain body parts. In some cases, it can be localized to certain body parts, but this is less common.
  • Infections, diabetes, heart failure, obesity, menopause, and alcoholism are some of the conditions that can cause excessive sweating.
  • Some common medications that can cause excessive sweating are antidepressants, migraine medications, pain relievers, opioids, and diabetes medications.
  • The best course of treatment is to consult a medical professional to identify and treat the underlying condition or identify the medication causing excessive sweating.
  • Its side effects can be treated by using sweat-diminishing and inhibiting products.

Gustatory Hyperhidrosis (Frey’s syndrome)

Compensatory Hyperhidrosis

  • Compensatory sweating happens when you completely stop sweating in one area, and your body compensates by sweating more in another.
  • This could be the result of trauma or injury to a body part, where the sweat glands are affected and no longer able to produce sweat, therefore your body starts sweating more in another area to make up for it.
  • Most commonly, compensatory sweating is an extremely common side effect of ETS, an extremely risky surgery to treat hyperhidrosis, which has been banned in certain countries because of the risks it poses. ETS surgery is most commonly used to treat palmar hyperhidrosis, and while sometimes effective, it often results in patients just sweating more in other, even more, unpleasant areas.

Hypohidrosis/Anhidrosis: Absent Sweat

Hypo = decreased | hidrosis - sweating

While not sweating enough may be a dream to a hyperhidrosis sufferer, the lack or complete absence of sweat can be a dangerous condition with serious side effects. Hypohidrosis is a condition characterized by limited sweating, while anhidrosis generally refers to the complete lack of sweating. They are sometimes used interchangeably.

A rare condition in which the sweat glands make little or no sweat. It can affect the whole body or a small part of the body. Hypohidrosis may be caused by severe burns, radiation, infection, inflammation, or other injuries to the skin. It may also be caused by certain medicines and some conditions that affect the skin, nerves, connective tissue, or sweat glands. It may be inherited as part of a genetic condition or develop later in life. Also called anhidrosis.

Hypohidrosis

  • Hypohidrosis is a decreased ability to sweat. It is a less severe form of anhidrosis, which is when a person is completely unable to sweat.
  • Someone who suffers from hypohidrosis is less able to sweat, meaning their body can’t cool down as efficiently.
  • They are at high risk for heat-related illnesses, as their body can’t properly cool down.
  • Some potential side effects include very dry skin, skin flushing, inability to tolerate heat and physical exertion, feeling excessively hot, and lightheadedness

Anhidrosis

  • Anhidrosis is the complete absence of sweating.
  • It can affect a specific area of the body, for example, following a burn injury, the sweat glands in the affected area may no longer work. Anhidrosis in one area often leads to compensatory sweating in another.
  • Anhidrosis can also occur on a large area of the body, in this case it poses severe risks as someone who cannot sweat an adequate amount are at risk of overheating due to improper body temperature regulation (which is done through sweating).
  • It can often be a side effect of medication, including antipsychotic medications and anticholinergics, which can interrupt the proper functioning of sweat glands.

Bromhidrosis = Malodorous Sweat

While everyone suffers from occasional body odour, some have it a lot worse than others, and in these severe cases, it’s called bromhidrosis. Sweat itself is an odorless liquid, but when it comes in contact with the bacteria on your skin it can release unpleasant odours.

Most people can rid themselves or control their body odour by following basic hygiene practices and using deodorants. However, those with bromhidrosis will report a very strong pungent smell, even just minutes after showering in some cases, making it very difficult to manage. Many who suffer from bromhidrosis, also suffer from hyperhidrosis, and vice versa.

There are two main types of the condition, categorized by which type of sweat gland is affected: apocrine or eccrine.

Apocrine bromhidrosis

  • Apocrine bromhidrosis is the most common type of the condition, which almost exclusively affects the underarm area. The ammonia and fatty acids present in apocrine sweat release a musty, pungent odor when broken down by bacteria.

Eccrine bromhidrosis

  • Eccrine bromhidrosis is mostly linked to the ingestion of certain types of strong-smelling foods such as garlic and onions. It can also be the result of taking certain medications or various metabolic conditions.


Chromhidrosis: Colourful Sweat

Chrome = colour | hidrosis = sweat

Some people sweat too much, some too little, and some...sweat in colour. Below is a quick guide to understanding the different types of chromhidrosis, aka colourful sweat.

Apocrine Chromhidrosis

  • Apocrine chromhidrosis is caused by the presence of lipofuscin (a yellowish-brown pigment), a pigment that has made its way into the sweat glands, when it’s not supposed to.
  • The cause of this is still unknown to scientists, but essentially this pigment makes its way into the apocrine glands where it oxidizes (which can give it a different color) and is then excreted out with the sweat.
  • Depending on the level of oxidation, it can cause black, blue, green, brown, red, and yellow sweat.
  • The condition is extremely rare, and so research on the topic is quite limited, and no cure or effective treatment for the condition exists.

Eccrine Chromhidrosis

  • Eccrine chromhidrosis is caused by the ingestion of certain dyes, chemicals, or drugs, which then find their way into the eccrine glands and where they are excreted with the sweat.
  • Cases of red, yellow, and blue sweat have been documented.
  • This type is treatable by identifying the color-causing agent and removing exposure to it.

Pseudochromhidrosis

  • Another more common type of the condition is called pseudochromhidrosis (pseudo = not genuine), which is when sweat becomes colored when it comes into contact with something on the surface of the skin.
  • Therefore, in this case, the sweat was not colored when leaving the body but has been given its color by encountering something on the skin (dyes, chemicals, etc.).
  • This is the more common type of the condition, and this one can easily be treated by identifying what is causing the sweat to become colored on the skin and removing exposure to it.
  • It is not considered “true” chromhidrosis, as the sweat itself is colorless.
  • Some examples can be sweat coming into contact with hair dye on the scalp, or sweat coming into dark blue pigment in jeans, which can make the sweat appear coloured.

Hematidrosis = Blood Sweat

The rarest of all sweat disorders is hematidrosis, which is when blood is excreted with sweat.

  • Hematidrosis is an extremely rare condition, where the body excretes blood-tinged sweat.
  • It happens when capillary blood vessels that feed the sweat glands rupture. This causes some blood to be found in the sweat.
  • It’s thought to be the result of severe mental anxiety and anguish, which activates the fight-or-flight response to a degree that causes hemorrhage of the blood vessels supplying the sweat glands.
  • The result is not pure blood being excreted from the sweat glands, but rather sweat containing trace amounts of blood that will also give the sweat a red hue.

There are many types of sweating disorders, what they all have in common is that they are largely misunderstood and can cause or be the cause of embarrassment and anxiety. Sweating, in its many forms, can affect someone’s physical, emotional, occupational, or social life, and general wellbeing. Consulting your healthcare professional, talking to someone, and educating yourself on treatment options are the first steps.

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