The Hidden Worry: Causes and Treatments for Hyperhidrosis and Bromhidrosis

Provider: Limiseok Theme Dermatology Clinic

Sweating is a natural bodily response to regulate body temperature. However, if you sweat excessively and it causes odor, you should suspect hyperhidrosis and bromhidrosis and receive appropriate diagnosis and treatment. More and more people are experiencing difficulties in social relationships or stress due to psychological withdrawal because of hyperhidrosis and bromhidrosis, and as the weather gets hotter, today we would like to share information about the causes and treatments for hyperhidrosis and bromhidrosis, which can lower quality of life.

What Is Hyperhidrosis?

Hyperhidrosis can also occur due to infection, endocrine abnormalities, or neurological disorders. When it occurs in a healthy person without a clear cause, it is called primary focal hyperhidrosis, a condition in which excessive sweating occurs mainly in areas such as the armpits, palms, and soles beyond what is necessary. Even if body temperature does not rise, sweating can increase excessively when a person feels tension, excitement, or stress, and emotional changes also have a major impact. Sweating is essential for eliminating waste products and regulating body temperature, but if you sweat too much, you may experience significant discomfort in daily life due to stickiness and unpleasant odor.

�a0 Hyperhidrosis Symptoms

Without exercise, axillary hyperhidrosis usually has a secretion rate of 50 mg/min or more. In the palms, a secretion rate of 20 mg/min or more is considered pathological.

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Hyperhidrosis may be suspected if two or more of the following symptoms persist.

�a0 ■ The area of heavy sweating includes one localized area such as the hands, feet, armpits, or face.

■ It is bilateral and relatively symmetrical.

■ Symptoms started before the age of 25.

■ There is a family history.

■ There is no sweating during sleep at night.

■ Sweating is severe enough to interfere with daily life.

�a0 �a0 What Is Bromhidrosis?

Bromhidrosis does not occur in everyone who sweats, but hyperhidrosis is often accompanied by it. In particular, axillary hyperhidrosis can cause clothes to become soaked and lead to difficulties, and it may also be accompanied by bromhidrosis, commonly called "underarm odor," making it difficult to use public spaces comfortably.

When sweat is secreted from areas with apocrine glands, bacteria act on the apocrine secretions to produce ammonia and short-chain fatty acids, which are the cause of the odor. Sweat itself does not cause underarm odor, but the greater the amount of sweat, the easier it is for underarm odor to develop. Removing underarm hair can reduce odor by preventing bacterial growth and the accumulation of sweat on the hair shaft.

�a0 �a0 Hyperhidrosis Treatment Methods

Hyperhidrosis treatment is broadly divided into three methods: medication, surgery, and Botox.

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Medication: Aluminum salts are the most widely used topical antiperspirants, and concentrations of 1–2% are used. Products containing aluminum chloride are used at 15–25%. They must be applied repeatedly every day, and side effects may include irritation, burning, and paresthesia.

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Botox treatment: In the past, surgeries such as nerve block procedures were often performed, but due to side effects such as compensatory hyperhidrosis, the approach has been shifting toward managing hyperhidrosis with Botox. Botulinum toxin injections are the most effective non-surgical treatment for focal hyperhidrosis. Botox has the advantage of lasting 4–7 months, with fewer side effects and a shorter procedure time. The method of using Botox is to inject it into the dermis, where it inhibits the release of acetylcholine, a neurotransmitter at the sweat gland synapse, thereby reducing sweating.

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Surgical treatment: Thoracic sympathectomy, a surgical treatment, removes the sympathetic ganglion using thoracoscopy and is performed for palmar hyperhidrosis, with improvement seen in 79% of patients. Surgery-related complications can include hemothorax, pneumothorax, and other injuries. Therefore, treatment should be undertaken carefully after sufficient consultation with medical staff.

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If you think you have excessive sweating and odor and are concerned that it may be hyperhidrosis or bromhidrosis, and you are considering consultation and treatment, it is best to visit a clinic and speak sufficiently with a doctor.

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At Limiseok Theme Dermatology, we do not simply focus on temporary symptom relief; we consider and treat the underlying skin problems. Since opening in 1995, based on more than 600,000 clinical cases, we have made it our principle to provide systematic, individualized treatment for skin problems. In addition, as a way to provide the best treatment service, we use more than 60 of the latest laser and medical devices, and through medical skin care, we address a variety of skin concerns.

If you have any questions about skin concerns other than hyperhidrosis and bromhidrosis, please contact Limiseok Theme Dermatology.

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