Sweating is one of the first methods the body uses to control temperature. It is common for people to sweat more when temperatures increase, during exercise or in response to situations that make them nervous, anxious or stressed. However for those who suffer from hyperhidrosis, sweating is excessive, unpredictable and occurs even when temperatures are cool or when an individual is at rest. This condition affects millions of people around the world. While it is not life-threatening, it can lead to significant discomfort, both physically and emotionally, and often requires medical attention. Neurologic, metabolic and other systemic diseases can sometimes cause excessive sweating, but most cases of hyperhidrosis occur in people who are otherwise healthy. Primary or focal hyperhidrosis occurs largely in the palms, feet or armpits and may have a genetic component as it tends to run in families. On the other hand, secondary hyperhidrosis may be the result of an underlying medical condition. Conditions that may cause secondary hyperhidrosis include menopause, low blood sugar, thyroid conditions, certain medications, some cancers and infectious diseases. Therapy for hyperhidrosis can be challenging for both the patient and the physician. A team of dermatologists, neurologists and cardiothoracic surgeons can work with you to create the best treatment plan for your needs. Initial treatment of hyperhidrosis may include both topical and systemic medications. If these methods fail to achieve desired results, treatment options may include iontophoresis and botulinum toxin (Botox) injections. In severe cases and when conservative treatments fail to bring relief, a minimally-invasive surgical procedure called endoscopic thoracic sympathectomy (ETS) may be recommended. This procedure, performed by a cardiothoracic surgeon, turns off the signal that tells the body to sweat excessively. It is usually done on patients whose palms sweat much more heavily than normal. It may also be used to treat extreme sweating of the face. ETS does not work as well for those with excessive armpit sweating. For excessive sweating in the armpits, there are two additional permanent treatment options. The first option is to surgically remove the sweat glands in the armpit. The second and less invasive option is miradry™. MiraDry works by delivering precisely controlled electromagnetic energy to the underarm area, eliminating the underarm sweat glands. To maximize the quality and duration of results, two treatments, three months apart are typically required. Each treatment lasts about an hour. If you or a loved one sweats profusely, has night sweats for no apparent reason or if unexplained or unpredictable wetness is disrupting your life, speak to your primary care physician or schedule an appointment with a board certified dermatologist. We can assemble a team of specialists who will take the time to listen and thoroughly understand your health issues and concerns. We tailor the care you receive to your personal health care needs and our specialists collaborate to offer you the best possible outcomes, safety and service.