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Hot & Bothered: Flushing, sweating, and what your dermatologist can do about it

The heat of summer is (finally!) winding to a close, but that doesn’t necessarily mean the days of sweating through your clothes or showing up at work red-faced are over. For some, feeling all hot and bothered is more than just an environmental issue.

Hyperhidrosis (excessive sweating) and flushing can both be embarrassing and physically uncomfortable skin conditions that make day-to-day life a landmine of awkward encounters and stuttered excuses. (Think: “Oh, don’t mind my glow — I just left the gym!” or “I think I feel a cold coming on, I’m not going to shake your hand.”) Here’s what you can do if you suffer from either.

What Causes Excessive Sweating & Flushing?

Dermatologists estimate that 3% of people in the U.S. experience excessive sweating, making it a remarkably common medical condition. There are two types of hyperhidrosis: Focal (also known as primary), meaning it occurs only in certain spots, like hands, underarms, or feet, and usually begins in childhood or adolescence, and secondary, which is typically all over the body and is a symptom of something else, like menopause, an underlying medical condition, or a drug side effect. While the cause of focal or primary hyperhidrosis is not known conclusively, it’s believed that it is a result of overactive nerves that cue sweating more readily than normal.

The causes of flushing are similar. Many cases of flushing are a symptom of something else, like rosacea, drug or alcohol reaction, or a handful of medical conditions that are far more sinister. Alternatively, flushing can be psychological or emotional — an overactive but otherwise natural response to embarrassment or anxiety — in which case it is called blushing. Blushing may occur alongside hyperhidrosis.

 

Diagnosis & Treatment of Flushing & Sweating

The first thing your dermatologist will need to establish is the root cause of your flushing or sweating. If they are symptoms of something else, you may need to visit your primary care physician to alter prescriptions or your dermatologist may be able to treat the underlying cause, like rosacea. In the case of flushing, if the reddening has nothing to do with emotional responses, your doctor could request additional testing, since it may be a symptom of a more serious illness.

If it turns out that you experience blushing or focal hyperhidrosis, which are neurological responses unrelated to another medical condition there are a few potential treatments.

 

For hyperhidrosis the treatments include:

  • Antiperspirant: You doctor may recommend clinical strength over the counter antiperspirant, or even stronger prescription antiperspirant. Antiperspirant works by plugging the sweat glands in the treated area, which signals the body to stop producing sweat there. The downsides? Antiperspirant can cause itching or burning where applied.
  • Iontophoresis: Iontophoresis machines can be used to treat the hands or feet, by placing them into a pan of water. The machine then runs a low electrical current through the water, which temporarily shuts down the sweat glands. Treatments typically begin at 20 to 40 minutes two to three times per week, but may be reduced significantly once you achieve results.
  • Botox injections: Usually used to treat the underarms, hands, and feet, very small injections of Botox can effectively block the chemical that triggers sweating. This treatment can last about 4 to 6 months.
  • Medicine: Prescription drugs can be used to turn off the sweat response throughout the body, though this carries several associated risks (after all, sweating is an essential part of our body’s ability to regulate temperature). This is usually only used to treat sweating all over the body or from the head.
  • Non-invasive procedures: FDA-cleared for excessive underarm sweating, miraDry is a non-invasive treatment that uses microwave energy to permanently destroy sweat glands.
  • Surgery: Surgery to treat hyperhidrosis can involve removing sweat glands from the underarms or destroying the nerves that send the signal to sweat to the palms. As always, surgery involves some risks, though it is a far more permanent solution if other treatments haven’t worked.

 

Blushing can be treated by:

  • Cognitive behavioral therapy: This treatment helps you observe the connections that cause you to blush and work toward breaking them down. Side benefit: If you suffer from social anxiety in general, this may help you manage other symptoms as well.
  • Medicine: Again, treating the underlying anxiety that causes overactive blushing may be the answer. If you do suffer from anxiety, drugs that address this issue may also serve to lessen blushing.  Persistent redness associated with rosacea can also be improved with certain prescription creams.  
  • Surgery: If you don’t experience anxiety that merits another form of treatment, or if alternate treatments haven’t worked, surgery may be an option. Like the surgical treatment for hyperhidrosis, this procedure involves cutting off the nerves that cause the overactive blushing.

 

Start Treating Your Blushing or Hyperhidrosis Now

Start a visit with your dermatologist now on SkyMD to get the conversation started about your excessive sweating or flushing. By submitting an initial visit through SkyMD, your dermatologist may be able to prescribe initial treatment or have you come in for treatment or further testing. You can quickly and easily get treatment started and see significant improvements in your quality of life fast — no more embarrassing pit stains or red cheeks for you!