Welcome
Lisa J. Pieretti
Executive Director
International Hyperhidrosis Society
The Know Sweat! Campaign
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To raise awareness of devastating condition
To encourage people who sweat excessively to visit a
dermatologist
To let people know that they are not alone!
Consists of public relations efforts and physician education
Also, partnership with college health programs (e.g.,
University of Miami, University of Texas, American
University)
An Introduction to Hyperhidrosis
David M. Pariser, M.D.
President, International Hyperhidrosis Society
Secretary/Treasurer, American Academy of Dermatology
Senior Physician, Pariser Dermatology Associates
What is Hyperhidrosis?
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A physiological, medical condition
characterized by excessive or
unexpected sweating
– Sweat exceeds normal amount
required to maintain consistent body
temperature
– Patients often produce up to four times
the average volume of sweat
– Occurs regardless of environmental
surroundings
What Causes Hyperhidrosis?
• Exact mechanism unknown
• Overproduction of neurotransmitter in sympathetic
nervous system OR
• Sweat glands overreact to normal levels of
neurotransmitter
How Prevalent is Hyperhidrosis?
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Nearly 8 million people in the U.S. have hyperhidrosis
Over 28 million people in the world
Three percent of global population suffers
Compared to 4.5 million adults in the
US have psoriasis
Barriers to Diagnosis
• Widespread lack of awareness
– More than half of people who sweat excessively never
diagnosed or treated
• Medical community inadequately informed, condition
is often misdiagnosed
• Sufferers think nothing can be done
– Think their sweating is normal
– Can’t imagine there is treatment for sweating beyond
regular deodorant
– Often too embarrassed to talk about it
How to Know if Sweating is
“Normal” or Excessive
• There are questions people can ask themselves to
determine whether they sweat too much, e.g.:
– How much time per day spent dealing with sweat?
– Do you carry “supplies” to help manage your sweat?
– How many times per day do you change clothes?
– Do you ever change your social plans due to excessive sweating
or fear of it?
– Does sweating in public cause distress?
– Have you lost friends or a job due to excessive sweating?
Primary Focal Hyperhidrosis
• Excessive sweating not caused by another medical
condition or medication
• Occurs symmetrically on armpits, hands, feet, or face
• Often begins in childhood or adolescence
• Does not occur while sleeping
• May be inherited
Secondary Generalized
Hyperhidrosis
• Can occur over large areas of the body
• May be a symptom of other medical conditions or as a
side effect of some medications
– Anxiety disorders, cancer, diabetes, thyroid malfunction, menopause,
TB
• Important to see a doctor as soon as possible to find
underlying condition
• Occurs even while sleeping
Lifestyle Implications
• Huge psychological and emotional impact can be
devastating to sufferer
• Makes simple daily activities challenging
• Impacts relationships, career choices, mental wellbeing, self-image
• Can lead to social isolation, anxiety disorders,
depression
Treatment Options
• Existing treatment options can be highly effective
– Antiperspirants
– Iontophoresis
– Botox® injections
– Oral medications
– Surgery
Reimbursement
• Not understood as legitimate medical condition by
some insurance companies
• Quality of Life impact message not heard
• Lobbying & education efforts ongoing
Know Sweat! Survey Results
David M. Pariser, M.D.
President, International Hyperhidrosis Society
Secretary/Treasurer, American Academy of Dermatology
Senior Physician, Pariser Dermatology Associates
Harris Interactive Survey
• Surveyed over 1,000 Americans in general population
• Objectives:
– Determine people’s “sweatiest” moments
– Determine people’s attitudes towards sweat and people who
sweat excessively
– Determine level of general awareness about hyperhidrosis and
treatment options
International Hyperhidrosis Society
Patient Survey
• Survey sent to IHHS patient database; over 750
responded
• Objectives:
– To highlight differences in attitudes towards sweating between
hyperhidrosis patients and those in general population
– To compare levels of awareness of hyperhidrosis and treatment
options
America’s “Sweatiest” Moments
• Sweatiest moments are job related – 63 percent of
people said on-the-job issues make them sweat (Harris
survey):
– Running late (32 percent)
– Making a presentation (26 percent)
– Going on a job interview (21 percent)
– Asking for a raise or promotion (nine percent)
– Preparing to resign (six percent)
– Opening an acceptance or rejection letter (two percent)
Excessive Sweating
• Twelve percent of Harris respondents said they sweat
all the time…
• Yet 83 percent of them had not seen a doctor about
their sweating, citing common reasons:
– I don’t think I have a problem (57 percent)
– I don’t think anything can be done about it (28 percent)
– I haven’t had the time (14 percent)
– I am too embarrassed (two percent)
Others’ Perceptions Matter
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A full 88 percent of IHHS patients have experienced a
negative reaction from others towards their sweating, versus
nine percent of Harris respondents
Harris population’s impressions of someone sweating are
mixed:
– Nervous (66 percent)
– Overweight/Out-of-Shape (49 percent)
– Hard-working (42 percent)
– Excited (29 percent)
– Sick or unhealthy (25 percent)
Coping with Sweating
• People who sweat excessively cope with it in different
ways:
– Wear or avoid certain clothing (74 percent)
– Avoid certain situations (47 percent)
– Keep a towel accessible (37 percent)
– Hold tissue in hands to avoid sweat (44 percent)
• 97 percent of people do something to reduce or
prevent their sweating, versus 86 percent of Harris
respondents
What Do Results Tell Us?
• Hyperhidrosis may be more prevalent than we think,
but people are not seeing their doctor about it
• People who DO go to doctors may not be getting
diagnosed appropriately
• Excessive sweating is a burden that can result in
ridicule and embarrassment
• There is a huge need to raise awareness of this
condition among the general population and the
medical community!
What Can We Do?
• Create community and support for people who are
suffering and let them know that they are not alone
and that treatment options exist
• Educate physicians about how to appropriately
diagnose and treat excessive sweating
• Raise public awareness of hyperhidrosis (88 percent of
Harris respondents had never even heard of the term)
so that people know
– that it is a true medical condition and
– that can be treated
Hyperhidrosis and Ethnic
Considerations
Flor Mayoral, M.D.
Department of Dermatology and Cutaneous Surgery
University of Miami
Differences Between Ethnic Groups
• Income gap
• Attitudes towards healthcare
• Minority stereotypes
2003 Median Annual Earnings by Race and Sex
Race/gender
White men
Black men
White women
Black women
Hispanic men
Hispanic women
Earnings
$41,211
$32,241
$31,169
$26,965
$26,083
$22,363
All men
All women
$40,668
$30,724
Wage gap
Wage ratio
100.0%
78.2
75.6
65.4
63.3
54.3
75.5%
NOTE: Includes full-time, year-round workers ages 15 and above. “White”
and “Black” exclude those who reported more than one race category.
“Hispanic” includes all those who so identified, regardless of race..
Income Gap
• Creates differences in treatment availability
– May live in neighborhoods where information on healthcare may
not be available
– Lack of information on hyperhidrosis in Spanish
• Creates differences in medical insurance coverage
– Does equal insurance coverage guarantee equal treatment?
Attitudes Towards Healthcare
• Attitudes are barrier to getting appropriate treatment
– Less likely to see a doctor because of lack of information
– More likely to think that hyperhidrosis may be a “normal”
condition in them
– More likely to be isolated within their own community
– Less likely to discuss something as embarrassing as excessive
sweating with their doctor
Minority Stereotyping
• Ethnic stereotyping further affects an individual with
hyperhidrosis
• Negative minority stereotypes can be reinforced with
negative attitudes towards sweaty people
The Psychological Effects of
Hyperhidrosis
Kathryn Connor, M.D.
Research Director, Anxiety and Traumatic Stress Program
Department of Psychiatry and Behavioral Sciences
Duke University
Quality of Life Issues
• Daily activities impacted, e.g.
– Worrying about clothes (bringing several sets to work, wearing
dark clothes only
– School/work papers ruined
– Sports and recreation choices are severely limited
• Sufferers are constantly adjusting behavior to account
for sweating, all day, every day
Quality of Life Issues
• Constant fear of embarrassment
– Avoiding certain situations
– Fear of raising arms
– Fear of touching others (shaking hands, hugging, being intimate)
– Fear of what people will think—shutting down
• Can lead to extreme self-image problems
Social/Psychological Issues
• Excessive sweating can lead to more serious issues
such as:
– Social isolation
• Sufferers feel different/isolated from family and friends, which
leads to damaged relationships
• Since they are ashamed to talk about their sweating, loved
ones don’t know and can’t understand
– Social anxiety
• Sometimes it can be too much to even leave the house
Social/Psychological Issues
– Paranoia
• The extreme self-consciousness can be completely
debilitating
• Self-image issues turn into total paranoia
– Depression
• Can even lead to clinical depression, which has further
ramifications
Testimonial
Sophia Parente
Testimonial
Frances Rivers
Questions and Answers
International Hyperhidrosis Society
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A resource for people who sweat excessively but may not have found
the support/information they need
Physician education is a top priority
SweatSolutions – a monthly newsletter of hope, support and
resources
www.SweatHelp.org
– Online support community
– Physician Finder
– Self assessment tool
– Up-to-date treatment information
– Insurance coverage tools
Thank you.