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Prevalence and Characteristics of Hyperhidrosis in Sweden: A Cross-Sectional Study in the General Population
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.ORCID iD: 0000-0002-1773-6896
Umeå University, Faculty of Medicine, Department of Nursing.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology.
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2016 (English)In: Dermatology, ISSN 1018-8665, E-ISSN 1421-9832, Vol. 232, no 5, p. 586-591Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Hyperhidrosis is defined as excessive sweating which can be primary or secondary. Data about the prevalence of primary hyperhidrosis are scarce for northern Europe.

OBJECTIVE: Our aim was to investigate the prevalence of hyperhidrosis focusing on its primary form and describe the quality of life impairments for the affected individuals.

METHODS: Five thousand random individuals aged 18-60 years in Sweden were investigated. The individuals' addresses were obtained from Statens personadressregister, SPAR, which includes all persons who are registered as resident in Sweden. A validated questionnaire regarding hyperhidrosis including the Hyperhidrosis Disease Severity Scale (HDSS) and 36-item Short Form (SF-36) health survey was sent to each individual. The participants were asked to return the coded questionnaire within 1 week.

RESULTS: A total of 1,353 individuals (564 male, 747 female and 42 with unspecified gender) with a mean age of 43.1 ± 11.2 years responded. The prevalence of primary hyperhidrosis was 5.5%, and severe primary hyperhidrosis (HDSS 3-4 points) occurred in 1.4%. Secondary hyperhidrosis was observed in 14.8% of the participants. Our SF-36 results showed that secondary hyperhidrosis causes a significant (p < 0.001) impairment of both mental and physical abilities while primary hyperhidrosis impairs primarily the mental health (p < 0.001).

CONCLUSION: Hyperhidrosis affects individuals in adolescence as a focal form while occurring as a generalised form with increasing age. Further, the prevalence of primary hyperhidrosis described in our study is comparable to other studies from the western hemisphere. While secondary, generalised hyperhidrosis impairs both physical and mental aspects of life, primary hyperhidrosis, with the exception of severe cases, mainly affects the mental health.

Place, publisher, year, edition, pages
2016. Vol. 232, no 5, p. 586-591
Keywords [en]
Hyperhidrosis, Prevalence, Survey, Quality of life
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:umu:diva-127514DOI: 10.1159/000448032ISI: 000392167200009PubMedID: 27576462OAI: oai:DiVA.org:umu-127514DiVA, id: diva2:1046638
Available from: 2016-11-14 Created: 2016-11-14 Last updated: 2018-06-09Bibliographically approved
In thesis
1. Primary hyperhidrosis: prevalence and impacts for the individual
Open this publication in new window or tab >>Primary hyperhidrosis: prevalence and impacts for the individual
2018 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Primary hyperhidrosis, excessive sweating, is a condition with unknown prevalence in many parts of the world. The disease debuts in adolescence and it affects men and women in equal proportions. A genetic background exists and the most common localisation on the body for excessive sweating is the axillary region. It is known that primary hyperhidrosis reduces quality of life and interferes with daily activities. Affected individuals often hide their sweating problems and the disease may lead to social withdrawal and isolation. Although botulinum toxin is an effective and available treatment, relatively few persons with primary hyperhidrosis seek medical healthcare and a minority of those are men.

We investigated the prevalence of primary hyperhidrosis in Sweden and how the disease impairs quality of life, changes in daily activities, signs of depression and anxiety and alcohol consumption before and after treatment with botulinum toxin. The severity of hyperhidrosis according to the affected body sites was also investigated. Further on we explored mens experiences living with primary hyperhidrosis by interviews and content analysis.

Our results showed that primary hyperhidrosis occurs in 5.5% of the Swedish population. The disease reduces quality of life and affects mainly the psychological health of the individuals. Persons with palmar and axillary hyperhidrosis rated their symptoms more severe and with much higher impact on their quality of life compared to persons suffering from hyperhidrosis elswhere on the body. Individuals with axillary hyperhidrosis more often reported a later debut and signs of peripheral vasoconstrictions were more common in this group compared to individuals with palmar hyperhidrosis. This made us believe that factors other than genetics seem to play a role in triggering axillary hyperhidrosis. Treatment with botulinum toxin A had a significant effect in reducing the symptoms and their interferences on daily life while increasing the overall quality of life. Signs of depression, stress and anxiety were also significantly reduced by treatment. This treatment was safe and no serious side-effects were noted. Qualitative content analysis of interviews with 15 men suffering from primary hyperhidrosis resulted in the theme: To be captured in a filthy body. The experiences of men with excessive sweating were thus interpreted as stigmatising. Stigma has a negative effect on mental health which reinforces our findings in quantitative studies when investigating quality of life. It is our assumption that the symptoms act as a vicious circle reducing quality of life, stigmatising the individual and limiting daily interactions. Addressing hyperhidrosis with information when the disease debuts in young people could reduce the stigma and enable early intervention via healthcare which may have a significant effect on the life of those affected.

Place, publisher, year, edition, pages
Umeå: Umeå universitet, 2018. p. 49
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 1940
Keywords
primary hyperhidrosis, prevalence, characteristics, localization, quality of life, botulinum toxin, depression and anxiety, stigma, content analysis
National Category
Dermatology and Venereal Diseases
Research subject
Dermatology and Venerology
Identifiers
urn:nbn:se:umu:diva-145946 (URN)978-91-7601-822-4 (ISBN)
Public defence
2018-04-20, Lionsalen, NUS, byggnad 7, målpunkt Y22, Umeå, 09:00 (Swedish)
Opponent
Supervisors
Funder
Västerbotten County Council
Available from: 2018-03-28 Created: 2018-03-22 Last updated: 2018-06-09Bibliographically approved

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Shayesteh, AlexanderJanlert, UrbanBrulin, ChristineBoman, JensNylander, Elisabet

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