Hyperhidrosis can affect all parts of the body, but when a person has primary focal hyperhidrosis, the most common type, it often impacts specific areas - like the groin. According to an article in the British Medical Journal, about 3% of the population is suspected to have hyperhidrosis, but only 9.3% of that population struggles with excessive sweating of the groin. That means that not only is groin sweating hard to deal with, but that it is not particularly well studied. Compared to other parts of the body impacted by primary focal hyperhidrosis, the groin has received very little attention. This is most likely due to the fact that there are more people with axillary, palmar and plantar hyperhidrosis, but that should not minimize the issue for those who suffer from sweating in the inguinal region.
As mentioned above, the most common cause of excessive groin sweating is primary focal hyperhidrosis, but it can also be a symptom of secondary hyperhidrosis, or even compensatory hyperhidrosis. Secondary hyperhidrosis can occur suddenly, and typically causes sweating to occur all over the body, and this can include the groin region. However, sweating is usually not uniformly focused in that one area. So, while secondary hyperhidrosis may cause the groin to sweat more, it would also equally impact other areas of the body. If a patient believes they may have groin sweating caused by secondary hyperhidrosis then it is important that they manage their hyperhidrosis with a doctor. Secondary hyperhidrosis can be caused by diseases and conditions that may be dangerous if left untreated. Certain common medications can also cause secondary hyperhidrosis to occur. Compensatory sweating can also could also cause groin sweating to arise. This type of hyperhidrosis is actually a side effect of endoscopic thoracic surgery, which ironically, is used to treat palmar and axillary hyperhidrosis. A large percentage of those who undergo surgery develop this condition and it can often include the inguinal region.
Many times when groin sweating is caused by primary focal hyperhidrosis there is no exact cause that can be found, but certain factors can make sweating worse. One of the most important factors is stress sweating. Stress will cause even a healthy person to sweat due to natural changes that occur in the autonomic nervous system, but these effects can be exacerbated in those with hyperhidrosis. Stress sweating is often associated with groin sweat, specifically because of the type of sweat glands that are located there. These glands are called apocrine glands and they produce a different type of sweat than eccrine glands.
There are two types of sweat glands: eccrine and apocrine. Eccrine glands occur all over the body and secrete a clear fluid that is primary made of water and some of the body’s waste products. The sweat from these glands is relatively odorless. Apocrine glands are only present on the axilla, perianal region, areola, scrotum, pubic mound and labia. That means apocrine glands are most active in the groin region. They are associated with hair follicles and secrete sweat into hair canals. The sweat produced by apocrine glands is thick and yellowish. It often has a displeasing smell because it has a high concentration of proteins and fatty acids, which bacteria from the skin quickly break down into foul smelling acids. These glands are innervated by the adrenergic system and are sensitive to adrenaline and noradrenaline. This means they can be activated by emotional responses. This is why groin sweating and stress are so closely related.
Treatments and Products Available
One of the simplest means of controlling groin sweat is to keep the area as clean and dry as possible. This can be difficult and time consuming for hyperhidrosis sufferers, but it can prevent skin breakdown and reduce odor. One option that can be used to keep groin skin dry is the use of absorbent underwear. These are available at most large clothing retailers and can give sufferers a sense of security that sweat will not show through clothing and it will keep moisture away from sensitive skin.
There are many antiperspirants available on the market. These differ from deodorant in that they contain an active ingredient that can reduce sweat production. Topical aluminum chloride is present in many of the over-the-counter topical treatments for hyperhidrosis, but it can be irritating in such a sensitive area. A new formulation of 15% aluminum chloride in salicylic acid gel has been found to reduce irritation and was found to provide between good and excellent results in 100% of patients with groin sweating. Look for products specifically made for use in sensitive areas. Many antiperspirants can be used in the treatment of craniofacial hyperhidrosis which also involves areas with sensitive skin.
Botox injections are an option for patients who do not receive enough symptom relief from topical treatments. There have not been many studies done on the efficacy of Botox in the treatment of groin sweating but it is a viable solution. Before Botox can be administered, a doctor will perform a starch-iodine test to determine where sweating is the worst. After this, the doctor will mark the areas that need to be treated and begin administering the Botox injections. Patients can expect relief from symptoms to last for three to six months before another session is needed. There have been few recorded side effects, but some reports have mentioned temporary edema (swelling) and small hematoma (clotted blood under skin) formation near the injections sites. Botox can provide patients with a relatively reliable and safe method to stop groin sweating without having to worry about daily or weekly treatments.
Depending on the severity of a patient’s sweating a doctor may choose to put them on an oral medication for hyperhidrosis. The most common medications doctors use are called anticholinergics and they can reduce the amount of secretions the body produces. Glycopyrrolate and oxybutynin are used to treat sweating in most cases. Both are anticholinergics most suited for the treatment of hyperhidrosis. These medications may also be used in conjunction with another localized treatment to keep sweating to a minimum.
- Benson, R. A., Palin, R., Holt, P. J., & Loftus, I. M. (2013). Diagnosis and management of hyperhidrosis. British Medical Journal (Online), 347. doi:10.1136/bmj.f6800. Retrieved September 5, 2018, from https://pdfs.semanticscholar.org/4064/16bd4a9ba1fe433e59c95e0aab9d3dd83cb5.pdf
- Pariser, D. M. (2014). Hyperhidrosis (4th ed., Vol. 32). Philadelphia, PA: Elsevier.
- Harker, M. (2013). Psychological Sweating: A Systematic Review Focused on Aetiology and Cutaneous Response. . Skin Pharmacology and Physiology, 26(2), 92-100. doi:10.1159/000346930. Retrieved September 5, 2018,from https://www.researchgate.net/publication/262042314_Psychological_Sweating_A_Systematic_Review_Focused_on_Aetiology_and_Cutaneous_Response
- Huddle, J. R. (2014). Hyperhidrosis: Causes, Treatment Options and Outcomes. New York, NY: Nova Science.
- Walling, H., & Swick, B. L. (2011). Treatment Options for Hyperhidrosis. . American Journal of Clinical Dermatology, 12(5), 285-295. Retrieved September 5, 2018, from https://search-proquest-com.proxy187.nclive.org/docview/1467836763?pq-origsite=summon