Does not occur while sleeping. May be inherited. Secondar

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Welcome

• Lisa J. Pieretti
• Executive Director
• International Hyperhidrosis Society

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The Know Sweat! Campaign

• 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)

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An Introduction to Hyperhidrosis

• David M. Pariser, M.D.
• President, International Hyperhidrosis Society
• Secretary/Treasurer, American Academy of
  Dermatology
• Senior Physician, Pariser Dermatology Associates

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What is Hyperhidrosis?

• 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

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What Causes Hyperhidrosis?

• Exact mechanism unknown
• Overproduction of neurotransmitter in sympathetic
  nervous system OR
• Sweat glands overreact to normal levels of
  neurotransmitter

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How Prevalent is Hyperhidrosis?

• 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

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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
• Cant imagine there is treatment for sweating
  beyond
• regular deodorant
• Often too embarrassed to talk about it

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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?

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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

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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

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Lifestyle Implications

• Huge psychological and emotional impact can be
  devastating to sufferer
• Makes simple daily activities challenging
• Impacts relationships, career choices, mental
  well-being, self-image
• Can lead to social isolation, anxiety disorders,
  depression

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Treatment Options

• Existing treatment options can be highly
  effective
• Antiperspirants
• Iontophoresis
• Botox injections
• Oral medications
• Surgery

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Reimbursement

• Not understood as legitimate medical condition by
  some insurance companies
• Quality of Life impact message not heard
• Lobbying education efforts ongoing

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Know Sweat! Survey Results

• David M. Pariser, M.D.
• President, International Hyperhidrosis Society
• Secretary/Treasurer, American Academy of
  Dermatology
• Senior Physician, Pariser Dermatology Associates

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Harris Interactive Survey

• Surveyed over 1,000 Americans in general
  population
• Objectives
• Determine peoples sweatiest moments
• Determine peoples attitudes towards sweat and
  people who sweat excessively
• Determine level of general awareness about
  hyperhidrosis and treatment options

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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

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Americas 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)

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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 dont think I have a problem (57 percent)
• I dont think anything can be done about it (28
  percent)
• I havent had the time (14 percent)
• I am too embarrassed (two percent)

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Others Perceptions Matter

• A full 88 percent of IHHS patients have
  experienced a negative reaction from others
  towards their sweating, versus nine percent of
  Harris respondents
• Harris populations 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)

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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

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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!

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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

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Hyperhidrosis and Ethnic Considerations

• Flor Mayoral, M.D.
• Department of Dermatology and Cutaneous Surgery
• University of Miami

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Differences Between Ethnic Groups

• Income gap
• Attitudes towards healthcare
• Minority stereotypes

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2003 Median Annual Earnings by Race and Sex
Race/gender Earnings Wage ratio
White men 41,211 100.0 Black
men 32,241 78.2 White women
31,169 75.6 Black women 26,965 65.4 Hispan
ic men 26,083 63.3 Hispanic women
22,363 54.3 All men 40,668 All women
30,724  Wage gap 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..

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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?

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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

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Minority Stereotyping

• Ethnic stereotyping further affects an individual
  with hyperhidrosis
• Negative minority stereotypes can be reinforced
  with negative attitudes towards sweaty people

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The Psychological Effects of Hyperhidrosis

• Kathryn Connor, M.D.
• Research Director, Anxiety and Traumatic Stress
  Program
• Department of Psychiatry and Behavioral Sciences
• Duke University

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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

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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 thinkshutting down
• Can lead to extreme self-image problems

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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 dont know and cant
  understand
• Social anxiety
• Sometimes it can be too much to even leave the
  house

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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

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Testimonial

• Sophia Parente

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Testimonial

• Frances Rivers

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Questions and Answers
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International Hyperhidrosis Society

• 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

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Thank you.