{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:24:51Z","timestamp":1789604691854,"version":"build-2803163510"},"reference-count":34,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2021,7,15]],"date-time":"2021-07-15T00:00:00Z","timestamp":1626307200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002960","name":"V\u00e4sterbotten L\u00e4ns Landsting","doi-asserted-by":"publisher","award":["RV-849721"],"award-info":[{"award-number":["RV-849721"]}],"id":[{"id":"10.13039\/501100002960","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Primary hyperhidrosis, excessive focal sweating is a common disease equally affecting men and women. Women tend to seek care more often and assess being more affected by hyperhidrosis in their daily life. The aim of this study was to explore experiences of living with primary hyperhidros in a sample of 15 women.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Individual, semi-structured interviews with a purposive sample of 15 women diagnosed with primary hyperhidrosis and analysed by qualitative content analysis utilising an inductive approach.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>The analysis resulted in a theme, constantly guarding the female image, based on three categories, misfitting the feminine norms, avoiding the attention of others and passing like any woman. Primary hyperhidrosis in women disrupted the ideal feminine appearance. Wearing clothes that concealed hyperhidrosis and distancing from social gatherings, in combination with negative remarks by others, created stress and anxiety and had a negative effect on self-esteem. Women felt poorly understood by others regarding the extent of their sweating and were misunderstood in intimate situations while trying to reduce the sweat production. Choices regarding education and career opportunities were affected, since being exposed and receiving attention due to primary hyperhidrosis was unwanted. Treatment with botulinum toxin liberated women from excessive sweating and removed a social handicap they described living with.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Primary hyperhidrosis in women disrupts the feminine appearance, lowers self-esteem and hinders social interactions. Clinicians assessing primary hyperhidrosis need to be aware that women may report the impairments from primary hyperhidrosis as being more associated with body image and appearance than with functional reductions in daily life. Educating patients, providing accurate information regarding the disease via media and cooperating with patient groups are important for increasing awareness and achieving progress in care for women with primary hyperhidrosis.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0254689","type":"journal-article","created":{"date-parts":[[2021,7,15]],"date-time":"2021-07-15T17:28:15Z","timestamp":1626370095000},"page":"e0254689","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":11,"title":["\u2018Excessive sweating is not a feminine thing\u2019: A qualitative study of women\u2019s experiences suffering from primary hyperhidrosis"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0700-7195","authenticated-orcid":true,"given":"Alexander","family":"Shayesteh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margareta","family":"Persson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Brulin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabet","family":"Nylander","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,7,15]]},"reference":[{"key":"pone.0254689.ref001","doi-asserted-by":"crossref","first-page":"896","DOI":"10.3949\/ccjm.70.10.896","article-title":"In hyperhidrosis (excess sweating), look for a pattern and cause","volume":"70","author":"LP Stolman","year":"2003","journal-title":"Cleve Clin J Med"},{"key":"pone.0254689.ref002","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1016\/j.jaad.2003.12.040","article-title":"US prevalence of hyperhidrosis and impact on individuals with axillary hyperhidrosis: results from a national survey","volume":"51","author":"DR Strutton","year":"2004","journal-title":"J Am Acad Dermatol"},{"key":"pone.0254689.ref003","doi-asserted-by":"crossref","first-page":"586","DOI":"10.1159\/000448032","article-title":"Prevalence and characteristics of hyperhidrosis in Sweden: a cross-sectional study in the general population","volume":"232","author":"A Shayesteh","year":"2016","journal-title":"Dermatology"},{"key":"pone.0254689.ref004","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1007\/s00403-016-1697-9","article-title":"Hyperhidrosis: an update on prevalence and severity in the United States","volume":"308","author":"J Doolittle","year":"2016","journal-title":"Arch Dermatol Res"},{"key":"pone.0254689.ref005","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1016\/j.jaad.2003.12.029","article-title":"Recognition, diagnosis, and treatment of primary focal hyperhidrosis","volume":"51","author":"J Hornberger","year":"2004","journal-title":"J Am Acad Dermatol"},{"key":"pone.0254689.ref006","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/j.jaad.2003.10.202","article-title":"Validity and reliability of the Hyperhidrosis Disease Severity Scale (HDSS)","volume":"50","author":"JW Kowalski","year":"2004","journal-title":"J Am Acad Dermatol"},{"key":"pone.0254689.ref007","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1111\/j.1524-4725.2006.32334.x","article-title":"An epidemiological study of hyperhidrosis","volume":"33","author":"W Lear","year":"2007","journal-title":"Dermatol Surg"},{"key":"pone.0254689.ref008","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1186\/s12955-017-0693-x","article-title":"The impact of hyperhidrosis on patients\u2019 daily life and quality of life: a qualitative investigation","volume":"15","author":"P Kamudoni","year":"2017","journal-title":"Health Qual. 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Inf"},{"key":"pone.0254689.ref024","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1007\/BF01954577","article-title":"The body-as-object versus the body-as-process: Gender differences and gender considerations","volume":"33","author":"SL Franzoi","year":"1995","journal-title":"Sex Roles"},{"key":"pone.0254689.ref025","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1017\/S0144686X02008905","article-title":"Older women\u2019s perceptions of ideal body weights: the tensions between health and appearance motivations for weight loss","volume":"22","author":"L Clarke","year":"2002","journal-title":"Ageing Soc"},{"key":"pone.0254689.ref026","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1111\/1471-6402.t01-1-00066","article-title":"What Women and Men Should Be, Shouldn\u2019t be, are Allowed to be, and don\u2019t Have to Be: The Contents of Prescriptive Gender Stereotypes","volume":"26","author":"DA Prentice","year":"2002","journal-title":"Psychol. 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