November 3, 2025 • 37 mins
In this episode, we speak with Kristen Hernandez, hyperhidrosis advocate, founder of the blog and Instagram account 'How to Hyperhidrosis' and Physician Assistant.
Tune in to hear us talk about:
- What led Kristen to enter the medical field
- Kristen's tips for putting on medical gloves with sweaty hands
- Why she is upfront with people about her hyperhidrosis
- How therapy transformed her outlook on living with hyperhidrosis
- Her diagnosis journey and her struggle to find a specialist who understood hyperhidrosis
- How she's helping treat and manage hyperhidrosis in patients today
- Her top 3 tips for attending a doctors appointment as someone with excessive sweating
- How to talk to your doctor about hyperhidrosis and how to find the right clinician
- What research is needed next on hyperhidrosis
✨Enjoyed the episode? Keep the conversation going by joining Sweat Girl Society's free membership community! Visit: https://sweatygirlsociety.com/community
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***
Connect with Kristen Hernandez:
🔗 Website: https://www.howtohyperhidrosis.com/
🔗 Instagram: https://www.instagram.com/howtohyperhidrosis/
🔗 Clinic (for US residents only): (818) 843-5864
About Sweaty Girl Society:
🔗 Website: https://sweatygirlsociey.com
🔗 Instagram: https://www.instagram.com/sweatygirlsociety
🔗 YouTube: https://www.youtube.com/@SweatyGirlSociety
***
Disclaimer: The information in this podcast is provided as an information resource only. It is not to be used or relied on for any medical, diagnostic or treatment purpose, and it should not be used as a substitute for professional diagnosis and treatment. Please consult your health care provider before making any health care decisions or for guidance about a specific medical condition.
Join Sweaty Girl Society's free membership community at sweatygirlsociety.com/community.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker (00:00):
We focus so much more on how it affects us and most
(00:04):
other people, they're not evenpaying attention.
For me, me telling people was away for me to regain control
back.
I learned that I can't changethe hyperhidrosis, but maybe I
could have a more fulfillinglife.
If I'm not hiding it as much,I've been through it all, and so
to be on the other side of itand guide patients and be the
(00:28):
support that I didn't have,there's really nothing that can
explain how much that motivatesme.
Karina, Sweaty Girl Society (00:38):
You are listening to the Sweaty Girl
Society Podcast, a show forwomen with hyperhidrosis, where
we share tips for living betterwith excessive sweating.
I'm your host, Karina.
Now let's get into the show.
Welcome back to the Sweaty GirlSociety Podcast.
In this episode, I'm speakingwith Kristen Hernandez,
hyperhidrosis advocate andfounder of How to Hyperhidrosis.
(01:00):
Kristen is also a Physician'sAssistant.
In this episode, Kristen offerslots of practical tips to help
you navigate the healthcaresystem and advocate for
yourself.
I think you're gonna love thisconversation.
Kristen, welcome to the show.
Kristen (01:14):
you for having me.
Karina, Sweaty Girl Socie (01:14):
Thank So in addition to being a
hyperhidrosis advocate andhaving hyperhidrosis yourself,
you are also a CertifiedPhysician's Assistant.
For those of us outside the US,like myself, can you explain
what a Physician's Assistant is?
Kristen (01:29):
So a Physician Assistant abbreviated as PA, in
some states now it's considereda Physician Associate.
So either one of those areinterchangeable.
We can diagnose, we can treat,we can prescribe, and see
patients on our own.
In some states like California,we have to be working under a
doctor or MD, but otherwise wehave autonomy of our patients.
(01:53):
So I have my own patients that Ican see.
And then right now I'm workingin internal medicine and
pulmonology.
Karina, Sweaty Girl Society (02:01):
So what led you to enter the
medical field?
Kristen (02:04):
I always had just this
Karina, Sweaty Girl Society (02:06):
I.
Kristen (02:07):
towards helping people.
That's so general and so.
a young age, I was volunteering,I was working in semi medical
related field, so I was an MAand then I worked for the
hospital to raise money, butthere was always something
missing and I always had thisidea like, oh, I want more
(02:30):
hands-on experience, which isironic considering how
hyperhidrosis so hands off.
Like,
Karina, Sweaty Girl Soc (02:37):
Mm-hmm.
Mm-hmm.
Kristen (02:38):
sweating.
And so that's kind of what tookso long, I, I guess you could
say to get me here.
I just had so much doubt, like,can I even do this?
I'm terrified of touchingpeople.
So I volunteered in the hospitaland I used that as my way of
being like, can I actually dothis?
And over time I became morecomfortable.
(03:00):
So then I did all theprerequisites, but it was always
a challenge because myhyperhidrosis was affecting me
academically.
I was having really bad testtaking anxiety because during
the exam I was not even focusingon the test.
I was focusing on my sweat andhow to manage it.
(03:21):
'cause I was like,
Karina, Sweaty Girl Soc (03:22):
Mm-hmm.
Kristen (03:22):
wet my scantron, which I've done multiple times that I
had to turn it in once.
And the professor's like, why isit
Karina, Sweaty Girl Socie (03:29):
Yeah.
Kristen (03:30):
Like.
I'm like, how do I explain this?
And so it started to affect meacademically.
I wasn't doing well in schooland at that point I started to
seek accommodations.
So it's been a challenge to gethere, but it was ultimately
always something I wanted to do.
Karina, Sweaty Girl Socie (03:46):
Yeah.
Whenever I hear of somebody inthe medical field who has
hyperhidrosis, I immediatelythink of wearing gloves.
how do you navigate wearinggloves and, I guess, do you
sweat on your hands?
Kristen (03:57):
sweat my hands, my upper
Karina, Sweaty Girl Societ (03:58):
Yes, yes.
Kristen (03:59):
my nose, my lower back, my underarms, my ankles, behind
my knees, everywhere.
scalp.
Karina, Sweaty Girl Society (04:08):
All the places.
Mm-hmm.
Kristen (04:11):
so yeah, a major thing.
I remember working in thehospital and it would take me,
it felt like five minutes, butjust to put gloves on.
I'd be like, okay, one second.
Like trying to get it on myhand.
I was like, oh my gosh, this isso embarrassing.
But it's funny because I learnedover time too, we focus so much
(04:32):
more on how it affects us.
And most other people, itdoesn't even phase'em.
They're not even payingattention.
They don't know what's going on.
So for me, a lot of the times ifI was in my rotations, I would
actually just tell my preceptorlike, hey, I have hyperhidrosis.
My hands are really sweaty, myface sweats.
(04:53):
So if you see me putting gloveson and it's taking a minute,
that's why like, it's a littlebit of a challenge.
They're like, okay, yeah, that'sfine, whatever.
But yeah, so putting gloves onalways a challenge, but I
actually had a conversation withone of the people from the
community who asked me aboutthis.
And you find ways to adapt, likeI said.
(05:13):
So for example, I would, I wouldput hand sanitizer because one
of the things in the school theyteach you is before you see a
patient, you have to wash yourhands or put hand sanitizer, so
I would do that and if my handswere still really sweaty, I
would grab a towel from theroom, wipe my hands down, then
get my gloves and try to putthem on.
And again, patients don't even.
(05:34):
Think about that.
They don't even know what I'mdoing.
And it doesn't affect my abilityto do what I need to do.
If it took a little bit longer,which sometimes it still does I
talk to them and ask them morequestions about why they're
there or other things abouttheir personal life.
So I kind of fill the time if Ineed to.
Karina, Sweaty Girl Socie (05:53):
Yeah.
I find that it's often we're sofocused on it because we're
living the experience, butpeople don't pick up on it.
That's interesting that you toldyour preceptor.
Do you feel like you've had moreempathy in the medical
community?
Kristen (06:07):
I think took me many years to just be able to say it
in general.
There was
Karina, Sweaty Girl Socie (06:12):
yeah,
Kristen (06:13):
in my life where I had a sit down with my family to be
like, this is my reality.
And I was crying.
'cause I was like, I don't thinkyou guys understand.
I may seem like a happy person,but a lot of challenges I face
that you
Karina, Sweaty Girl Soc (06:28):
Mm-hmm.
Kristen (06:47):
So.
By the time that I got to PAschool, I already knew, I just
need a say it upfront it was away for me to gain control back.
Hyperhidrosis is you have nocontrol my entire life you try
to control things as much as youcan, but despite that you still
sweat excessively.
(07:07):
Like there's really not much youcan do.
And so I always
Karina, Sweaty Girl Soc (07:10):
Mm-hmm.
Kristen (07:12):
And so for me, me telling people was a way for me
to regain control back.
So my preceptors too, because Iknew it was gonna be a challenge
for me.
there were even instances in PAschool where we do physical
exams on our classmates and oneof'em is doing a physical exam
(07:33):
on the feet.
And I was like, absolutely not.
I was just like, I am not, Iknow I'm a hyper advocate, but
I'm also a human being and I'malso a patient that is.
gravely embarrassed and I don'twant people to see my sweaty
feet.
So I told my professors, ifsomeone
Karina, Sweaty Girl Society (07:52):
I understand if someone,
Kristen (07:54):
they can to practice, but this is just something that
I really feel uncomfortable withthey're totally fine with it.
They're like, that's fine.
If they really need it, they'lluse another person's feet And so
in that way, I was able toadvocate for myself while also
maintaining that feeling ofsafety and control.
Karina, Sweaty Girl Socie (08:12):
Yeah.
It, it takes a bit to get there,right?
Throughout my life there's beentimes I've gone for a massage
and, the massage therapist isgoing in the direction of my
feet, and in the past I would'velet them touch my feet and been
really uncomfortable with it andin a freeze response I guess.
Whereas over the years, as I'vegotten older, I can advocate and
say now, let's not touch myfeet.
(08:33):
I don't need my feet massagetoday, like, I have
hyperhidrosis, or just leave it.
Right?
But it, it takes time to be ableto talk about it.
You have talked before, in otherinterviews about your journey
with therapy.
Can you speak more about thatand, how that transformed your
viewpoint on your condition?
Kristen (08:51):
so
Karina, Sweaty Girl Society (08:51):
Um,
Kristen (08:52):
me, getting
Karina, Sweaty Girl Society (08:53):
so.
Kristen (08:53):
was, I mean, I felt in some ways I was a hypocrite.
I'm going into a field where I'mtelling people to get help, but
couldn't even seek therapy.
So who am I to tell someone elseto seek therapy if I can't even
do it for myself?
So that was a motivation for meto take that first step.
(09:15):
And it's terrifying because I'mlike, oh, they're gonna think
I'm crazy.
They're gonna think, you are theproblem.
This is what's going on.
And in reality, it was.
opposite.
For the first time I could talkto
Karina, Sweaty Girl Socie (09:27):
First time
Kristen (09:28):
feeling
Karina, Sweaty Girl Society (09:29):
to someone without.
Kristen (09:31):
and for most of my sessions I was crying.
it's exhausting because I was inmy mid twenties when I started
therapy, so I lived majority ofmy life'cause I've had hyper
since I was four, just hidingthis all in.
So a lot of those sessions, likeI said,
Karina, Sweaty Girl Socie (09:49):
Yeah,
Kristen (09:50):
and just literally getting it out.
Karina, Sweaty Girl Socie (09:53):
Yeah.
Having a witness, havingsomebody hear your story.
Kristen (09:57):
like lifesaving for me in a way because it was also a
realization, again, going backto the hiding and the lack of
awareness I had about mycondition was how much it was
actually impacting meemotionally.
For a lot of us, we live withchronic stress because we're
worried about it, and even ifsomeone else doesn't care or
(10:18):
doesn't notice.
anyone is sweating excessively24 hours a day, it's
uncomfortable.
And that goes back to the sweatyfeet.
You may not care about my sweatyfeet, but it literally just
feels uncomfortable.
Like right now I'm sitting in mysocks and my feet are sweaty,
and I'm used to that feeling,but it's not like the most
comfortable feeling,
Karina, Sweaty Girl Socie (10:41):
same.
Same.
Kristen (10:42):
going to therapy and learning how to talk about it
and express what I was feeling,I think was such a huge thing
for me and in my progressionwith dealing with hyperhidrosis,
because I also learned that Ican't change the hyperhidrosis,
but maybe I could have a morefulfilling life i'm just more
(11:03):
upfront and not hiding it asmuch.
It was in my personalexperience, life changing.
And that's why I recommend it somuch for people because
hyperhidrosis is not just aphysical ailment, there is such
a psychological to how itimpacts us on a daily basis.
Karina, Sweaty Girl Society (11:24):
So where would you say your
relationship is today withhyperhidrosis?
Kristen (11:28):
I think it's definitely better than what it was.
I think it goes back to mefeeling comfortable talking
about it.
I have grown a passionadvocating for hyperhidrosis and
having you and Maria and all theother advocates talk about it,
definitely makes it, easier totalk about because you know that
you're not the only one outthere.
(11:49):
And so in terms of myrelationship with hyperhidrosis,
I feel at ease and I feel moreconfident, in my current state.
Right now I'm not doing anytreatments and I know
15-year-old Kristen would bedevastated by that.
it's not necessarily becausethere aren't certain treatments
that can benefit me, justbecause I lived my entire life
(12:12):
focusing on hyperhidrosis andtrying to fix it.
I mean, and this is what therapyhelped me with, is sometimes I
don't need to fix everything Ican just be, that in itself has
relieved a lot of the stress ofliving with hyperhidrosis.
Finding the comfort in my ownskin.
I feel like I have a healthierrelationship with hyperhidrosis
(12:35):
for sure.
Karina, Sweaty Girl Society (12:36):
I can really relate to that.
There is a certain level offreedom when we accept that this
is the way it is and aren'tstriving always to find the fix.
So in terms of your, journeywith hyperhidrosis, when did you
receive an official diagnosis?
And what was that experiencelike for you?
Kristen (12:57):
in PA school, presented on this in my classmate.
This is where my advocacy, I waslike, I need to tell the whole
world about this because I knowone of my classmates is gonna
run into a patient withhyperhidrosis.
And what I learned in that isthat the average diagnosis time
period is 10 years, and that istotally on point with me.
So I had hyperhidrosis at age offour.
(13:20):
I didn't get diagnosed till 14.
I went to a dermatologist, theydid the sweat iodine test where
they put iodine, they let itdry, they put powder.
Karina, Sweaty Girl Society (13:30):
Oh, they did.
Kristen (13:30):
and it turns black and it shows where the sweat is.
Nowadays I feel I can tell ifsomeone has me to bring
hyperhidrosis I don't know if Ineed to do all that testing.
But yeah, so they did that testand I'm like, okay, you have
something called hyperhidrosis.
And I'll never forget this, thedoctor was like, well.
We know that it's hyperhidrosis,but there's currently nothing we
(13:51):
can really do and there's nocure.
And so the first thing theyrecommended was these topicals,
which were really irritant to myskin.
And so I didn't use those forvery long.
And then later they recommendediontophoresis.
But at that time, the machineswere made a lot differently and
were really painful and when I'dask for advice, they didn't
(14:15):
really know.
So it was here's the device,figure it out.
This is maybe what you shoulddo.
But there wasn't really anyguidance on, okay, well what if
this hurts a lot?
I can't sit here for
Karina, Sweaty Girl Socie (14:28):
Yeah.
Kristen (14:28):
let alone 10 minutes or 15 minutes.
it was essentially like, well,that's what you have to do.
So I would sit there in agony.
And eventually that also didn'twork because it was too painful.
I was like, it's not worth it.
I couldn't do it.
Karina, Sweaty Girl Soc (14:43):
Mm-hmm.
Kristen (14:43):
okay.
Karina, Sweaty Girl Socie (14:43):
Yeah.
Kristen (14:44):
and ultimately I found a doctor through a family friend
and I went to this doctor.
Like so informative right away.
They were able to explain theprocess and super supportive.
And it was just like someoneknows what this is and
understands it better than I do,which was such a relief because
(15:06):
as many of us, we always have toexplain and explain what
hyperhidrosis is and why it's sodebilitating, and why you need
treatment, and why, why, why,why, right?
There's always so much toexplaining.
Karina, Sweaty Girl Soc (15:18):
Mm-hmm.
Kristen (15:20):
This happened to be an endocrinologist.
I was with this doctor untilthey retired.
And I was really fortunate.
I started oral medication whichworked really well for me for
about seven years, and I trieddifferent ones and then I
started to get side effects likea migraine.
Karina, Sweaty Girl Soci (15:39):
Agree.
Kristen (15:39):
again, it was kind of at that point where I was also
like, I'm okay.
Not doing anything, so I juststopped medication.
Karina, Sweaty Girl Societ (15:46):
Your journey sounds very similar to
mine in terms of the initialdiagnosis.
When you said 10 years, I justdid the math on mine too, and it
was precisely 10 years.
My earliest memory ofhyperhidrosis was around age 10.
And I got diagnosed when I was20.
I find that interesting thatthey did the test.
I recently went to my doctor,because I was interested in
(16:07):
trying glycopyrrolate and mydoctor started asking questions
like how do you know you havehyperhidrosis?
Where do you sweat?
This sort of thing, because I'venever had the test that you were
describing done.
And I, I just held up both of myhands, which were dripping, and
I stood up from the examinationtable where I had completely
(16:28):
soaked the paper lining.
And she's like, oh, okay.
Yeah, you have hyperhidrosis,right?
Kristen (16:33):
That's so great.
Karina, Sweaty Girl Socie (16:34):
Which is interesting around diagnosis
because I've come across thequestion in our community and in
the world, how do I know I havehyperhidrosis, how much sweat is
normal versus how much sweatmeans hyperhidrosis?
And I think for those of us whoare confident that we have
hyperhidrosis, it's quite clear.
But what qualifies a diagnosisof hyperhidrosis.
Kristen (16:55):
A very
Karina, Sweaty Girl Soc (16:56):
that's.
Kristen (16:57):
interesting question.
'cause you're right, for somepeople who have severe,
excessive sweating, it's veryfor others it may not be so much
and when I was doing researchregarding it, what I struggled
with is what is the actualparameter?
There was some that was like, ifyour sweat beads are a certain
(17:18):
amount of centimeters ormillimeters, and I'm like, who
is going out here measuring mysweat beads on my hand?
That's not an accuratedescription.
And then there was a scale ofhow much it impacts you on a
daily basis.
And I was also like, well,that's not exactly related to
(17:38):
the sweat, the physicalcomponent.
That's more the psychologicalcomponent.
And so in terms of dermatologydiagnoses, a lot of these are
based off quality of lifescales.
But I always ask are yousweating when you're just
sitting?
Do you start excessivelysweating when you've just woken
up?
Are you sweating at night?
(17:59):
So all these instances where theaverage person not, I typically
ask those types of questions andthat's a red flag.
Like, okay, this seems morelikely to be, it's also very
important for patients to go totheir providers or clinicians
because they need to be screenedfor other conditions that can
(18:19):
cause excessive sweating.
So whether it's related to thepituitary gland or their
thyroid, there's a lot ofreasons why people can have
excessive sweating.
Maybe it's a medication they'reusing that's causing excessive
sweating.
Hormones.
I have a lot of patients inmenopause that are having hot
flashes so there's a lot ofreasons why we can excessively
(18:39):
sweat.
So one, in terms of the initialdiagnosis, it's kind of based
off the patient's experience.
Some of those questions and thenI always ask.
Them bring a video because maybethey're dry in the office and
they're like, oh, of course, youknow, I'm trying to prove myself
and my hands all of a suddenbecame dry or my face is dry,
providing video or images canreally be helpful.
(19:02):
So making sure that they screenfor any other conditions first
and then doing hyperhidrosisevaluation next.
Karina, Sweaty Girl Soc (19:10):
Gotcha.
So as a physician's assistant,have you treated many people
with hyperhidrosis, whetherthey've come to you for
hyperhidrosis or you notice itas part of other treatment?
Kristen (19:20):
first patient I had was during my dermatology rotation.
I had an opportunity with apatient and it happened to be
their first time coming in atall ever to get treated.
I was like, I havehyperhidrosis, understand.
do you sweat?
And I feel like I was able toask questions that maybe other
(19:43):
providers, at least they neverasked me, like, you sweat here?
Do you sweat there?
Just to get an idea of theextent of the hyperhidrosis and
also to figure out what type oftreatment would better fit them.
So that was my firsthyperhidrosis patient.
I've had two other ones thatI've been able to help and
(20:06):
manage But it's interesting youasked because where I'm at now,
I'm now ready to see patients inoffice and do consults and see
patients for hyperhidrosis.
So if anyone out there wants ahyperhidrosis advocate and
clinician who treatshyperhidrosis, I'm your girl.
Karina, Sweaty Girl Societ (20:25):
Wow, that's amazing.
I haven't heard of many peoplewho specialize in hyperhidrosis
other than a Botox clinic or thetreatment side, but to actually
get the diagnosis and helpnavigate care, that's really
exciting.
Kristen (20:38):
excited about it and
Karina, Sweaty Girl Socie (20:39):
Yeah.
Kristen (20:40):
Like a part of little Kristen heals because I'm able
to give something someone that Inever got, and at the same time
I feel sad because I'm like,gosh, my experience was so
terrible.
it's kind that balance.
It's so rewarding that I cangive back in that way.
Karina, Sweaty Girl Society (20:58):
You know, one thing, on a slightly
related topic is for me, goingto the doctor has always been.
Triggering of my sweat because Ianticipate having to lay down or
sit on the table with the paper,the paper, uh, that covers.
I don't know what the medicalterm for the paper is, but I
(21:19):
always sweat through it.
Is this something you'veexperienced and what advice both
as being a patient of careyourself, as well as a provider
of care, what tips would youoffer to somebody going to a
doctor's appointment so they canmake it more comfortable for
themselves and not have to havethese reactions?
Kristen (21:38):
that's a great question.
So
Karina, Sweaty Girl Society (21:39):
So.
Kristen (21:40):
in these exams, it depends on what type of exam.
So one, I'll ask, do I need tocompletely undress or can I keep
my shirt on?
Like, can I keep, you know,whatever they're examining.
I see if there's any part ofclothing I can still keep on.
Second, it's kind of hardbecause.
I've experienced the same thing.
I am sweating through thispaper.
(22:01):
I'm sticking to it.
It's gripping and sticking to mybody, like oh my gosh.
Karina, Sweaty Girl Socie (22:07):
Yeah.
Kristen (22:08):
and so in those exams, I keep my socks on at least.
Karina, Sweaty Girl Socie (22:13):
Yeah.
Kristen (22:13):
I'm at least more comfortable.
but yeah, it's really hard.
I do know that Maria did a postabout it and she brought her own
towels and her own resources sothat she could lay, I think she
was laying on a towel or usingit for her hands.
One of the things.
So that's a way we can feel alittle bit more comfortable
because not all offices havetowels readily available.
Karina, Sweaty Girl Society (22:37):
And that's Maria from my Life is a
Puddle.
Her blog.
She did a blog post on it.
Yeah.
Kristen (22:41):
had shared that to me like, oh, that's a really good
idea.
But honestly, sometimes when Igo to the doctor, I completely
forget.
Karina, Sweaty Girl Socie (22:47):
Yeah.
Kristen (22:47):
that's one way that you can help least make yourself
feel a little bit morecomfortable.
Like you said, the paper islike, oh my gosh, the paper.
Karina, Sweaty Girl Socie (22:56):
Yeah.
It's just the horrifying, uh,moment when you have to get up.
Yeah.
And the, the gowns, being thatblue, it just shows the sweat so
much and Yeah.
Yeah.
Can be an uncomfortableexperience.
Kristen (23:10):
say we're doing a full physical exam and I can only
leave my socks on i'll keep mysweater on my side, so at least
I can use it to soap up mysweaty hands.
Or I can just grab it and thenwhen they need to check this
area, I'll move it.
But it's kinda like a hankyessentially that I just keep
with me.
Karina, Sweaty Girl Societ (23:26):
Yes, it's key to have some things at
the ready to soak up the sweatwith.
So what advice would you offerto somebody who wants to speak
with their doctor for the firsttime about hyperhidrosis?
I know that can be a bit of ascary thing as well.
I remember speaking with mydoctor for the first time and I
was like, will she dismiss me?
(23:46):
Will she believe me?
Will she think that I'm gross?
Is this even a real thing?
So what are some pieces ofadvice you would give to
somebody?
Kristen (23:55):
I did a blog on my How to Hyperhidrosis Blog about how
to prepare for a doctor visit.
And one of the things I talkabout is writing all your
questions down that thoughtabout, that you wanna know
about.
So bringing in a list, I alwaystell my patients, bring a list
in next time, because sometimesyou're in there and you forget
(24:15):
everything that you wanted toask.
and then second is providingimages or video to show proof of
your hyperhidrosis.
It doesn't have to be your wholebody, but just certain spots
just to show evidence in caseyou get into the office, the AC
magically dries your hands orwhatever, and then you have no
proof.
(24:35):
And then one of the other thingsI've done in the past is I've
called the offices before I evenmake an appointment.
I'll ask does the doctor treathyperhidrosis if they're not
sure?
Can you ask what type oftreatments does he or she
provide?
Because I've been to officeswhere it's like this was a waste
(24:55):
of my time.
Also I don't wanna pay anothercopayment in the United States
where we have insurance that wehave to pay a certain amount,
don't wanna waste my money on aphysician that doesn't know
what's going on.
And so those three things, Ithink are the main things.
So writing your notes.
Videos or images and theninterviewing the office that you
(25:16):
wanna go to.
Now, if you don't have theopportunity to pick and choose
what clinician you go to, thenhaving those questions and video
and images is really important.
It's also important because alot of these visits are 15
minutes maybe.
So you have to take advantage ofthat time you have.
So even if you do have a longlist of questions, trying to
(25:39):
pick, okay, if I'm limited ontime, what are the top two
things that I absolutely need toknow by the end of this
appointment?
and that way you have a startingpoint.
You can do a follow up and thengo from there and ask the rest
of your questions when that nextappointment is.
Karina, Sweaty Girl Soc (25:55):
That's.
Great advice.
So in the US what is the pathwayyou would follow?
In Canada here, we wouldtypically go to our family
doctor first.
And then the family doctor wouldrefer us to a dermatologist.
Is it similar in the US?
Kristen (26:07):
On insurance.
Karina, Sweaty Girl Soc (26:09):
depends on insurance.
Okay.
Kristen (26:10):
PPO insurance, there's HMO insurance.
The PPO for the most part, youcan go anywhere you want, so you
don't have to go through yourprimary doc.
You can just go straight to adermatologist, straight to an
endocrinologist.
Now with that, some offices, sodermatology, the specialties
(26:31):
will require a note from yourprimary to say they need to be
seen.
And that's because a lot ofthese offices are.
Really, really busy.
So they wanna make sure, you'recoming to us because we actually
need to see you type of thing.
So there's that caveat.
And then with some HMOinsurances, you need
authorization, meaning similarto you.
(26:51):
You have to go through yourprimary doctor, and then they
have to refer you to aspecialist.
you know, if you work ininternal medicine or family
medicine like me and you alreadyknow about hyperhidrosis, you
can skip that step and just betreated your primary or your
internal med doctor.
So that's kind of what I wasdoing in PA school.
(27:14):
I did a pediatric rotation and Idid a presentation on
hyperhidrosis because.
you were 10.
I was four.
We could have been screened at ayounger age and maybe had a
better quality of life for those10 years that we weren't
diagnosed.
So yeah, there's a lot ofdifferent avenues, but in the
(27:34):
United States, it's kind ofdependent on insurance.
Karina, Sweaty Girl Socie (27:37):
Okay.
Interesting.
And that raises an interestingpoint.
From what I know, at least inCanada, it's a dermatologist
that would treat hyperhidrosistypically, but is it really a
dermatological condition?
Right?
There's a lot that we don't knowabout hyperhidrosis and who is
the right person to treat it.
Do you have any thoughts
Kristen (27:58):
yeah,
Karina, Sweaty Girl Society (27:58):
Um,
Kristen (27:58):
always
Karina, Sweaty Girl Socie (27:59):
yeah.
Kristen (27:59):
a challenge with that as well, just because also my
personal experience, one of thedoctors that helped me the most
wasn't a dermatologist, it wasan endocrinologist, they
understood the pathophysiologybehind hyperhidrosis, and they
explained it to me.
I was like, oh, I neverunderstood it this way.
So in that respect, I don't knowif a dermatologist or
(28:22):
endocrinologist a familymedicine or internal medicine is
the best.
I think it just depends on.
Who has knowledge on it.
Unfortunately, that's kind ofwhere we're at because there are
a lot of gaps within thesespecialties.
Some kind of know about
Karina, Sweaty Girl Socie (28:38):
Yeah.
Kristen (28:38):
of don't.
Now, as far as the UnitedStates, there might be some
procedures that you can do at adermatology office, but you
can't do at a endocrinologyoffice.
So for example, Botox, that's awidely cosmetic procedure, and
so it overlaps with it being aprocedure for hyperhidrosis.
So it makes sense that theywould be the ones handling that.
(29:01):
In terms of oral medication,yeah, they can also handle oral
medication.
So technically it is a skinrelated condition, but it's more
of a neuroendocrine possiblecondition.
And that's the research we needto better understand and
appropriately assign who shouldbe addressing dealing with these
(29:21):
types of conditions.
And then on top of that,educating this population of
providers so that it doesn'tmatter who you go to, someone
will still be able to manageyou.
cause right now
Karina, Sweaty Girl Socie (29:32):
Yeah.
Kristen (29:32):
there could be a whole list of dermatologists that
treat hyperhidrosis, not all ofthem are equal.
Karina, Sweaty Girl Soci (29:39):
Right.
Yeah, it's interesting becausehyperhidrosis presents on the
skin.
That's the obvious symptom isthe sweat.
But there's so much more goingon behind the scenes and there's
so much we don't know.
So where are you hopefulresearch will go over the next
decade?
Kristen (29:55):
is hard to say.
'cause right now there's a lotof limitations with research.
At one point, there was beingdone regarding genetic testing
for hyperhidrosis, and itsoverlap POTS And so I don't know
how far they are into theresearch, but that was just very
(30:17):
preliminary.
A lot of the research is solelydone on underarm treatment,
which in some ways it's adisservice because we know that
we sweat in multiple places andwe know that the underarms is
the easier part of the body totreat.
But the face, for me personally,that's the hardest thing to hide
(30:40):
my hands.
I can hide in my
Karina, Sweaty Girl Soc (30:41):
Mm-hmm.
Kristen (30:42):
I can hide with a sweater, but my face, I can't
hide.
So,
Karina, Sweaty Girl Socie (30:47):
Yeah.
Kristen (30:48):
I think has always been a challenge in terms of how to
manage it.
Karina, Sweaty Girl Socie (30:52):
Yeah, we had a conversation in the
Sweaty Girl Society communityabout this.
And if there was one place youcould stop sweating, what would
that be?
And most people did say facewhereas when my doctor asked me
the first thing she said, do yousweat in your underarms?
That was the first thing thatshe went to.
People often think underarms,hands, feet, and of course
underarm sweat is not fun.
(31:12):
It can be very embarrassing butthere are so many more areas
that we sweat in like the grointhat rarely gets talked about.
But as I speak with more andmore women who have
hyperhidrosis, that is a very,very common place that we
experience sweating and youalmost never hear about that
when you see the list of wherepeople sweat.
(31:34):
So lots of work to be done abouthow we talk about hyperhidrosis
and how we communicate it.
Kristen (31:40):
Yeah, and in other
Karina, Sweaty Girl Socie (31:42):
Yeah.
Kristen (31:43):
Botox is a covered procedure, meaning patients
don't have to pay and it'scleared to to be used for Botox
to treat hyperhidrosis all overthe body, including the groin.
Whereas here in the UnitedStates, it's only approved for
underarms hands, I believe, andfeet.
(32:05):
So anywhere else on the body,
Karina, Sweaty Girl Socie (32:06):
Okay.
Kristen (32:07):
covered.
So even though I have hypers onmy face, I've gotten Botox, but
insurance will not cover it.
So I've had to pay some dollarsout of pocket, and that's kind
of.
The burden that we have to payliterally in terms of finding
treatment, because it worked forme.
(32:27):
It worked for three months, Iwould do it, but again, it's
money outta my pocket that.
It's a lot of money
Karina, Sweaty Girl Soci (32:34):
Right.
Kristen (32:34):
on treatment and it's effective for some people, and
that's the thing withhyperhidrosis treatment is what
works for me may not work foryou, but if Botox works for me,
but now I have to pay$400 everythree months, and then there's
another patient who can gethyperhidrosis treatment that is
covered by insurance it's justnot equal in that respect.
Karina, Sweaty Girl Society (32:56):
For sure.
Can you talk a little bit aboutyour advocacy work and what led
you to start your blog andbecome active on social media?
Kristen (33:05):
so it started
Karina, Sweaty Girl Socie (33:06):
Yeah.
Kristen (33:06):
the pandemic.
I was working in the er, it.
Very hectic at the same time Iwould happen to be doing
therapy.
And that's kind of an outlet, Iguess, that I used to just
express what was going on withme Never in a million years
would I have thought there's somany people out there with
hyperhidrosis.
(33:27):
And so it was a therapy for me.
'cause I would be up till 3:00AM making my blog.
And I'm also a creative person,so I like the aspect of creating
something designing it.
And so that's where it startedwas something I was doing as a
hobby.
And then I started to learnthere's other people out there.
(33:49):
Learned from Maria, My Life as aPuddle, I found her page and she
invited me to participate in anarticle for her blog.
And that gave me more confidencein talking about hyperhidrosis.
I was like, there's not a placeat that time where you can see
hyperhidrosis, see possibletreatments.
(34:12):
And so that's why I created theblog.
Then the Instagram followed.
I wanted to be honest and talkabout the things people didn't
wanna talk about.
That's generally my personality,say things that might shock
people, and so talking about,you know, groin sweat and all
(34:32):
these things that we were soashamed about sharing in regards
to our sweating is somethingthat I was like, oh, I
definitely have to approachthat, or discuss that.
And so that's where it started.
And then it just becamesomething that was.
Very rewarding, and it motivatedme more to become more active.
(34:53):
I think Maria was definitely aguiding light in that, we call
her the OG for a reason.
Karina, Sweaty Girl Soc (34:57):
Mm-hmm.
Yeah, for sure.
I really appreciate your Storiesthat you post of everyday
moments in your life where youhave some face sweat happening
or your hands are sweating Ijust think it helps to normalize
everybody's experience and showwhat it looks like to live with
hyperhidrosis.
So what's next for you, for yourwork, both in the medical field
(35:18):
or online?
What's next for your advocacywork?
Kristen (35:21):
right now, as I
Karina, Sweaty Girl Society (35:22):
So.
Kristen (35:22):
earlier.
I'm now starting to see patientsin the office.
We can also do telehealth.
So I'm really, really excitedjust to be able to be on the
other side of things as apatient for so long and
struggling again, advocating formyself, getting the treatment I
needed, on the phone withinsurance, asking why my
(35:45):
medication wasn't covered.
I've been through it all, and soto be on the other side of it,
and provide that resource andguide patients and be the
support that I didn't have,there's really nothing that can
explain how much that motivatesme to advocate for
hyperhidrosis.
(36:05):
'cause I can finally give backand give people proper
treatment.
Karina, Sweaty Girl Soci (36:09):
That's amazing.
Well, there's not that manyvoices in this space, so really
appreciate what you're doing.
Kristen (36:15):
Thank you Karina, and
Karina, Sweaty Girl Socie (36:16):
Yeah,
Kristen (36:17):
happy that you're now part of our advocacy group'cause
we do need more voices outthere.
Karina, Sweaty Girl Socie (36:22):
yeah.
Absolutely.
Thanks for that.
So where can people find youonline?
Kristen (36:27):
online, my Instagram is How to Hyperhidrosis, and then
my blog is also How toHyperhidrosis.com.
If you want to see me as apatient, I'm located in Burbank,
California and the phone numberis(818) 843-5864.
(36:48):
Ask that you wanna see me forhyperhidrosis and they'll
schedule an appointment.
I'm super, super excited aboutthat'cause again, it's just the
next step in advocacy for me.
Karina, Sweaty Girl Soci (36:57):
That's right.
That's amazing.
And we'll put all your contactdetails in the show notes and in
the description.
And thank you, Kristen.
I learned a lot today, a reallygreat conversation, and I really
appreciate your time.
Kristen (37:07):
am like so
Karina, Sweaty Girl Socie (37:08):
Thank you.
I'm.
Kristen (37:09):
and I love talking about hyperhidrosis, so thank
you again for having me.
We focus so much more on how it affects us and most
(00:04):
other people, they're not evenpaying attention.
For me, me telling people was away for me to regain control
back.
I learned that I can't changethe hyperhidrosis, but maybe I
could have a more fulfillinglife.
If I'm not hiding it as much,I've been through it all, and so
to be on the other side of itand guide patients and be the
(00:28):
support that I didn't have,there's really nothing that can
explain how much that motivatesme.
Karina, Sweaty Girl Society (00:38):
You are listening to the Sweaty Girl
Society Podcast, a show forwomen with hyperhidrosis, where
we share tips for living betterwith excessive sweating.
I'm your host, Karina.
Now let's get into the show.
Welcome back to the Sweaty GirlSociety Podcast.
In this episode, I'm speakingwith Kristen Hernandez,
hyperhidrosis advocate andfounder of How to Hyperhidrosis.
(01:00):
Kristen is also a Physician'sAssistant.
In this episode, Kristen offerslots of practical tips to help
you navigate the healthcaresystem and advocate for
yourself.
I think you're gonna love thisconversation.
Kristen, welcome to the show.
Kristen (01:14):
you for having me.
Karina, Sweaty Girl Socie (01:14):
Thank So in addition to being a
hyperhidrosis advocate andhaving hyperhidrosis yourself,
you are also a CertifiedPhysician's Assistant.
For those of us outside the US,like myself, can you explain
what a Physician's Assistant is?
Kristen (01:29):
So a Physician Assistant abbreviated as PA, in
some states now it's considereda Physician Associate.
So either one of those areinterchangeable.
We can diagnose, we can treat,we can prescribe, and see
patients on our own.
In some states like California,we have to be working under a
doctor or MD, but otherwise wehave autonomy of our patients.
(01:53):
So I have my own patients that Ican see.
And then right now I'm workingin internal medicine and
pulmonology.
Karina, Sweaty Girl Society (02:01):
So what led you to enter the
medical field?
Kristen (02:04):
I always had just this
Karina, Sweaty Girl Society (02:06):
I.
Kristen (02:07):
towards helping people.
That's so general and so.
a young age, I was volunteering,I was working in semi medical
related field, so I was an MAand then I worked for the
hospital to raise money, butthere was always something
missing and I always had thisidea like, oh, I want more
(02:30):
hands-on experience, which isironic considering how
hyperhidrosis so hands off.
Like,
Karina, Sweaty Girl Soc (02:37):
Mm-hmm.
Mm-hmm.
Kristen (02:38):
sweating.
And so that's kind of what tookso long, I, I guess you could
say to get me here.
I just had so much doubt, like,can I even do this?
I'm terrified of touchingpeople.
So I volunteered in the hospitaland I used that as my way of
being like, can I actually dothis?
And over time I became morecomfortable.
(03:00):
So then I did all theprerequisites, but it was always
a challenge because myhyperhidrosis was affecting me
academically.
I was having really bad testtaking anxiety because during
the exam I was not even focusingon the test.
I was focusing on my sweat andhow to manage it.
(03:21):
'cause I was like,
Karina, Sweaty Girl Soc (03:22):
Mm-hmm.
Kristen (03:22):
wet my scantron, which I've done multiple times that I
had to turn it in once.
And the professor's like, why isit
Karina, Sweaty Girl Socie (03:29):
Yeah.
Kristen (03:30):
Like.
I'm like, how do I explain this?
And so it started to affect meacademically.
I wasn't doing well in schooland at that point I started to
seek accommodations.
So it's been a challenge to gethere, but it was ultimately
always something I wanted to do.
Karina, Sweaty Girl Socie (03:46):
Yeah.
Whenever I hear of somebody inthe medical field who has
hyperhidrosis, I immediatelythink of wearing gloves.
how do you navigate wearinggloves and, I guess, do you
sweat on your hands?
Kristen (03:57):
sweat my hands, my upper
Karina, Sweaty Girl Societ (03:58):
Yes, yes.
Kristen (03:59):
my nose, my lower back, my underarms, my ankles, behind
my knees, everywhere.
scalp.
Karina, Sweaty Girl Society (04:08):
All the places.
Mm-hmm.
Kristen (04:11):
so yeah, a major thing.
I remember working in thehospital and it would take me,
it felt like five minutes, butjust to put gloves on.
I'd be like, okay, one second.
Like trying to get it on myhand.
I was like, oh my gosh, this isso embarrassing.
But it's funny because I learnedover time too, we focus so much
(04:32):
more on how it affects us.
And most other people, itdoesn't even phase'em.
They're not even payingattention.
They don't know what's going on.
So for me, a lot of the times ifI was in my rotations, I would
actually just tell my preceptorlike, hey, I have hyperhidrosis.
My hands are really sweaty, myface sweats.
(04:53):
So if you see me putting gloveson and it's taking a minute,
that's why like, it's a littlebit of a challenge.
They're like, okay, yeah, that'sfine, whatever.
But yeah, so putting gloves onalways a challenge, but I
actually had a conversation withone of the people from the
community who asked me aboutthis.
And you find ways to adapt, likeI said.
(05:13):
So for example, I would, I wouldput hand sanitizer because one
of the things in the school theyteach you is before you see a
patient, you have to wash yourhands or put hand sanitizer, so
I would do that and if my handswere still really sweaty, I
would grab a towel from theroom, wipe my hands down, then
get my gloves and try to putthem on.
And again, patients don't even.
(05:34):
Think about that.
They don't even know what I'mdoing.
And it doesn't affect my abilityto do what I need to do.
If it took a little bit longer,which sometimes it still does I
talk to them and ask them morequestions about why they're
there or other things abouttheir personal life.
So I kind of fill the time if Ineed to.
Karina, Sweaty Girl Socie (05:53):
Yeah.
I find that it's often we're sofocused on it because we're
living the experience, butpeople don't pick up on it.
That's interesting that you toldyour preceptor.
Do you feel like you've had moreempathy in the medical
community?
Kristen (06:07):
I think took me many years to just be able to say it
in general.
There was
Karina, Sweaty Girl Socie (06:12):
yeah,
Kristen (06:13):
in my life where I had a sit down with my family to be
like, this is my reality.
And I was crying.
'cause I was like, I don't thinkyou guys understand.
I may seem like a happy person,but a lot of challenges I face
that you
Karina, Sweaty Girl Soc (06:28):
Mm-hmm.
Kristen (06:47):
So.
By the time that I got to PAschool, I already knew, I just
need a say it upfront it was away for me to gain control back.
Hyperhidrosis is you have nocontrol my entire life you try
to control things as much as youcan, but despite that you still
sweat excessively.
(07:07):
Like there's really not much youcan do.
And so I always
Karina, Sweaty Girl Soc (07:10):
Mm-hmm.
Kristen (07:12):
And so for me, me telling people was a way for me
to regain control back.
So my preceptors too, because Iknew it was gonna be a challenge
for me.
there were even instances in PAschool where we do physical
exams on our classmates and oneof'em is doing a physical exam
(07:33):
on the feet.
And I was like, absolutely not.
I was just like, I am not, Iknow I'm a hyper advocate, but
I'm also a human being and I'malso a patient that is.
gravely embarrassed and I don'twant people to see my sweaty
feet.
So I told my professors, ifsomeone
Karina, Sweaty Girl Society (07:52):
I understand if someone,
Kristen (07:54):
they can to practice, but this is just something that
I really feel uncomfortable withthey're totally fine with it.
They're like, that's fine.
If they really need it, they'lluse another person's feet And so
in that way, I was able toadvocate for myself while also
maintaining that feeling ofsafety and control.
Karina, Sweaty Girl Socie (08:12):
Yeah.
It, it takes a bit to get there,right?
Throughout my life there's beentimes I've gone for a massage
and, the massage therapist isgoing in the direction of my
feet, and in the past I would'velet them touch my feet and been
really uncomfortable with it andin a freeze response I guess.
Whereas over the years, as I'vegotten older, I can advocate and
say now, let's not touch myfeet.
(08:33):
I don't need my feet massagetoday, like, I have
hyperhidrosis, or just leave it.
Right?
But it, it takes time to be ableto talk about it.
You have talked before, in otherinterviews about your journey
with therapy.
Can you speak more about thatand, how that transformed your
viewpoint on your condition?
Kristen (08:51):
so
Karina, Sweaty Girl Society (08:51):
Um,
Kristen (08:52):
me, getting
Karina, Sweaty Girl Society (08:53):
so.
Kristen (08:53):
was, I mean, I felt in some ways I was a hypocrite.
I'm going into a field where I'mtelling people to get help, but
couldn't even seek therapy.
So who am I to tell someone elseto seek therapy if I can't even
do it for myself?
So that was a motivation for meto take that first step.
(09:15):
And it's terrifying because I'mlike, oh, they're gonna think
I'm crazy.
They're gonna think, you are theproblem.
This is what's going on.
And in reality, it was.
opposite.
For the first time I could talkto
Karina, Sweaty Girl Socie (09:27):
First time
Kristen (09:28):
feeling
Karina, Sweaty Girl Society (09:29):
to someone without.
Kristen (09:31):
and for most of my sessions I was crying.
it's exhausting because I was inmy mid twenties when I started
therapy, so I lived majority ofmy life'cause I've had hyper
since I was four, just hidingthis all in.
So a lot of those sessions, likeI said,
Karina, Sweaty Girl Socie (09:49):
Yeah,
Kristen (09:50):
and just literally getting it out.
Karina, Sweaty Girl Socie (09:53):
Yeah.
Having a witness, havingsomebody hear your story.
Kristen (09:57):
like lifesaving for me in a way because it was also a
realization, again, going backto the hiding and the lack of
awareness I had about mycondition was how much it was
actually impacting meemotionally.
For a lot of us, we live withchronic stress because we're
worried about it, and even ifsomeone else doesn't care or
(10:18):
doesn't notice.
anyone is sweating excessively24 hours a day, it's
uncomfortable.
And that goes back to the sweatyfeet.
You may not care about my sweatyfeet, but it literally just
feels uncomfortable.
Like right now I'm sitting in mysocks and my feet are sweaty,
and I'm used to that feeling,but it's not like the most
comfortable feeling,
Karina, Sweaty Girl Socie (10:41):
same.
Same.
Kristen (10:42):
going to therapy and learning how to talk about it
and express what I was feeling,I think was such a huge thing
for me and in my progressionwith dealing with hyperhidrosis,
because I also learned that Ican't change the hyperhidrosis,
but maybe I could have a morefulfilling life i'm just more
(11:03):
upfront and not hiding it asmuch.
It was in my personalexperience, life changing.
And that's why I recommend it somuch for people because
hyperhidrosis is not just aphysical ailment, there is such
a psychological to how itimpacts us on a daily basis.
Karina, Sweaty Girl Society (11:24):
So where would you say your
relationship is today withhyperhidrosis?
Kristen (11:28):
I think it's definitely better than what it was.
I think it goes back to mefeeling comfortable talking
about it.
I have grown a passionadvocating for hyperhidrosis and
having you and Maria and all theother advocates talk about it,
definitely makes it, easier totalk about because you know that
you're not the only one outthere.
(11:49):
And so in terms of myrelationship with hyperhidrosis,
I feel at ease and I feel moreconfident, in my current state.
Right now I'm not doing anytreatments and I know
15-year-old Kristen would bedevastated by that.
it's not necessarily becausethere aren't certain treatments
that can benefit me, justbecause I lived my entire life
(12:12):
focusing on hyperhidrosis andtrying to fix it.
I mean, and this is what therapyhelped me with, is sometimes I
don't need to fix everything Ican just be, that in itself has
relieved a lot of the stress ofliving with hyperhidrosis.
Finding the comfort in my ownskin.
I feel like I have a healthierrelationship with hyperhidrosis
(12:35):
for sure.
Karina, Sweaty Girl Society (12:36):
I can really relate to that.
There is a certain level offreedom when we accept that this
is the way it is and aren'tstriving always to find the fix.
So in terms of your, journeywith hyperhidrosis, when did you
receive an official diagnosis?
And what was that experiencelike for you?
Kristen (12:57):
in PA school, presented on this in my classmate.
This is where my advocacy, I waslike, I need to tell the whole
world about this because I knowone of my classmates is gonna
run into a patient withhyperhidrosis.
And what I learned in that isthat the average diagnosis time
period is 10 years, and that istotally on point with me.
So I had hyperhidrosis at age offour.
(13:20):
I didn't get diagnosed till 14.
I went to a dermatologist, theydid the sweat iodine test where
they put iodine, they let itdry, they put powder.
Karina, Sweaty Girl Society (13:30):
Oh, they did.
Kristen (13:30):
and it turns black and it shows where the sweat is.
Nowadays I feel I can tell ifsomeone has me to bring
hyperhidrosis I don't know if Ineed to do all that testing.
But yeah, so they did that testand I'm like, okay, you have
something called hyperhidrosis.
And I'll never forget this, thedoctor was like, well.
We know that it's hyperhidrosis,but there's currently nothing we
(13:51):
can really do and there's nocure.
And so the first thing theyrecommended was these topicals,
which were really irritant to myskin.
And so I didn't use those forvery long.
And then later they recommendediontophoresis.
But at that time, the machineswere made a lot differently and
were really painful and when I'dask for advice, they didn't
(14:15):
really know.
So it was here's the device,figure it out.
This is maybe what you shoulddo.
But there wasn't really anyguidance on, okay, well what if
this hurts a lot?
I can't sit here for
Karina, Sweaty Girl Socie (14:28):
Yeah.
Kristen (14:28):
let alone 10 minutes or 15 minutes.
it was essentially like, well,that's what you have to do.
So I would sit there in agony.
And eventually that also didn'twork because it was too painful.
I was like, it's not worth it.
I couldn't do it.
Karina, Sweaty Girl Soc (14:43):
Mm-hmm.
Kristen (14:43):
okay.
Karina, Sweaty Girl Socie (14:43):
Yeah.
Kristen (14:44):
and ultimately I found a doctor through a family friend
and I went to this doctor.
Like so informative right away.
They were able to explain theprocess and super supportive.
And it was just like someoneknows what this is and
understands it better than I do,which was such a relief because
(15:06):
as many of us, we always have toexplain and explain what
hyperhidrosis is and why it's sodebilitating, and why you need
treatment, and why, why, why,why, right?
There's always so much toexplaining.
Karina, Sweaty Girl Soc (15:18):
Mm-hmm.
Kristen (15:20):
This happened to be an endocrinologist.
I was with this doctor untilthey retired.
And I was really fortunate.
I started oral medication whichworked really well for me for
about seven years, and I trieddifferent ones and then I
started to get side effects likea migraine.
Karina, Sweaty Girl Soci (15:39):
Agree.
Kristen (15:39):
again, it was kind of at that point where I was also
like, I'm okay.
Not doing anything, so I juststopped medication.
Karina, Sweaty Girl Societ (15:46):
Your journey sounds very similar to
mine in terms of the initialdiagnosis.
When you said 10 years, I justdid the math on mine too, and it
was precisely 10 years.
My earliest memory ofhyperhidrosis was around age 10.
And I got diagnosed when I was20.
I find that interesting thatthey did the test.
I recently went to my doctor,because I was interested in
(16:07):
trying glycopyrrolate and mydoctor started asking questions
like how do you know you havehyperhidrosis?
Where do you sweat?
This sort of thing, because I'venever had the test that you were
describing done.
And I, I just held up both of myhands, which were dripping, and
I stood up from the examinationtable where I had completely
(16:28):
soaked the paper lining.
And she's like, oh, okay.
Yeah, you have hyperhidrosis,right?
Kristen (16:33):
That's so great.
Karina, Sweaty Girl Socie (16:34):
Which is interesting around diagnosis
because I've come across thequestion in our community and in
the world, how do I know I havehyperhidrosis, how much sweat is
normal versus how much sweatmeans hyperhidrosis?
And I think for those of us whoare confident that we have
hyperhidrosis, it's quite clear.
But what qualifies a diagnosisof hyperhidrosis.
Kristen (16:55):
A very
Karina, Sweaty Girl Soc (16:56):
that's.
Kristen (16:57):
interesting question.
'cause you're right, for somepeople who have severe,
excessive sweating, it's veryfor others it may not be so much
and when I was doing researchregarding it, what I struggled
with is what is the actualparameter?
There was some that was like, ifyour sweat beads are a certain
(17:18):
amount of centimeters ormillimeters, and I'm like, who
is going out here measuring mysweat beads on my hand?
That's not an accuratedescription.
And then there was a scale ofhow much it impacts you on a
daily basis.
And I was also like, well,that's not exactly related to
(17:38):
the sweat, the physicalcomponent.
That's more the psychologicalcomponent.
And so in terms of dermatologydiagnoses, a lot of these are
based off quality of lifescales.
But I always ask are yousweating when you're just
sitting?
Do you start excessivelysweating when you've just woken
up?
Are you sweating at night?
(17:59):
So all these instances where theaverage person not, I typically
ask those types of questions andthat's a red flag.
Like, okay, this seems morelikely to be, it's also very
important for patients to go totheir providers or clinicians
because they need to be screenedfor other conditions that can
(18:19):
cause excessive sweating.
So whether it's related to thepituitary gland or their
thyroid, there's a lot ofreasons why people can have
excessive sweating.
Maybe it's a medication they'reusing that's causing excessive
sweating.
Hormones.
I have a lot of patients inmenopause that are having hot
flashes so there's a lot ofreasons why we can excessively
(18:39):
sweat.
So one, in terms of the initialdiagnosis, it's kind of based
off the patient's experience.
Some of those questions and thenI always ask.
Them bring a video because maybethey're dry in the office and
they're like, oh, of course, youknow, I'm trying to prove myself
and my hands all of a suddenbecame dry or my face is dry,
providing video or images canreally be helpful.
(19:02):
So making sure that they screenfor any other conditions first
and then doing hyperhidrosisevaluation next.
Karina, Sweaty Girl Soc (19:10):
Gotcha.
So as a physician's assistant,have you treated many people
with hyperhidrosis, whetherthey've come to you for
hyperhidrosis or you notice itas part of other treatment?
Kristen (19:20):
first patient I had was during my dermatology rotation.
I had an opportunity with apatient and it happened to be
their first time coming in atall ever to get treated.
I was like, I havehyperhidrosis, understand.
do you sweat?
And I feel like I was able toask questions that maybe other
(19:43):
providers, at least they neverasked me, like, you sweat here?
Do you sweat there?
Just to get an idea of theextent of the hyperhidrosis and
also to figure out what type oftreatment would better fit them.
So that was my firsthyperhidrosis patient.
I've had two other ones thatI've been able to help and
(20:06):
manage But it's interesting youasked because where I'm at now,
I'm now ready to see patients inoffice and do consults and see
patients for hyperhidrosis.
So if anyone out there wants ahyperhidrosis advocate and
clinician who treatshyperhidrosis, I'm your girl.
Karina, Sweaty Girl Societ (20:25):
Wow, that's amazing.
I haven't heard of many peoplewho specialize in hyperhidrosis
other than a Botox clinic or thetreatment side, but to actually
get the diagnosis and helpnavigate care, that's really
exciting.
Kristen (20:38):
excited about it and
Karina, Sweaty Girl Socie (20:39):
Yeah.
Kristen (20:40):
Like a part of little Kristen heals because I'm able
to give something someone that Inever got, and at the same time
I feel sad because I'm like,gosh, my experience was so
terrible.
it's kind that balance.
It's so rewarding that I cangive back in that way.
Karina, Sweaty Girl Society (20:58):
You know, one thing, on a slightly
related topic is for me, goingto the doctor has always been.
Triggering of my sweat because Ianticipate having to lay down or
sit on the table with the paper,the paper, uh, that covers.
I don't know what the medicalterm for the paper is, but I
(21:19):
always sweat through it.
Is this something you'veexperienced and what advice both
as being a patient of careyourself, as well as a provider
of care, what tips would youoffer to somebody going to a
doctor's appointment so they canmake it more comfortable for
themselves and not have to havethese reactions?
Kristen (21:38):
that's a great question.
So
Karina, Sweaty Girl Society (21:39):
So.
Kristen (21:40):
in these exams, it depends on what type of exam.
So one, I'll ask, do I need tocompletely undress or can I keep
my shirt on?
Like, can I keep, you know,whatever they're examining.
I see if there's any part ofclothing I can still keep on.
Second, it's kind of hardbecause.
I've experienced the same thing.
I am sweating through thispaper.
(22:01):
I'm sticking to it.
It's gripping and sticking to mybody, like oh my gosh.
Karina, Sweaty Girl Socie (22:07):
Yeah.
Kristen (22:08):
and so in those exams, I keep my socks on at least.
Karina, Sweaty Girl Socie (22:13):
Yeah.
Kristen (22:13):
I'm at least more comfortable.
but yeah, it's really hard.
I do know that Maria did a postabout it and she brought her own
towels and her own resources sothat she could lay, I think she
was laying on a towel or usingit for her hands.
One of the things.
So that's a way we can feel alittle bit more comfortable
because not all offices havetowels readily available.
Karina, Sweaty Girl Society (22:37):
And that's Maria from my Life is a
Puddle.
Her blog.
She did a blog post on it.
Yeah.
Kristen (22:41):
had shared that to me like, oh, that's a really good
idea.
But honestly, sometimes when Igo to the doctor, I completely
forget.
Karina, Sweaty Girl Socie (22:47):
Yeah.
Kristen (22:47):
that's one way that you can help least make yourself
feel a little bit morecomfortable.
Like you said, the paper islike, oh my gosh, the paper.
Karina, Sweaty Girl Socie (22:56):
Yeah.
It's just the horrifying, uh,moment when you have to get up.
Yeah.
And the, the gowns, being thatblue, it just shows the sweat so
much and Yeah.
Yeah.
Can be an uncomfortableexperience.
Kristen (23:10):
say we're doing a full physical exam and I can only
leave my socks on i'll keep mysweater on my side, so at least
I can use it to soap up mysweaty hands.
Or I can just grab it and thenwhen they need to check this
area, I'll move it.
But it's kinda like a hankyessentially that I just keep
with me.
Karina, Sweaty Girl Societ (23:26):
Yes, it's key to have some things at
the ready to soak up the sweatwith.
So what advice would you offerto somebody who wants to speak
with their doctor for the firsttime about hyperhidrosis?
I know that can be a bit of ascary thing as well.
I remember speaking with mydoctor for the first time and I
was like, will she dismiss me?
(23:46):
Will she believe me?
Will she think that I'm gross?
Is this even a real thing?
So what are some pieces ofadvice you would give to
somebody?
Kristen (23:55):
I did a blog on my How to Hyperhidrosis Blog about how
to prepare for a doctor visit.
And one of the things I talkabout is writing all your
questions down that thoughtabout, that you wanna know
about.
So bringing in a list, I alwaystell my patients, bring a list
in next time, because sometimesyou're in there and you forget
(24:15):
everything that you wanted toask.
and then second is providingimages or video to show proof of
your hyperhidrosis.
It doesn't have to be your wholebody, but just certain spots
just to show evidence in caseyou get into the office, the AC
magically dries your hands orwhatever, and then you have no
proof.
(24:35):
And then one of the other thingsI've done in the past is I've
called the offices before I evenmake an appointment.
I'll ask does the doctor treathyperhidrosis if they're not
sure?
Can you ask what type oftreatments does he or she
provide?
Because I've been to officeswhere it's like this was a waste
(24:55):
of my time.
Also I don't wanna pay anothercopayment in the United States
where we have insurance that wehave to pay a certain amount,
don't wanna waste my money on aphysician that doesn't know
what's going on.
And so those three things, Ithink are the main things.
So writing your notes.
Videos or images and theninterviewing the office that you
(25:16):
wanna go to.
Now, if you don't have theopportunity to pick and choose
what clinician you go to, thenhaving those questions and video
and images is really important.
It's also important because alot of these visits are 15
minutes maybe.
So you have to take advantage ofthat time you have.
So even if you do have a longlist of questions, trying to
(25:39):
pick, okay, if I'm limited ontime, what are the top two
things that I absolutely need toknow by the end of this
appointment?
and that way you have a startingpoint.
You can do a follow up and thengo from there and ask the rest
of your questions when that nextappointment is.
Karina, Sweaty Girl Soc (25:55):
That's.
Great advice.
So in the US what is the pathwayyou would follow?
In Canada here, we wouldtypically go to our family
doctor first.
And then the family doctor wouldrefer us to a dermatologist.
Is it similar in the US?
Kristen (26:07):
On insurance.
Karina, Sweaty Girl Soc (26:09):
depends on insurance.
Okay.
Kristen (26:10):
PPO insurance, there's HMO insurance.
The PPO for the most part, youcan go anywhere you want, so you
don't have to go through yourprimary doc.
You can just go straight to adermatologist, straight to an
endocrinologist.
Now with that, some offices, sodermatology, the specialties
(26:31):
will require a note from yourprimary to say they need to be
seen.
And that's because a lot ofthese offices are.
Really, really busy.
So they wanna make sure, you'recoming to us because we actually
need to see you type of thing.
So there's that caveat.
And then with some HMOinsurances, you need
authorization, meaning similarto you.
(26:51):
You have to go through yourprimary doctor, and then they
have to refer you to aspecialist.
you know, if you work ininternal medicine or family
medicine like me and you alreadyknow about hyperhidrosis, you
can skip that step and just betreated your primary or your
internal med doctor.
So that's kind of what I wasdoing in PA school.
(27:14):
I did a pediatric rotation and Idid a presentation on
hyperhidrosis because.
you were 10.
I was four.
We could have been screened at ayounger age and maybe had a
better quality of life for those10 years that we weren't
diagnosed.
So yeah, there's a lot ofdifferent avenues, but in the
(27:34):
United States, it's kind ofdependent on insurance.
Karina, Sweaty Girl Socie (27:37):
Okay.
Interesting.
And that raises an interestingpoint.
From what I know, at least inCanada, it's a dermatologist
that would treat hyperhidrosistypically, but is it really a
dermatological condition?
Right?
There's a lot that we don't knowabout hyperhidrosis and who is
the right person to treat it.
Do you have any thoughts
Kristen (27:58):
yeah,
Karina, Sweaty Girl Society (27:58):
Um,
Kristen (27:58):
always
Karina, Sweaty Girl Socie (27:59):
yeah.
Kristen (27:59):
a challenge with that as well, just because also my
personal experience, one of thedoctors that helped me the most
wasn't a dermatologist, it wasan endocrinologist, they
understood the pathophysiologybehind hyperhidrosis, and they
explained it to me.
I was like, oh, I neverunderstood it this way.
So in that respect, I don't knowif a dermatologist or
(28:22):
endocrinologist a familymedicine or internal medicine is
the best.
I think it just depends on.
Who has knowledge on it.
Unfortunately, that's kind ofwhere we're at because there are
a lot of gaps within thesespecialties.
Some kind of know about
Karina, Sweaty Girl Socie (28:38):
Yeah.
Kristen (28:38):
of don't.
Now, as far as the UnitedStates, there might be some
procedures that you can do at adermatology office, but you
can't do at a endocrinologyoffice.
So for example, Botox, that's awidely cosmetic procedure, and
so it overlaps with it being aprocedure for hyperhidrosis.
So it makes sense that theywould be the ones handling that.
(29:01):
In terms of oral medication,yeah, they can also handle oral
medication.
So technically it is a skinrelated condition, but it's more
of a neuroendocrine possiblecondition.
And that's the research we needto better understand and
appropriately assign who shouldbe addressing dealing with these
(29:21):
types of conditions.
And then on top of that,educating this population of
providers so that it doesn'tmatter who you go to, someone
will still be able to manageyou.
cause right now
Karina, Sweaty Girl Socie (29:32):
Yeah.
Kristen (29:32):
there could be a whole list of dermatologists that
treat hyperhidrosis, not all ofthem are equal.
Karina, Sweaty Girl Soci (29:39):
Right.
Yeah, it's interesting becausehyperhidrosis presents on the
skin.
That's the obvious symptom isthe sweat.
But there's so much more goingon behind the scenes and there's
so much we don't know.
So where are you hopefulresearch will go over the next
decade?
Kristen (29:55):
is hard to say.
'cause right now there's a lotof limitations with research.
At one point, there was beingdone regarding genetic testing
for hyperhidrosis, and itsoverlap POTS And so I don't know
how far they are into theresearch, but that was just very
(30:17):
preliminary.
A lot of the research is solelydone on underarm treatment,
which in some ways it's adisservice because we know that
we sweat in multiple places andwe know that the underarms is
the easier part of the body totreat.
But the face, for me personally,that's the hardest thing to hide
(30:40):
my hands.
I can hide in my
Karina, Sweaty Girl Soc (30:41):
Mm-hmm.
Kristen (30:42):
I can hide with a sweater, but my face, I can't
hide.
So,
Karina, Sweaty Girl Socie (30:47):
Yeah.
Kristen (30:48):
I think has always been a challenge in terms of how to
manage it.
Karina, Sweaty Girl Socie (30:52):
Yeah, we had a conversation in the
Sweaty Girl Society communityabout this.
And if there was one place youcould stop sweating, what would
that be?
And most people did say facewhereas when my doctor asked me
the first thing she said, do yousweat in your underarms?
That was the first thing thatshe went to.
People often think underarms,hands, feet, and of course
underarm sweat is not fun.
(31:12):
It can be very embarrassing butthere are so many more areas
that we sweat in like the grointhat rarely gets talked about.
But as I speak with more andmore women who have
hyperhidrosis, that is a very,very common place that we
experience sweating and youalmost never hear about that
when you see the list of wherepeople sweat.
(31:34):
So lots of work to be done abouthow we talk about hyperhidrosis
and how we communicate it.
Kristen (31:40):
Yeah, and in other
Karina, Sweaty Girl Socie (31:42):
Yeah.
Kristen (31:43):
Botox is a covered procedure, meaning patients
don't have to pay and it'scleared to to be used for Botox
to treat hyperhidrosis all overthe body, including the groin.
Whereas here in the UnitedStates, it's only approved for
underarms hands, I believe, andfeet.
(32:05):
So anywhere else on the body,
Karina, Sweaty Girl Socie (32:06):
Okay.
Kristen (32:07):
covered.
So even though I have hypers onmy face, I've gotten Botox, but
insurance will not cover it.
So I've had to pay some dollarsout of pocket, and that's kind
of.
The burden that we have to payliterally in terms of finding
treatment, because it worked forme.
(32:27):
It worked for three months, Iwould do it, but again, it's
money outta my pocket that.
It's a lot of money
Karina, Sweaty Girl Soci (32:34):
Right.
Kristen (32:34):
on treatment and it's effective for some people, and
that's the thing withhyperhidrosis treatment is what
works for me may not work foryou, but if Botox works for me,
but now I have to pay$400 everythree months, and then there's
another patient who can gethyperhidrosis treatment that is
covered by insurance it's justnot equal in that respect.
Karina, Sweaty Girl Society (32:56):
For sure.
Can you talk a little bit aboutyour advocacy work and what led
you to start your blog andbecome active on social media?
Kristen (33:05):
so it started
Karina, Sweaty Girl Socie (33:06):
Yeah.
Kristen (33:06):
the pandemic.
I was working in the er, it.
Very hectic at the same time Iwould happen to be doing
therapy.
And that's kind of an outlet, Iguess, that I used to just
express what was going on withme Never in a million years
would I have thought there's somany people out there with
hyperhidrosis.
(33:27):
And so it was a therapy for me.
'cause I would be up till 3:00AM making my blog.
And I'm also a creative person,so I like the aspect of creating
something designing it.
And so that's where it startedwas something I was doing as a
hobby.
And then I started to learnthere's other people out there.
(33:49):
Learned from Maria, My Life as aPuddle, I found her page and she
invited me to participate in anarticle for her blog.
And that gave me more confidencein talking about hyperhidrosis.
I was like, there's not a placeat that time where you can see
hyperhidrosis, see possibletreatments.
(34:12):
And so that's why I created theblog.
Then the Instagram followed.
I wanted to be honest and talkabout the things people didn't
wanna talk about.
That's generally my personality,say things that might shock
people, and so talking about,you know, groin sweat and all
(34:32):
these things that we were soashamed about sharing in regards
to our sweating is somethingthat I was like, oh, I
definitely have to approachthat, or discuss that.
And so that's where it started.
And then it just becamesomething that was.
Very rewarding, and it motivatedme more to become more active.
(34:53):
I think Maria was definitely aguiding light in that, we call
her the OG for a reason.
Karina, Sweaty Girl Soc (34:57):
Mm-hmm.
Yeah, for sure.
I really appreciate your Storiesthat you post of everyday
moments in your life where youhave some face sweat happening
or your hands are sweating Ijust think it helps to normalize
everybody's experience and showwhat it looks like to live with
hyperhidrosis.
So what's next for you, for yourwork, both in the medical field
(35:18):
or online?
What's next for your advocacywork?
Kristen (35:21):
right now, as I
Karina, Sweaty Girl Society (35:22):
So.
Kristen (35:22):
earlier.
I'm now starting to see patientsin the office.
We can also do telehealth.
So I'm really, really excitedjust to be able to be on the
other side of things as apatient for so long and
struggling again, advocating formyself, getting the treatment I
needed, on the phone withinsurance, asking why my
(35:45):
medication wasn't covered.
I've been through it all, and soto be on the other side of it,
and provide that resource andguide patients and be the
support that I didn't have,there's really nothing that can
explain how much that motivatesme to advocate for
hyperhidrosis.
(36:05):
'cause I can finally give backand give people proper
treatment.
Karina, Sweaty Girl Soci (36:09):
That's amazing.
Well, there's not that manyvoices in this space, so really
appreciate what you're doing.
Kristen (36:15):
Thank you Karina, and
Karina, Sweaty Girl Socie (36:16):
Yeah,
Kristen (36:17):
happy that you're now part of our advocacy group'cause
we do need more voices outthere.
Karina, Sweaty Girl Socie (36:22):
yeah.
Absolutely.
Thanks for that.
So where can people find youonline?
Kristen (36:27):
online, my Instagram is How to Hyperhidrosis, and then
my blog is also How toHyperhidrosis.com.
If you want to see me as apatient, I'm located in Burbank,
California and the phone numberis(818) 843-5864.
(36:48):
Ask that you wanna see me forhyperhidrosis and they'll
schedule an appointment.
I'm super, super excited aboutthat'cause again, it's just the
next step in advocacy for me.
Karina, Sweaty Girl Soci (36:57):
That's right.
That's amazing.
And we'll put all your contactdetails in the show notes and in
the description.
And thank you, Kristen.
I learned a lot today, a reallygreat conversation, and I really
appreciate your time.
Kristen (37:07):
am like so
Karina, Sweaty Girl Socie (37:08):
Thank you.
I'm.
Kristen (37:09):
and I love talking about hyperhidrosis, so thank
you again for having me.
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