There's nothing more embarrassing than sweating profusely in public places, yet one expert says many people suffer through the humiliation for decades.

At least 15 million people in the U.S. have excessive sweating (hyperhidrosis), according to the American Academy of Dermatology (AAD). Yet, half of people with the condition delay the many effective treatments available for 10 years or more.

"We all sweat to some degree," said Dr. Maral Skelsey, director of the Dermatologic Surgery Center of Washington, D.C. "However, some people sweat heavily for years without realizing it's a medical condition and that something can be done about it."

People with hyperhidrosis sweat even without the usual triggers, such as heat or physical activity. It occurs in the armpits, feet and hands and typically starts before age 25, with at least one episode a week. It does not cause sweating at night.

"It can be really devastating for children," Skelsey said in an AAD news release. "It affects their social life. Nobody wants to hold their hand. They can't use crayons because they get all wet. They don't want to go to school."

For adults, the condition can limit dating and career choices and even clothing options.

"Hyperhidrosis can have a long-term impact if you constantly avoid professions or situations where you interact with people and shake hands," Skelsey said. "Additionally, people with hyperhidrosis are more likely to have attention-deficit disorder, depression and anxiety, as well as other skin conditions like warts and eczema."

The good news: Nobody has to live with it. "There's a lot we know about this condition. It doesn't have to have such a profound effect on a person's quality of life," Skelsey said.

Prescription or over-the-counter clinical strength antiperspirants are effective when applied at night to the armpits or hands, he said, and new prescription wipes can decrease armpit sweat in kids as young as age 9.

Other treatment options include Botox injections in the armpits and hands; the oral medication glycopyrronium; laser surgery; and microwave thermolysis, in which electromagnetic energy is used to stop sweat glands from functioning.

Another option is iontophoresis. Hands or feet are placed in a pan of water, then a direct current is introduced to block sweat production.

A last resort is surgery to remove sweat glands. But this can increase sweating elsewhere.

"There are so many treatments available that can improve patients' daily life and quality of life substantially," Skelsey said. "If one thing doesn't work, there are other options."

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