Sweating is normal — it's how the body cools itself. But for the 3% of people in the U.S. living with hyperhidrosis, excessive sweating can interfere with daily activities and quality of life.
Evaluation of hyperhidrosis starts by ensuring that patients understand their condition and how excessive sweating can be managed.
My patients are often surprised — and relieved — to discover that effective treatments are available. Some have even delayed seeking care because they didn't realize how much it could help.
That's why I believe it's important for everyone to understand what hyperhidrosis is and how it can be managed. Here are answers to some of the most common questions patients ask me about the condition.
What is hyperhidrosis, and how is it different from regular sweating?
Hyperhidrosis is a medical condition that causes a person to sweat excessively. While we all need to sweat to prevent the body from overheating, people with hyperhidrosis sweat even when they don't need to cool off.
A person with hyperhidrosis might not necessarily perspire from head to toe. Often, they'll drip sweat from one or two body parts (like the palms, feet, underarms, or head) and stay dry everywhere else. My patients with hyperhidrosis often describe this type of sweating as uncomfortable and embarrassing, especially in social or professional situations.
Anyone can get hyperhidrosis. However, a person is more likely to be affected if it runs in their family or if they have another medical condition that can lead to excessive sweating, like diabetes. In some cases, medicines or food supplements can cause heavy perspiration, too.
How do I know if I have hyperhidrosis?
Sweating when you're hot or anxious is normal. But if it seems like you're sweating for no reason, hyperhidrosis could be to blame.
When a patient comes to see me, I often suspect hyperhidrosis when they have:
- Visible sweating, even at rest. The sweat may even soak through the person's clothing.
- Sweating that gets in the way of everyday activities. For instance, a person might drip sweat on their computer or have their hand slip when trying to open a doorknob.
- Skin that turns soft, white, or peels where there's frequent sweat.
- Frequent skin infections. The sweaty areas may be prone to athlete's foot or jock itch.
What causes hyperhidrosis?
Experts suspect hyperhidrosis occurs when nerves signaling the body to sweat become overactive. This, in turn, triggers excessive perspiration.
Some people develop hyperhidrosis as a standalone condition, usually during childhood or adolescence. For some of my patients, hyperhidrosis begins later. In those cases, common causes include:
- Diabetes
- Gout
- Injury, such as head trauma
- Medication or supplement side effects
- Menopause
- Obesity
- Overactive thyroid
- Tumor
- Infection
What treatments are available for hyperhidrosis?
A wide range of options are available. The right treatment — or combination of treatments — depends on the patient's symptoms and preferences. The options I discuss with my patients include:
Iontophoresis
This at-home treatment involves soaking the hands or feet in a shallow pan of tap water while a medical device sends a low-voltage electrical current through the water. The current temporarily shuts down a person's sweat glands to reduce perspiration. I reassure patients that, while they may feel a mild tingling sensation during their treatment, the current is not painful or dangerous.
Iontophoresis can be effective but time-consuming, with sessions taking anywhere from 20 to 40 minutes each. Results are often seen within 6 to 10 treatments. A patient may need to start doing two or three treatments per week and scale back to weekly or monthly treatments as their symptoms improve.
Botox injections
Botox may be best known for reducing wrinkles, but it's also an FDA-approved treatment for underarm hyperhidrosis. Research suggests that it may also be effective for the head, hands, and feet.
Botox injections work by temporarily blocking chemicals that stimulate the sweat glands. The effects typically kick in within four or five days and can last up to six months. Injections are administered again when symptoms increase.
Prescription antiperspirant solutions and wipes
Prescription solutions containing the active ingredient aluminum chloride and wipes with glycopyrronium can help manage excessive sweating in certain body areas. The products need to be applied daily. Some patients find that they cause mild skin irritation or dry mouth.
Prescription medications
Oral nerve-blocking medications work by temporarily blocking the nerves that trigger excessive sweating. They're an option for treating hyperhidrosis anywhere in the body.
Oral medications can be highly effective, but because they stop sweating, they make it harder for the body to cool. That makes them a riskier choice for athletes, people who work in hot conditions, or people who live in warm climates. It's also possible to have side effects such as dry eyes, blurry vision, and heart palpitations.
Surgery
If other treatments have been ineffective, I sometimes recommend surgery to remove the underarm sweat glands. It's also possible to perform nerve surgery, or sympathectomy, to remove spinal nerves that control hand sweating.
Surgery is the right choice for some patients. But the effects are permanent, and the procedures can come with risks. For instance, nerve surgery to manage hand sweating may cause heavy sweating elsewhere in the body. You and your dermatologist can weigh the pros and cons to decide what's right for you.
Thermolysis
During this in-office non-surgical procedure, a handheld machine uses thermal energy that permanently destroys sweat glands in the underarms. Results are usually seen in one or two treatment sessions, which take about an hour each. This treatment option requires patients to go to a certified provider.
Are there any lifestyle changes that can help?
I like to remind my patients that simple habit shifts can support their hyperhidrosis treatments:
- Wear breathable clothing. Natural fabrics like cotton, wool, or silk are best. Moisture-wicking fabrics are ideal for exercise.
- Wear shoes and socks made from natural materials. Leather shoes are more breathable compared to those made from synthetic materials.
- Keep feet dry. Wear moisture-wicking socks and change them once or twice a day, drying your feet in between. When you can wear sandals or go barefoot, do so.
When should I see a doctor about excessive sweating?
If you are living with excessive sweating, schedule a consultation with a dermatologist who's experienced in treating hyperhidrosis. The experienced team at Temple Dermatology will assess your condition and work with you to find a treatment that meets your needs. Call 800-TEMPLE-MED (800-836-7536) or request an appointment online.
Helpful Resources
Looking for more information?
- Meet the Dermatology Team at Temple
- Learn more about Hyperhidrosis Surgery at Temple
- Blog — 5 Reasons to See Your Dermatologist
