Hyperhidrosis (Excessive Sweating)

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What is hyperhidrosis?

Hyperhidrosis is the medical term for excessive sweating. It is not normal sweating due to heat or exercise. It is a medical condition that causes too much sweating in certain areas of the body, while other areas remain dry. It most commonly affects the hands, feet, underarms or head. The sweating can be so severe it drips from these areas.

Normally, sweating is the body’s way of cooling itself. In response to heat, physical activity, or emotions, the body releases sweat. As the sweat evaporates, it cools the skin and lowers body temperature. This prevents the body from overheating. In hyperhidrosis, sweating occurs when it isn’t necessary, at unpredictable times, and at levels far greater than normal.

There are two types of excessive sweating—primary and secondary hyperhidrosis. There is no known cause for primary hyperhidrosis. About 3% of the population suffers from this form of hyperhidrosis, which usually runs in families. Secondary hyperhidrosis is due to another medical condition, such as diabetes or menopause.

Fortunately, there are treatments available to help control excessive sweating. Hyperhidrosis treatment depends on the area where it occurs and the type. For secondary hyperhidrosis, treating the underlying condition often helps. Primary hyperhidrosis treatment options include topical therapy, medicines, and procedures to eliminate sweating.

Excessive sweating is usually not dangerous, but it can lead to complications. It can also be a source of mental and emotional problems from stress and embarrassment. See your doctor if you have noticed excessive sweating at least once a week for the past six months.

Sometimes, excessive sweating is a symptom of a serious or life-threatening condition, such as a heart attack. Seek immediate medical care (call 911) if you have excessive sweating with any of these symptoms:

  • Anxiety

  • Chest pain, pressure, squeezing or tightness

  • Lightheadedness—like you might pass out

  • Nausea or vomiting

  • Shortness of breath

  • Upper body pain

What are the symptoms of hyperhidrosis?

The main symptom of hyperhidrosis is excessive sweating. In secondary hyperhidrosis, sweating usually occurs all over the body. It can occur during waking hours or while you are asleep. If you suddenly develop night sweats, it could be a sign of a more serious condition. Contact your doctor for an appointment.

For primary hyperhidrosis, sweating has the following characteristics:

  • It occurs at least once a week while you are awake and not when you are sleeping.

  • It typically affects the palms of the hands, soles of the feet, underarms, face or scalp. Other areas of the body remain dry.

  • It occurs bilaterally, meaning on both sides of the body.

  • It can be so profuse that it drips from the affected areas or visibly soaks through clothing.

  • It can ruin clothing and interfere with daily activities.

Serious symptoms that might indicate a life-threatening condition

In some cases, excessive sweating can be due to a life-threatening condition, such as a heart attack. Seek immediate medical care (call 911) if you, or someone you are with, have excessive sweating with any of these symptoms including:

  • Anxiety

  • Chest pain, pressure, squeezing or tightness

  • Lightheadedness

  • Nausea or vomiting

  • Shortness of breath

  • Upper body pain

You don’t have to live with the embarrassment of excessive sweating. If your sweating persists and isn’t getting better, see your doctor for a diagnosis. There are solutions for both primary and secondary hyperhidrosis.

What causes hyperhidrosis?

Primary hyperhidrosis results from overactive nerves that supply the sweat glands, but there is no known underlying cause for nerve overactivity. The nerves signal the sweat glands to release sweat even when there is no trigger, such as heat or physical activity.

Secondary hyperhidrosis causes include certain medicines and supplements that cause sweating as a side effect and medical conditions including:

  • Alcoholism

  • Diabetes and low blood sugar

  • Gout

  • Heart attack

  • Infections and certain cancers

  • Menopause, overactive thyroid, and obesity

  • Nervous system disorders, spinal cord injury, and head trauma

What are the risk factors for hyperhidrosis?

The main risk factor for developing primary hyperhidrosis is having a family member with the same problem. Excessive sweating tends to run in families, which suggests the cause has a genetic factor. It occurs in people of all races, in all climates, and at all ages. However, many people first notice excessive sweating during childhood or teenage years.

Reducing your risk of hyperhidrosis

There is no known way to reduce the risk of developing primary hyperhidrosis. If you know hyperhidrosis runs in your family, talk with your doctor about what to look for and when you should be concerned.

You can reduce the risk of secondary hyperhidrosis by treating the underlying medical condition. For chronic conditions like diabetes, regular medical care is an important part of controlling your health. A medication change may help, but do not change the dose of or stop taking a prescribed drug without first discussing it with the prescribing doctor.

How is hyperhidrosis treated?

Secondary hyperhidrosis is best treated by addressing the underlying medical condition. Primary hyperhidrosis has no underlying medical condition, so treatment aims to control the sweating. Consulting with a dermatologist who has plenty of experience treating hyperhidrosis may be necessary.

There are several options depending on where the sweating is occurring. This includes:

  • Prescription-strength antiperspirants and topical creams may help reduce sweating of the underarms, hands, feet, face or hairline. This is usually the first treatment choice for many people. These products may cause skin irritation.

  • Botulinum toxin injections can reduce underarm sweating. This option works by temporarily preventing the nerves from releasing a chemical that stimulates sweat glands. It reduced sweating by about 50% in studies. The effect lasts up to six months and wears off gradually. Repeat treatments are necessary.

  • Iontophoresis turns off the sweat glands in the hands and feet using a mild electric current. It involves submerging the hands or feet in a tub of water with a device that provides the current. Sessions take up to 40 minutes and most people need up to 10 sessions to control sweating. Then, maintenance sessions are repeated as necessary.

  • Medications for hyperhidrosisblock the nerves that stimulate the sweat glands throughout the whole body. This may be an option for sweating of the face or if topical products cause irritation. Side effects can be serious because these medicines interfere with the body’s ability to cool itself.

  • Antidepressants can be effective in decreasing sweating. They have the added benefit of helping relieve anxiety and social problems that often accompany hyperhidrosis.

If these treatment options fail to control sweating, surgery may be an option for underarm or hand sweating. To surgically treat hand sweating, doctors cut or destroy the spinal nerves that control hand sweating. For underarm sweating, doctors can remove sweat glands using various techniques. There is also a newer option for underarm sweating that destroys the sweat glands with microwave energy. However, it is not widely available.

What are the potential complications of hyperhidrosis?

Hyperhidrosis can lead to skin infections when the skin remains constantly moist. Keeping your skin as dry as possible will help prevent this. Choose moisture-wicking athletic socks, change them often, and use foot powder for sweating feet. For underarm sweating, choose clothing that will let your skin breathe—loose-fitting shirts made of wicking material or natural fibers, such as wool or silk.

Hyperhidrosis can also cause significant anxiety, embarrassment, and social withdrawal. Learning relaxation techniques, such as meditation or biofeedback, can help ease the stress. This can have an added benefit of decreasing known sweating triggers. A counselor can also help you work through your emotions surrounding hyperhidrosis.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Apr 15
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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