Excessive Sweating (Hyperhidrosis)

What is excessive sweating (hyperhidrosis)?

Excessive sweating is when the body releases too much fluid from the sweat glands. It's also called hyperhidrosis. It's often an ongoing (chronic) condition. Sweating is a normal process. It helps manage body temperature and other processes of the body. But excessive sweating is more than is needed to do this. Excessive sweating can affect the entire body, but it usually occurs in the palms, soles, armpits, or groin area. The symptoms can start when you're a child and continue into adulthood.

What causes excessive sweating?

In most cases, the cause isn't known. This is known as primary hyperhidrosis. But it may be caused by thyroid problems, low blood sugar, nervous system disorders, medicines, or other problems. This is known as secondary hyperhidrosis. In some cases, the cause of hyperhidrosis can be serious.

Who is at risk for excessive sweating? 

A person is more at risk for excessive sweating if they have any of the below:

• Thyroid problems

• Low blood sugar problems

• A nervous system disorder

• Medicine that can cause sweating

What are the symptoms of excessive sweating?

Symptoms can occur a bit differently in each person. The main symptom of hyperhidrosis is heavy sweating that:

• Can cause problems with daily activities, work, and social events

• Happens during the day but not at night

• May happen with no physical activity

• Is not affected by temperature

The sweating occurs most often in any or all of these areas:

• Bottoms of the feet

• Palms

• Underarms

In some cases, it may also occur in these areas:

• Face

• Groin

• Scalp

• Under the breasts

Areas that produce excessive sweat usually appear pink or white. In severe cases, the skin may appear cracked, scaly, and soft, especially on the feet. You may also have odor caused by bacteria and yeast on the wet skin.

The symptoms of excessive sweating can be like other health conditions. Make sure to see your healthcare provider for a diagnosis.

How is excessive sweating diagnosed?

Your healthcare provider will ask about your symptoms and medical history. Your provider will give you a physical exam. You may also have tests, such as a blood test to check for thyroid problems.

How is excessive sweating treated?

Treatment will depend on your symptoms, your age, and your general health. It will also depend on how severe the condition is. Treatment may include:

• Antiperspirant. An antiperspirant that has 10% to 15% aluminum chloride can block sweat glands and help stop sweating. It comes in creams, sticks, gels, and sprays. You can buy antiperspirant at a drugstore. Or your healthcare provider may give you a stronger prescription antiperspirant that has 20% aluminum chloride. Antiperspirant should be applied to dry skin at night before bed. It needs to be applied every night for a week or 2, and then once or twice a week or as needed. This can irritate the skin for some people. This medicine is not used on the face.

• Anticholinergic medicine. This medicine can be taken by mouth to help reduce sweating. Possible side effects can include blurry vision, dry mouth, dry eyes, and constipation. A version for the skin (topical) has recently become available.

• Botulinum toxin. This medicine is injected into the areas with sweat glands. It can help prevent sweat glands from working normally for a few months. You'll need to get injections every few months. It can be painful and costly.

• Iontophoresis. This treatment uses electricity to block sweat glands. Moist pads are put on the skin, or your hands or feet are placed in shallow water. Chemicals may be added to the water. An electrical current is sent through fluid. The process is done several times a week until sweating is reduced, and then once a week or as advised.

• Surgery. In severe cases, surgery can be done to remove your sweat glands. Or surgery can be done to cut the nerves that send signals to the sweat glands. Either of these types of surgery can stop sweat permanently. But it can lead to compensatory hyperhidrosis. This means you will start sweating from another part of your body.

• Treating another health condition or changing a medicine. A health condition or a medicine can cause secondary hyperhidrosis. If that's the case, excessive sweating can be managed by treating the health condition or by changing a medicine. Your healthcare provider will talk with you about these changes if you have secondary hyperhidrosis.

Talk with your healthcare provider about the risks, benefits, and possible side effects of all treatments.

What are possible complications of excessive sweating?

You may have skin problems in the areas where you sweat. The skin may become moist, pale, swollen, and soft enough to rub away easily. This is known as skin maceration. It can lead to loss of skin, pain, and skin infection. You can help prevent this problem by treating your hyperhidrosis and keeping your skin dry as much as possible.

Living with excessive sweating 

Hyperhidrosis may be caused by or made worse by emotional stress and heat. It can also cause problems with work and social life. You may have stains on your clothes and not want to shake hands with people. It can be upsetting to cope with the problems of excess sweat. Talk with your healthcare provider about:

• Support groups

• Individual counselling if you are feeling isolated or depressed

• Ways to prevent skin maceration

• Other ways to manage your condition long-term

The following strategies may also help:

• If you are bothered by odor, try bathing daily with antibacterial soap and drying yourself completely.

• Let your shoes dry completely before wearing them again. Try not to wear the same pair of shoes 2 days in a row. Wearing leather shoes or sandals can help keep your feet cool.

• Wear cotton socks or socks that pull moisture away from the skin. Change your socks during the day if needed.

• Wear dress shields. These are pads you can place under your arms.

• Keep an extra shirt, pants, or pair of socks with you if it makes you feel more secure about being in public. It will give you the option to change your clothes if necessary.

• Consider keeping a sweat journal that identifies specific triggers. Triggers might include certain spices or foods such as caffeine, chocolate, hot sauce, spicy foods, and alcohol.

• If your sweating is triggered by stress, relaxation methods, like yoga, may help.

When should I call my healthcare provider?

Call the healthcare provider if you have:

• Symptoms that don't get better, or get worse

• Signs of a skin infection

• Chest pain, shortness of breath, or fast heartbeat while sweating

• Sweating during sleep

• Other new symptoms

Key points about excessive sweating

• Excessive sweating it when the body releases too much fluid from the sweat glands. It's also called hyperhidrosis. It's often an ongoing (chronic) condition.

• Excessive sweating can affect the entire body, but it usually occurs in the palms, soles, armpits, or groin area.

• In most cases, the cause isn't known. It may be caused by thyroid problems, low blood sugar, nervous system disorders, medicines, or other problems.

• The condition can affect a person's quality of life and cause social isolation and depression. Mental health counseling may help.

• Treatment may include antiperspirant, medicine, injections, surgery, or treatments for another health condition.

• Skin maceration can lead to loss of skin, pain, and skin infection. You can help prevent this problem by treating your hyperhidrosis, and keeping your skin dry as much as possible, and getting medical care if signs of an infection occur.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.

• Before your visit, write down questions you want answered.

• Bring someone with you to help you ask questions and remember what your provider tells you.

• At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new directions your provider gives you.

• Know why a new medicine or treatment is prescribed and how it will help you. Also know what the side effects are.

• Ask if your condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if you do not take the medicine or have the test or procedure.

• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your healthcare provider if you have questions.