Hyperhidrosis
Hyperhidrosis is excessive sweating beyond what the body needs to regulate temperature. It can soak clothing, make the hands drip, disrupt daily life, and contribute to social anxiety and embarrassment.
Also known as Excessive sweating
Overview
Hyperhidrosis means your body makes more sweat than it needs to control its temperature. Sweat from the eccrine sweat glands cools the body as it evaporates from the skin’s surface.
Treatment usually starts with antiperspirants. If those don’t work, medications and therapies may be tried, and surgery may be considered in severe cases. If an underlying medical condition is found, it may be treated as the cause.
Types
The most common form. It is usually inherited and mainly affects the armpits, hands, feet and face, typically starting before age 25.
Triggered by an underlying medical condition or medication, such as diabetes, Parkinson's disease, or certain drugs such as naproxen. It can cause sweating during sleep.
Symptoms
Symptoms range from occasional mild discomfort to constant, disruptive sweating:
- Consistently wet skin
- Damp, uncomfortable clothing
- Beads of sweat dripping from areas such as the cheeks, forehead, or other body parts
Over time, the condition can also cause:
- Skin irritation, itching, and inflammation
- Body odor
- Foot problems, such as cracked or peeling skin (plantar hyperhidrosis)
The condition can also have an emotional impact, with some people feeling embarrassed and avoiding social situations.
Causes & risk factors
Sweating is caused by overactive eccrine sweat glands, often triggered by nerve signals. The precise reasons are still under research.
- Primary hyperhidrosis: caused by faulty nerve signals. It tends to run in families and has no clear medical cause.
- Secondary hyperhidrosis: linked to medications (including pain relievers, antidepressants, diabetes drugs and hormonal medications) and to conditions such as diabetes, menopausal hot flashes, thyroid disorders, some cancers, nervous system disorders and infections.
Frequently asked questions
Last reviewed
References
Diagnosis
Diagnosis typically involves a physical exam and a review of your symptoms and medical history. Hyperhidrosis is diagnosed when there is excessive sweating for at least six months, plus at least two of the following:
- Sweating on the underarms, palms, soles, or face
- Symmetric sweating on both sides of the body
- Sweating that does not occur at night or is significantly reduced at night
- Sweating episodes lasting at least one week
- Family history of hyperhidrosis
- Sweating that interferes with daily activities
- Age under 25
Tests may include:
- Starch-iodine test: sweaty areas turn dark blue after iodine and starch are applied.
- Paper test: special paper absorbs sweat and is weighed to measure the amount.
- Blood or imaging tests: used to look for underlying hormonal or neurological causes.
Treatment
Treatment begins with addressing any known underlying cause. If none is found, the focus is on managing sweating. Symptoms may return even after treatment.
Medications
- Prescription antiperspirants containing aluminum chloride, applied at bedtime and washed off in the morning
- Glycopyrrolate creams for the face and head
- Glycopyrronium tosylate wipes for the hands, feet, and underarms
- Oral nerve-blocking medications
- Certain antidepressants
- Botulinum toxin injections, typically repeated about every six months
Procedures and surgery
- Iontophoresis: hands or feet are soaked in water while a mild electric current is applied
- Microwave therapy (miraDry) for armpit sweat glands, given in two sessions three months apart
- Sweat gland removal by curettage, liposuction, or suction curettage for armpit-only sweating
- Sympathectomy (nerve surgery) for hand sweating, which may cause compensatory sweating elsewhere
- Sympathotomy, a variation that interrupts nerve signals without removing the nerve
Prevention
Doctors & departments
Specialists and departments who diagnose and treat this condition.
Find a specialistCare at Wattanavipa
Consultations, tests and most treatments are available at Wattanavipa, with follow-up visits to adjust treatment as needed.
Have a question about your health?
Talk to a Vejthani specialist or book a visit at Wattanavipa.