Hyperhidrosis | How to treat excessive sweating

Key takeaways

• Hyperhidrosis is excessive sweating not caused by exercise or your environment
• Excessive sweating can cause anxiety, stress, social problems, and embarrassment
• There are two types of hyperhidrosis – primary and secondary
• You can make adjustments to your lifestyle and routine to help you manage
• Antiperspirants, suitable clothing, and a healthy diet can all help
• In severe cases, treatment or surgery may be recommended

What is hyperhidrosis?

Hyperhidrosis is excessive sweating that’s not caused by exercise or your environment. For example, if you sweat excessively regardless of resting in a relatively cool climate, you may have hyperhidrosis.

People with hyperhidrosis typically find the heavy perspiration is worst on their palms, hands, face, underarms, and back. In serious cases, sweat may appear uncontrollable, to the point where it leaks off your body, through clothing, and onto chairs and other surrounding objects.

Whilst the condition doesn’t pose a threat to your physical health, it can be emotionally draining, distressing, and embarrassing for some. Many people with hyperhidrosis struggle to find a long-term solution and end up using strong antiperspirants and avoiding certain social situations.

Primary hyperhidrosis

Primary hyperhidrosis typically begins during childhood or adolescence and persists throughout life.

There is no identifiable cause for primary hyperhidrosis other than changes to the nerve signals responsible for regulating sweat gland activity.

Secondary hyperhidrosis

Secondary hyperhidrosis is caused by taking certain medications or the onset of a medical condition. Some people find that certain antibiotics, antidepressants, and painkillers cause secondary hyperhidrosis.

The sweating is usually far more widespread than with primary hyperhidrosis, which tends to focus perspiration in the palms, face, and underarms.

What are the symptoms?

The only primary symptom of hyperhidrosis is sweating that interferes with your everyday life and routine. This will differ from person to person based on factors like genetics, diet, exercise routine, and age.

Secondary symptoms

There are a range of secondary symptoms that you may or may not experience depending on the severity of your condition.

These include:

• Increased body-odour
• Embarrassment
• Anxiety
• Stress
• Irritation of the skin
• Social problems
• Increased self-awareness
• Dermatitis or eczema

How it can impact daily life

Hyperhidrosis can make working and socialising difficult. It can increase stress and anxiety levels and cause embarrassment in social situations. In severe cases, people may withdraw and only engage in necessary tasks out of shame or embarrassment.

Summer can be a particularly uncomfortable time for people with hyperhidrosis. Avoiding social situations during such a sociable time can lead to social anxiety and isolation.

You may find you need to wash your clothes more frequently than other people because they get so damp. Personal hygiene practices like drying out your underarms in the toilet or washing your hands may raise questions amongst co-workers or friends who do not understand the condition.

In severe cases, hyperhidrosis can affect lifestyle choices, relationships, and career prospects.

What causes hyperhidrosis?

Hyperhidrosis can get better or worse depending on factors like anxiety level, mood, and environment. Whilst environment and psychological factors do play a part, there is currently no identifiable cause for primary hyperhidrosis.

This can make getting treatment difficult and leave sufferers in the dark as to the best way to address their symptoms.

At-home treatments for hyperhidrosis

Choose the right clothing

Loose-fitting clothes can help aerate your skin and accelerate the evaporation of sweat. If you suffer with hyperhidrosis, opt for loose shirts and flowing dresses where possible. You may also find that looser clothes feel more comfortable because they prevent chaffing and rubbing.

In recent years, several sweat-absorbent fabrics have hit the market. The fibres used to make these garments draw sweat away from the skin and absorb it, preventing it from lingering on your skin.

Experiment with fabrics like merino wool and cotton and avoid nylon and other synthetic fibres where possible. You may find these natural options more comfortable because of their moisture-wicking properties.

Dietary changes

Certain foods and beverages have the potential to trigger or exacerbate sweating in some individuals. Making dietary changes to avoid these triggers and incorporating foods that help regulate body temperature can be a valuable tool when trying to manage excessive sweating.

If you suffer from hyperhidrosis, trial and error can be a helpful way of spotting foods and liquids that trigger or worsen your symptoms. These typically include:

• Spicy foods
• Caffeine
• Alcohol
• Hot beverages

On the other hand, staying hydrated with water and consuming foods rich in magnesium, such as leafy greens, nuts, and whole grains can help regulate sweating.

While dietary changes may not eliminate hyperhidrosis entirely, they can potentially reduce the frequency or severity of sweating episodes for some individuals.

Drying creams

Drying creams (also known as antiperspirant creams) contain aluminium-based compounds that work by temporarily blocking sweat ducts to reduce the amount of sweat that reaches the surface of the skin.

Drying creams are typically applied to clean and dry skin before you go to bed (giving them time to work overnight), whilst others may require regular application throughout the day for best results.

Drying creams are often most effective treating the underarms, palms, and feet. When used correctly, they can provide longer-lasting relief when compared to traditional antiperspirant sprays or roll-on deodorants.

Glycopyrronium wipes

Glycopyrronium wipes contain glycopyrronium bromide (an anticholinergic medication) that slows the transmission of nerve signals to the sweat glands.

They are convenient, easy to use, and offer a discreet solution for managing excessive sweating. Apply once a day, preferably in the evening, on clean, dry skin to the areas most affected.

Antiperspirants for hyperhidrosis

Combatting excessive sweating with a typical deodorant is difficult. Whilst many brands and products claim they’re for excessive sweating, most deodorants just mask odour.

Antiperspirants are different. They’re specifically designed to target and block the pores that are responsible for drawing sweat from our skin.

For people suffering with excessive sweating or hyperhidrosis, strong versions are available. These typically contain “aluminium chloride” and may be labelled as ‘long-lasting’. They’re available in roll-on and spray form to give you more protection from a single application.

Unique application instructions

When to see a doctor

If excessive sweating is causing you problems, we recommend booking a GP appointment to discuss potential remedies and treatments.

Before your appointment, it can be helpful to make a brief note of the following:

• If it’s stopping you doing certain things
• How long it’s been a problem for you
• When it’s at its worst
• If the episodes come and go in certain environments or situations
• Whether you have a family history of excessive sweating
• Anything you’ve done to try and treat the problem

Medical treatments for hyperhidrosis

In severe cases (where at-home and non-surgical treatments have failed), a surgical treatment may be recommended to treat excessive sweating.

Any form of surgery or invasive treatment should always be viewed as a last resort and not considered without talking things through with a healthcare professional first.

Botox injections

Botox treatment involves injecting the cosmetic form of botulinum toxin into the skin in tiny amounts to block the nerves that stimulate our sweat glands. This prevents the glands from producing sweat.

Botox injections for hyperhidrosis should always be administered by a doctor. The area to be treated will be numbed with a local anaesthetic before multiple injections are made just under the skin's surface.

Botox injections are highly effective for reducing sweating, with results typically lasting from 4 to 12 months before the patient requires another treatment.

Whilst effective, there can be side effects. These include temporary bruising, pain at the injection site, and the potential for weakness in nearby muscles.

Iontophoresis

Iontophoresis involves passing a mild electrical current through water before it arrives on the skin's surface. Typically, iontophoresis treatment is applied to the hands or feet and works by altering the function of the targeted sweat glands.

During this procedure, the affected body part is immersed in a tray of water while a device delivers the electrical current for about 20 to 30 minutes. Multiple sessions are typically needed to achieve and maintain results, with the frequency of treatments typically decreasing over time.

Side effects are typically mild and may include skin irritation or dryness at the treatment site.

Sweat gland surgery

There are different surgical procedures that directly target the sweat glands, including:

• Endoscopic thoracic sympathectomy (ETS): this surgery involves ‘cutting’ or ‘clamping’ the nerves that control sweating in the hands, face, or armpits
• Laser sweat ablation: laser energy is used to destroy sweat glands in the underarm area.

Sweat gland surgery is typically performed under a general anaesthetic and involves making small incisions with the use of a camera to guide the procedure. Laser sweat ablation is less invasive and involves using a laser to target sweat glands directly.

Surgery carries potential risks and side effects, including compensatory sweating (increased sweating in other areas of the body), pain, bleeding, infection, and nerve damage.

Last updated Thursday 27 June 2024

First published on Thursday 27 June 2024