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How Can I Treat Excessive Sweating?

DrSugar Explains Hyperhidrosis, aka Excessive Sweating

DrSugar is in the house! This week she's explaining the condition known as hyperhidrosis, aka excessive sweating.

Even though Summer is winding down, it's still quite warm in many parts of the US, which inspired an explanation on excessive sweating, known as hyperhidrosis in medical terms. Hyperhidrosis can be a difficult condition to have and for some can be quite embarrassing or cause social anxiety.

The Mayo Clinic defines hyperhidrosis as frequent or constant excessive sweating. Sweating is the body's mechanism for cooling itself down, which is a normal response to an increase in body temperature. However, people with hyperhidrosis sweat in quantities above the amount needed to regulate and cool the body's temperature. According to Medicine Net, an estimated two to three percent of Americans suffer from hyperhidrosis, which typically affects the underarms, the palms of the hands, and the soles of the feet. Underarm hyperhidrosis typically starts in puberty, whereas the hands and feet hyperhidrosis can begin even earlier in life. While some people with excessive sweating can have neurologic, metabolic, or other systemic medical conditions, most people with hyperhidrosis are typically otherwise healthy. To learn more about hyperhidrosis, keep reading!


There are two types of hyperhidrosis. Focal hyperhidrosis affects the palms, soles, and sometimes the underarms, and it usually happens while the person is awake. It often begins before the age of 20. It is thought that focal hyperhidrosis may be genetic, as it tends to run in families. Generalized hyperhidrosis affects large areas of the body. It can occur for no apparent reason but also may have an underlying cause such as medications, menopause/hot flashes, low blood sugar, overactive thyroid, leukemia, lymphoma, heart attack, or infectious disease.

Diagnosing hyperhidrosis involves a history and physical exam performed by a medical professional, possible lab tests (in order to determine if the excessive sweating is due to another medical condition), and possibly a thermoregulatory sweat test. During this test, a moisture-sensitive indicator powder is applied to the skin, and this powder changes color in areas where excessive sweating occurs at room temperature. Then, you are exposed to high heat and humidity in a sweat room that causes sweating over the entire body. People with hyperhidrosis tend to sweat even more in the palms in a warm environment, whereas people without hyperhidrosis tend to not sweat from the palms.

Treatment for hyperhidrosis includes prescription antiperspirant, anticholinergic drugs, iontophoresis, Botox, and surgery. Anticholinergic drugs block acetylcholine, which is a chemical messenger in the body that stimulates sweat glands. Iontophoresis delivers a low level of electrical current to the hands, feet, or armpits while the body is immersed in water. This is thought to temporarily block sweat glands. Botox is an injection that is typically used to smooth facial wrinkles but has also been found to be helpful for hyperhidrosis. It works by blocking the nerves that trigger the sweat glands. It isn't a cure-all and can take multiple injections to work. The treatments can be painful, only last for four months, and can have side effects (however, they are rare) including hand muscle weakness and headaches. Surgical options include removing the sweat glands or cutting the nerves that carry the signals to the sweat glands.

Have a question for DrSugar? You can send it to me via private message here, and I will forward it to the good doctor.

DrSugar's posts are for informational purposes only and should not be considered medical advice, diagnosis, or treatment recommendations. Click here for more details.

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