Sweating is an important, natural bodily function that regulates temperature. However, if you’re sweating like it’s a hot summer day in the middle of winter, you may be dealing with a medical condition called hyperhidrosis. According to Dr. Esther (EB) Henebeng of U.S. Dermatology Partners Fairfax, “When sweating isn’t linked to a specific cause like the temperature or activity levels, it may be hyperhidrosis. Without a known cause, excessive sweating is frustrating and can be embarrassing. If you’re struggling with this condition, you’re not alone, and there are many treatment options to reduce excessive sweating.” In this blog, Dr. Henebeng discusses at-home treatments for excessive sweating and medical treatment for hyperhidrosis provided by dermatologists.
What Is Hyperhidrosis?
So, what is hyperhidrosis? Dr. Henebeng explains, “Hyperhidrosis is a medical diagnosis that refers to a condition that causes sweating that is disproportionate to the activity, temperature, or physiologic needs. Simply speaking, the body is sweating more than necessary for temperature regulation. There are two hyperhidrosis diagnoses, primary and secondary. These types of hyperhidrosis are differentiated to assist with treatment planning.”
Primary Hyperhidrosis
Also called idiopathic hyperhidrosis, this is the more common form of excessive sweating. This condition occurs due to overactivity in the sympathetic nervous system, triggering sweat production. It usually begins in childhood or the teen years, and it impacts specific areas. Primary hyperhidrosis is typically symmetrical impacting both sides of the body in areas like the hands, underarms, and feet. It also affects the face and scalp. It almost always occurs during the day and isn’t as severe during sleep. Night sweats are usually tied to secondary medical concerns that should be evaluated.
Secondary Hyperhidrosis
This form of hyperhidrosis has a specific underlying cause and is often a side effect of a medical condition or medication. It can begin later in life and impact larger areas of the body. Excessive sweating can be chronic, unrelated to temperature or activity, and even occurr during sleep. Some underlying causes include thyroid disorders, diabetes, menopause, cancer, neurologic conditions, and infections. Some antidepressants and blood pressure drugs also trigger hyperhidrosis symptoms. For those with secondary hyperhidrosis, finding treatments to manage the underlying condition typically alleviates sweating.
Common Signs and Symptoms
The most obvious symptom of hyperhidrosis is excessive sweating, but it can impact different parts of the body. Some of the common symptoms include:
- Sweaty palms, a condition known as palmar hyperhidrosis, has symptoms like damp hands, trouble gripping objects, and other issues.
- Underarm sweating, clinically referred to as axillary hyperhidrosis, leads to visible sweat stains and frequent clothing changes. Axillary hyperhidrosis is the most common form, but it is not always responsive to topical treatments.
- Foot sweating, called plantar hyperhidrosis, causes wet socks, pronounced foot odor, skin cracking, and greater risk for fungal infection.
- Facial and scalp sweating leads to dripping moisture that can melt makeup, smudge glasses, and make hair appear sweaty or greasy. This can be especially difficult during professional interactions.
How Hyperhidrosis Impacts Daily Life
It’s easy to think of hyperhidrosis as a purely physical condition, but it affects so much more. In addition to the common physical symptoms, patients often report:
- Embarrassment related to pronounced symptoms.
- Fear of intimate contact.
- Avoiding hugs or handshakes.
- Social or professional anxiety.
- Decreased confidence.
- Professional challenges.
- Skin irritation and infections.
- Rashes and itching.
- Increased odor.
- Sleep disrupted by night sweats.
How Dermatologists Diagnose Hyperhidrosis
In order to offer sweaty palms treatment and solutions for excessive sweating everywhere, dermatologists need to accurately diagnose your hyperhidrosis and rule out any underlying conditions. That means the dermatologist will perform a physical exam , discuss symptoms, and gather detailed information about your personal and family medical history. The dermatologist may order lab work or additional evaluations to ensure the diagnosis is accurate and to rule out any other conditions. Before your consultation, get prepared by considering answers to the following questions: :
- When did the symptoms begin?
- What parts of the body are affected?
- Does sweating occur during sleep?
- Do you have to change clothing frequently?
- Have you tried other treatments?
- Is there any noticeable pattern to how much and when you sweat?
- Are you sweating symmetrically on both sides of the body?
- Is your skin irritated or showing signs of infection or inflammation in the affected areas?
Hyperhidrosis Treatment Options
The good news, according to Dr. Henebeng is, “There are numerous, effective hyperhidrosis treatment options, but no product or procedure is right for everyone. During a consultation, a dermatologist will discuss your desired results and potential treatment options to ensure you find the one that makes sense for you. In almost all cases, I recommend starting with the most conservative treatments like prescription topicals before moving to more advanced clinical procedures.”
Treatment Factors
The following factors should be considered when developing a hyperhidrosis treatment plan:
- Location of excessive sweating (hands, underarms, face, etc.).
- Severity of excessive sweat, including frequency of sweating.
- Age and medical history of the patient and their immediate family.
- Previous reactions to treatments (over the counter and prescription).
Topical Treatments
For most patients, the best first step is to use prescription-strength antiperspirants. The active ingredients in these products can be more potent than those available over the counter. These treatments work by blocking sweat glands, which reduces the production of sweat. The main benefit of this treatment option is that it’s non-invasive and affordable. It’s the first line of defense for excessive sweating located on feet, hands, and underarms. For some, the active ingredients can irritate skin, leading to itching or burning, and for those struggling with severe hyperhidrosis the prescription antiperspirants may not be effective.
Oral Medications
For more advanced cases that aren’t managed with topical treatments, dermatologists may recommend anticholinergic medications. These medicines reduce sweat production by blocking the nerve signals that trigger sweat production. Oral medications are usually only recommended if topicals aren’t effective, or the patient has multiple affected areas or whole-body sweating. There are side effects to these medications that may be worsened in combination with other medicines, so it’s important to discuss all medications you’re taking to minimize risk for interactions. Dermatologists should carefully review your health history and monitor your response to ensure you are tolerating this treatment well.
Botox® Injections
You may have heard of botulinum toxin injections, with brand names like Botox, being used for anti-aging benefits, but it’s also one of the most effective treatments for focal hyperhidrosis. This means excessive sweating that is limited to one or only a few locations. Botox injections block the nerve signals that trigger sweat glands. When neurotoxins are injected, the gland stops producing sweat temporarily. Retreatment is required every four to six months to sustain results. Botulinum toxin injections are effective for use on the underarms, palms, feet, forehead, and scalp. These injections are administered in the dermatologist’s office, there is minimal downtime, and any mild side effects should resolve within a few days.
Medical Devices
For some, a gentle electrical current applied through an iontophoresis machine offers relief by temporarily disabling sweat glands. This unique medical device passes a low-level electrical current through water and applies the current to sweat glands in the area impacted by hyperhidrosis. It’s most often recommended to treat hyperhidrosis impacting the hands and feet. This treatment requires several weekly sessions to get started followed by maintenance procedures every other week. Other in-office devices use energy waves to stop sweat gland overproduction.
Surgical Options
In the most severe cases when other treatments are ineffective, surgical options may be recommended. An endoscopic thoracic sympathectomy may be performed. This procedure blocks the nerve pathways that trigger sweating. The procedure is permanent, but it isn’t right for every patient. Some experience compensatory sweating in other locations after this procedure. Another surgical option is to remove individual sweat glands. This can be done through axillary curettage, a procedure that uses heat to cut through tissue and cauterize simultaneously, making it a less invasive surgical option that promotes faster healing. Other surgical options include liposuction-assisted removal and laser sweat gland destruction.
Lifestyle and Supportive Strategies
While dermatologic treatments are recommended for hyperhidrosis, there are also some lifestyle and supportive strategies that offer underarm sweating solutions and relief from symptoms of excessive sweating, including:
- Wearing light, breathable fabrics and moisture-wicking materials.
- Choosing dark or patterned clothing that will minimize the appearance of moisture from sweating.
- Using sweat-management products like absorbent inserts for shoe s and moisture-wicking undergarments.
- Applying antifungal powders or using barrier wipes to absorb or wick moisture away from skin.
- Cleansing regularly and keeping skin as dry as possible to prevent irritation and infection.
When to See a Dermatologist
Clinical dermatology hyperhidrosis options may be necessary to reduce sweating and improve health and wellbeing. If you’ve been struggling with excessive sweating, consider consulting a dermatologist if:
- Excessive sweat interferes with daily activities.
- Over-the-counter anti-perspirants and deodorants aren’t effective.
- Sweating occurs during sleep or rest.
- Symptoms worsen or new symptoms develop.
- You’re looking for a long-term solution.
Hyperhidrosis Is Real & Treatable
Dr. Henebeng concludes, “Hyperhidrosis is not just sweating more than other people. It’s a real, treatable medical condition that deserves to be taken seriously. That starts with a visit to a dermatologist who can explain excessive sweating causes and help patients explore their treatment options.”
Schedule a Dermatology Consultation to Discuss Treatment Options
Excessive sweating doesn’t have to be your normal. Discuss treatment options for hyperhidrosis with a knowledgeable dermatologist today. Get started with one of the board-certified dermatologists at U.S. Dermatology Partners by filling out our scheduling request. We’ll be in touch to finalize the details of your visit.
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