Excessive Sweating Hyperhidrosis

Overview

Hyperhidrosis (say: hy-per-hy-DROH-sis) means sweating much more than your body needs to stay cool. Everyone sweats — it is how the body cools itself down. With hyperhidrosis, the sweat glands switch on when they don't need to, so you may be soaked even when it is cool or when you are resting. It most often affects the hands, feet, underarms, face and head, and it usually happens on both sides of the body equally. It is a real medical condition, not a sign of poor hygiene, and it is not something you are doing wrong.

Yes. Sweating too much is quite common. It is thought to affect several people in every hundred, and the type that runs in families often starts in childhood or the teenage years. It is often under-reported because people feel embarrassed to bring it up.

It can affect anyone at any age. The type that happens on its own usually starts before age 25 and often runs in families. Sweating that starts suddenly in an older adult, or sweating at night, is less likely to be the 'on its own' type and deserves a check-up, because it can be linked to other conditions or to medicines.

Symptoms

Common symptoms

• Visible, dripping sweat on the hands, feet, underarms or face
• Sweating when it is cool or when you are sitting still and not hot
• Clothes becoming soaked or showing sweat marks, sometimes several times a day
• Sweat that makes it hard to hold a pen, use a phone, turn a door handle or grip tools
• Slipping inside shoes, or socks that are wet through
• Avoiding handshakes, hugs or raised arms because of embarrassment
• Skin that is sore, peeling, chapped or itchy where you sweat a lot
• Sweat that drips from the face or forehead in social or work situations

Symptoms in children

• Clammy, cold-feeling hands and feet, even in cool weather
• Wet socks or shoes, or sweat marks on school clothes
• Reluctance to hold hands, write on paper, or join in sports
• Embarrassment or teasing at school, or avoiding school activities
• Sweating that started around puberty — this is when the 'on its own' type often begins
• Night sweats in a child should always be checked by a doctor, as this is less usual in children

Symptoms in older adults

• Sweating that has newly started later in life — this is more often linked to another cause and should be checked
• Drenching night sweats, or needing to change nightclothes or bedding
• Sweating alongside weight loss, a change in appetite, or feeling generally unwell
• Sweating that began after starting or changing a medicine — ask your doctor or pharmacist
• Sweating with hot flushes, which can happen around the menopause
• Skin folds becoming sore, moist or infected where sweat collects

Causes

Main causes

• Overactive nerve signals: in most people with sweating that happens on its own, the nerves that trigger the sweat glands are simply 'switched on' more than needed. This type often runs in families.
• Hormone changes: an overactive thyroid gland, the menopause, or changes after pregnancy can all cause extra sweating.
• Diabetes and blood sugar changes: high or low blood sugar can cause sweating.
• Infections: fever and infections often cause sweating, especially at night.
• Some types of cancer, such as lymphoma, can cause drenching night sweats — this is uncommon, but it is why night sweats are always worth checking.
• Medicines: some antidepressants, painkillers, blood pressure medicines and hormone treatments can cause sweating as a side effect.
• Anxiety and panic: these can trigger heavy sweating, and heavy sweating can also trigger anxiety — the two often feed into each other.
• Other conditions: an overactive thyroid, Parkinson's disease, heart problems, lung problems, and alcohol or substance withdrawal can all cause sweating.
• Heat and humidity, hot drinks, spicy food, caffeine and alcohol can make sweating worse, though they are not the underlying cause.

Risk factors

• A family history of excessive sweating
• Being in your teens or twenties, when the condition often starts
• Taking certain medicines, including some for mental health, pain or blood pressure
• Living with diabetes, thyroid problems, or going through the menopause
• Being pregnant or having recently given birth
• High levels of stress or anxiety
• Being overweight, which can make sweating feel more noticeable
• Living in a hot climate or working in a hot environment

When to see a doctor

See a doctor urgently if:

• Night sweats that soak your nightclothes or bedding — get this checked soon rather than waiting
• Sweating that started suddenly in adulthood, especially with weight loss, fever, or feeling unwell
• New sweating after starting a new medicine
• Sweating with a racing heartbeat, shakiness or unexplained weight loss

Book a routine appointment if:

• Sweating that soaks through your clothes most days
• Sweating on your hands or face that makes work, writing, or using a phone difficult
• Sweating that stops you from doing things you enjoy, or makes you feel anxious or embarrassed
• Skin that is often sore, red, peeling or itchy in sweat-prone areas
• Sweating that is getting worse over time
• You have tried pharmacy antiperspirants and they have not helped enough

Diagnosis

A doctor will usually start by talking with you about your sweating: when it started, where it happens, whether it happens at night, and how much it affects your daily life. They will ask about your medicines, your family history, and other symptoms. They will also examine you and look at the areas where you sweat. Often this is enough to make a diagnosis. If they suspect another cause, they may order simple tests.

Tests that may be done

• Blood tests to check your thyroid, blood sugar, and general health
• A sweat test: a special powder or dye is painted on the skin and shows which areas are producing sweat and how much
• A 'sweat weight' test, where a small piece of paper is weighed before and after being placed on the skin to measure sweat
• A cool-room test where the whole body is warmed up and the pattern of sweating is observed
• Tests for other causes, such as an ECG (heart tracing) or a chest X-ray, if your doctor thinks they are needed

What to expect at your appointment

Most people need only a conversation and an examination. Your doctor may ask you to keep a simple diary of when sweating happens for a week or two. You do not need to prepare specially for the visit, but it helps to bring a list of your medicines and to note down when the sweating started and what makes it worse. You can also mention how it affects your mood, work or social life — that helps your doctor judge how much treatment you need.

Treatment

Treatment usually starts with simple measures and moves step by step to stronger options if needed. There is no single 'best' treatment — it depends on which part of your body sweats and how much it affects your life. Many people get good results from pharmacy antiperspirants and small daily changes. Others need a prescription treatment, a procedure, or, rarely, surgery. It is fine to go back to your doctor if the first thing you try does not work.

Self-care at home

• Use a strong antiperspirant rather than a deodorant. Deodorants cover smell; antiperspirants reduce sweat. Apply it at night to clean, dry skin — this is when it works best.
• Bathe daily with a gentle wash, and dry skin folds thoroughly afterwards.
• Wear loose, breathable clothing, such as cotton or modern sports fabrics that wick moisture away, and light colours that show sweat less.
• Change socks often and use absorbent underarm pads or sweat shields inside clothes.
• Keep a spare shirt or top at work or in your bag.
• Carry a small towel or wipes and use them as needed — this is practical, not a failure.
• Cut back on caffeine, alcohol and very spicy food if you notice they make sweating worse.
• Keep cool where you can: a handheld fan, a cooler room, and cool showers on hot days all help.
• Look after your skin: if an area becomes red or sore, keep it clean and dry and ask your pharmacist about a protective cream.
• Try relaxation or breathing exercises if stress makes your sweating worse.

Medical treatments

If self-care is not enough, your doctor may suggest one of several approaches. Prescription-strength antiperspirants are often the next step and are applied to the skin. Some tablets can calm the nerve signals that switch on sweat glands, though they can cause dry mouth and other side effects, so they are not right for everyone. Another option is a course of small injections that temporarily block the nerve signals to the sweat glands in a specific area such as the underarms — the effect wears off after some months and the treatment is repeated. A treatment called iontophoresis, which uses a gentle electrical current through water, can work well for hands and feet. Some clinics offer treatments that use heat or microwave energy to reduce sweat glands in the underarms. Your doctor will discuss the pros and cons of each option with you, including side effects and how long the effect lasts, and will help you choose what fits your situation.

When is surgery considered?

Surgery is considered only for severe sweating that has not improved with other treatments and is really affecting your life. It is usually done by a specialist. Options include surgery to remove sweat glands in the underarms, or an operation that interrupts the nerve signals to the sweat glands, usually for sweaty hands or face. Surgery can work very well, but it carries risks, including a chance that sweating increases elsewhere on the body. Your specialist will talk this through carefully with you so you can weigh up the benefits and risks.

Living with this condition

Excessive sweating can be frustrating and embarrassing, but there are practical habits that make a real difference. Many people with hyperhidrosis build a small toolkit: a spare top, absorbent pads, a compact fan, and a towel in the bag. Choosing the right fabrics and colours, avoiding triggers where you can, and keeping skin clean and dry all help you feel more in control.

Lifestyle tips

• Choose light, breathable fabrics and avoid tight synthetic clothing next to the skin
• Use antiperspirant at night on clean, dry skin for best results
• Keep spare clothes, socks, wipes or pads where you need them most — at work, in the car, in your bag
• Notice your triggers — heat, stress, caffeine, alcohol, spicy food — and plan around them
• Stay cool at home with fans, lighter bedding and cooler room temperatures at night
• Wash sweat-prone clothing often, and wash your skin gently and dry it well
• Consider clothing designed for excessive sweating, which is now widely available online

Diet and exercise

There is no special diet that cures hyperhidrosis, but some people find that cutting back on caffeine, alcohol and very spicy food reduces their sweating. Drink water regularly, especially in the heat or when exercising. Exercise is good for your health and mood — you may just want to plan it for cooler times of day, wear moisture-wicking clothing, and have a shower and a change of clothes afterwards. Don't let sweating stop you from being active: exercise also helps with stress, which can be a trigger.

Mental health and emotional wellbeing

It is very common to feel self-conscious, anxious or low about excessive sweating. Many people avoid social events, handshakes, dating, or even job interviews because of it. This is understandable — but you do not have to just put up with it. Talking to your doctor about how it affects you is part of getting the right help. If sweating is making you feel anxious or depressed, or if you are having thoughts of harming yourself, please reach out for support straight away. You can contact your local crisis line or emergency services, or speak to a doctor or counsellor you trust. You deserve support, and things can get better.

Prevention

The type of excessive sweating that happens on its own cannot be prevented — it is not caused by anything you did, and it is not a hygiene issue. But you can reduce how much it affects you by using antiperspirant regularly, choosing the right clothing, avoiding triggers and getting treatment early. If your sweating is caused by another condition or a medicine, treating or adjusting that cause can help a great deal, so it is worth getting checked.

Vaccines

There is no vaccine for excessive sweating.

Screening programmes

There is no routine screening programme for excessive sweating. If sweating runs in your family, or if you have new nighttime sweating, a check-up with your doctor is sensible.

Complications

If left untreated

• Sore, irritated or chapped skin in the areas where you sweat
• Skin infections, especially in skin folds, and a higher chance of fungal rashes or warts on the hands and feet
• Heat rash and discomfort in hot weather
• Embarrassment, anxiety, low mood and avoiding social situations
• Avoiding work or study opportunities that involve meeting people or handling equipment
• In extreme cases, loss of fluid and salt in very hot weather, which can cause tiredness and dizzy spells

Long-term outlook

The outlook is good. Most people with excessive sweating find a treatment that makes a real difference, whether that is a strong antiperspirant, a prescription treatment or a procedure. Many find that sweating becomes easier to manage over time, and some people notice it improves with age. If the first treatment you try does not work, tell your doctor — there is usually something else to try. With the right support, most people get back to doing the things they enjoy.

Find support

External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.