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Hyperhidrosis

Medically reviewed by Drugs.com. Last updated on Sep 16, 2022.

Overview

Hyperhidrosis (hi-pur-hi-DROE-sis) is excessive sweating that's not always related to heat or exercise. You may sweat so much that it soaks through your clothes or drips off your hands. Heavy sweating can disrupt your day and cause social anxiety and embarrassment.

Hyperhidrosis treatment usually helps. It often begins with antiperspirants. If these don't help, you may need to try different medications and therapies. In severe cases, your health care provider may suggest surgery to remove the sweat glands or to disconnect the nerves related to producing too much sweat.

Sometimes an underlying condition may be found and treated.

Symptoms

The main symptom of hyperhidrosis is heavy sweating. This goes beyond the sweating from being in a hot environment, exercising, or feeling anxious or stressed. The type of hyperhidrosis that usually affects the hands, feet, underarms or face causes at least one episode a week when you're awake. And the sweating usually happens on both sides of the body.

When to see a doctor

Sometimes excessive sweating is a sign of a serious condition.

Seek immediate medical attention if you have heavy sweating with dizziness, pain in the chest, throat, jaw, arms, shoulders or throat, or cold skin and a rapid pulse.

See your health care provider if:

Causes

Sweating is the body's mechanism to cool itself. The nervous system automatically triggers sweat glands when your body temperature rises. Sweating also occurs, especially on your palms, when you're nervous.

Primary hyperhidrosis is caused by faulty nerve signals that trigger eccrine sweat glands to become overactive. It usually affects the palms, soles, underarms and sometimes the face.

There is no medical cause for this type of hyperhidrosis. It can run in families.

Secondary hyperhidrosis is caused by an underlying medical condition or by taking certain medications, such as pain relievers, antidepressants, and some diabetes and hormonal medications. This type of hyperhidrosis may cause sweating all over the body. Conditions that might cause it include:

Sweat glands

Eccrine sweat glands occur over most of the body and open directly onto the skin's surface. Apocrine glands open into the hair follicle, leading to the surface of the skin. Apocrine glands develop in areas with many hair follicles, such as on the scalp, armpits and groin. Eccrine sweat glands are involved in hyperhidrosis, though apocrine glands may play a role as well.

Complications

Complications of hyperhidrosis include:

Diagnosis

Diagnosing hyperhidrosis may start with your health care provider asking about your medical history and symptoms. You may also need a physical exam or tests to further evaluate the cause of your symptoms.

Lab tests

Your health care provider may recommend blood, urine or other lab tests to see if your sweating is caused by another medical condition, such as an overactive thyroid (hyperthyroidism) or low blood sugar (hypoglycemia).

Sweat tests

Or you may need a test that pinpoints the areas of sweating and evaluates how severe your condition is. Two such tests are an iodine-starch test and a sweat test.

Sweat test

Moisture-sensitive powder indicates the presence of heavy sweating (top) compared with hands after surgery to treat hyperhidrosis (bottom).

Treatment

Treating hyperhidrosis may start with treating the condition causing it. If a cause isn't found, treatment focuses on controlling heavy sweating. If new self-care habits don't improve your symptoms, your health care provider may suggest one or more of the following treatments. Even if your sweating improves after treatment, it may recur.

Medications

Drugs used to treat hyperhidrosis include:

Surgical and other procedures

Your health care provider might suggest other treatments:

Each of these procedures may be done with general anesthesia or with local anesthesia and sedation.

Lifestyle and home remedies

The following suggestions may help control sweating and body odor:

Coping and support

Hyperhidrosis can be the cause of discomfort and embarrassment. You may have trouble working or enjoying recreational activities because of wet hands or feet or wet stains on clothing. You might feel anxious about your symptoms and become withdrawn or self-conscious. You may be frustrated or upset by other people's reactions.

Talk about your concerns with your health care provider, a counselor or a medical social worker. Or you may find it helpful to talk with other people who have hyperhidrosis.

Preparing for an appointment

You may start by seeing your primary care provider. You may then be referred to a specialist in diagnosing and treating conditions of the hair and skin (dermatologist). If your condition is not responding to treatment, you may be referred to a specialist in the nervous system (neurologist) or a surgeon.

Here's some information to help you get ready for your appointment.

What you can do

Before your appointment, you might want to list answers to the following questions:

What to expect from your doctor

Your health care provider is likely to ask you several questions, such as:

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