Excessive sweating

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at December 10, 2015
StartSymptomsExcessive sweating

Hyperhidrosis is generally either caused by a preexisting condition, or by a small disruption in the nervous system. Excessive sweating is easily treatable through high-strength antiperspirants, medications, simple procedures, and surgeries. Those with excessive sweating should seek medical advice, as it may be indicative of an underlying condition.


Definition & Facts

The medical term for excessive sweating is hyperhidrosis. Up to 3% of the population is affected by this condition. Hyperhidrosis can be localized or generalized, and is further divided into primary hyperhidrosis and secondary hyperhidrosis. Localized hyperhidrosis is when a specific body part sweats much more than normal, such as the underarms, groin, hands, or feet.

Generalized hyperhidrosis is the term for when the entire body sweats excessively. Primary hyperhidrosis is any excessive sweating that is not caused by a medication or medical condition, and secondary hyperhidrosis is excessive sweating that has an underlying cause. Untreated hyperhidrosis can lead to side effects such as dehydration, skin irritation, and social embarrassment.


The cause of localized hyperhidrosis is unknown, but generally thought to be caused by a minor malfunction of the nervous system. Generalized hyperhidrosis, however, has a wide array of possible causes. It can be a side effect of medications, including blood pressure medications, medication for dry mouth, antibiotics, and supplements.

Psychiatric medications are another common cause of excessive sweating, with up to 19% of SSRI users experiencing this side effect. Painkillers are a commonly used medication that can also cause hyperhidrosis when the user stops taking it, especially if said painkiller is an opioid medication. If hyperhidrosis but is not caused by a medication, it could be a symptom of an underlying condition, such as a thyroid problem, diabetes, menopause, pregnancy, obesity, alcoholism, generalized anxiety disorder, cancer, and many others.

For all of these conditions listed, receiving proper medical treatment is very important, so those experiencing hyperhidrosis should not hesitate to talk to a doctor about excessive sweating. At the same time, excessive sweating is often harmless. Less alarming possible causes of hyperhidrosis include nervousness, caffeine use, nicotine use, and sensitivity to a food ingredient.

When to see a doctor

As a general rule, generalized hyperhidrosis is a cause for concern. However, excessive sweating is only a cause for concern if it happens when the environment is a normal temperature, the patient is not nervous or anxious, there is no fever present, and the patient is not engaging in exercise or any other physical exertion.

If all of these conditions are true, and there is excessive sweating, it may be a sign of a more serious problem. Night sweating (for example, waking up with drenched sheets) is also a sign that hyperhidrosis needs treatment. Asymmetrical sweating, for example, sweating excessively in only one armpit, is another sign that the patient should seek medical advice.

Sudden changes in the way one sweats, or changes in sweat later in life, are another sign. If excessive sweating is accompanied by other symptoms, it may be a sign of an entirely different condition. However, if excessive sweating is interfering with life, that is a good enough reason to go see a doctor.

Treatment & Therapy

Mild to moderate cases of excessive sweating can be easily treated with antiperspirants. There are prescription-strength antiperspirants that can be prescribed for excessive sweating. Prescription antiperspirants contain a much higher concentration of the active ingredients than over-the-counter products, and are often enough treatment to manage excessive sweating.

Excessive sweating that is not relieved with strong antiperspirants may call for further measures. One of these measures is iontophoresis, a medical treatment that uses low electrical impulses to temporary render the sweat glands unable to function. In some cases, a doctor may prescribe a medication to reduce sweating, such as glycopyrrolate. Glycopyyrolate can be taken orally or topically to reduce hyperhidrosis. Oxybutynin is another possible medication to treat this condition, and also comes in oral and topical forms.

Both of these medications work by blocking nerve signals to the sweat glands, preventing them from being activated. If a patient doesn't respond to these medications, a procedure such as a botulinum toxin injection may be useful. Botulin injection is generally used for localized hyperhidrosis, most often underarm hyperhidrosis, as the pain and side effects of the procedure make it unsuitable for large areas of skin, as in generalized hyperhidrosis.

Severe hyperhidrosis that does not respond to any other treatment may require surgery to treat. An endoscopic thoracic sympathectomy is one such surgery, which is used for excessive underarm sweating. A small cut is made in a nerve in the chest that triggers excessive sweating. After the surgery, nerve impulses will not be able to reach the underarms to cause excessive sweating.

A lumbar sympathectomy is a similar procedure, but the nerve is located in the abdomen, and it is used to resolve excessive foot sweating. There are other similar surgeries that all achieve the same goal. Of course, if excessive sweating is caused by a preexisting other condition, then that condition must be treated itself in order to get rid of excessive sweating.

Prevention & Prophylaxis

There are not really any ways to prevent primary hyperhidrosis that doctors know of. It is thought to be caused by a small mistake by the nervous system, and it is not known how that can be prevented. However, other medical conditions that can cause excessive sweating often are preventable.

Obesity, a condition that can cause excessive sweating, is preventable by simply maintaining a healthy weight through diet and exercise. Similar to obesity, diabetes is another condition that may cause excessive sweating and can be prevented by maintaining a healthy diet and weight, at least in the case of diabetes type 2. Many conditions that cause secondary hyperhidrosis are also unpreventable, however, such as cancer, menopause, anxiety, and pregnancy.

Although these conditions are not preventable, they should still be treated for their own sake in order to reduce excessive sweating. Further ways to prevent excess sweating include staying in a temperate environment that isn't too hot, avoiding unnecessary physical exertion, wearing cool clothing and using electric fans for ventilation.

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