Excessive sweating (Hyperhidrosis)
Created: 09.01.2025
Updated 09.01.2025
Approved by: Consultant Dermatologist, Dr James Denny
What is Hyperhidrosis?
Hyperhidrosis means excess sweating. It affects up to 3% of the population. Sweating is the body's way of regulating heat. There are two types of sweat glands: One type of gland contributes to cooling by evaporation (sweating) and is found all over the body except for the lips. The second type is called the "scent glands", which give the smell of sweat and are mainly found in the armpits, in the abdomen and around the nipples.
All individuals sweat, and it is essential for regulating body temperature. However, some people experience excessive sweating despite a normal body or room temperature. This can become a nuisance.
What are the symptoms?
The symptoms of hyperhidrosis include excessive sweating, often occurring in specific areas such as the palms, soles of the feet, underarms, or face. Individuals with hyperhidrosis may experience persistent sweating even when the temperature is cool or when they are at rest. This can lead to sweat-soaked clothing and visible sweat marks on clothes, as well as the need to change clothes multiple times a day. The condition can cause emotional discomfort, with individuals feeling embarrassed or anxious about the visible sweating, especially in social situations. Hyperhidrosis typically affects both sides of the body symmetrically, such as both hands or both feet, and may occur intermittently or continuously.
What are the treatments?
Treatment for hyperhidrosis aims to reduce excessive sweating and improve quality of life, with options depending on severity. Clinical-strength antiperspirants containing aluminum chloride are often the first line of defense, as they block sweat glands. Oral medications, such as anticholinergics like oxybutynin, can reduce sweating by inhibiting the signals that trigger perspiration. Botox injections are effective for treating localized areas like the underarms, palms, or feet by blocking sweat-producing nerves, though the effects are temporary. Iontophoresis, which uses a mild electrical current to reduce sweating in the hands and feet, is another option. In severe cases, surgical options like sympathectomy or sweat gland destruction may be considered. Lifestyle changes, such as wearing breathable clothing and avoiding triggers like heat and stress, can also help manage symptoms. Treatment selection depends on the severity and affected areas, and a healthcare provider can guide the most appropriate approach.
What is the prognosis?
The prognosis for hyperhidrosis varies depending on the severity of the condition and the effectiveness of treatments. While hyperhidrosis is not life-threatening, it can significantly impact quality of life, leading to social embarrassment, emotional distress, and reduced confidence. The condition can be managed effectively with treatments such as antiperspirants, oral medications, botox injections, or even surgery in severe cases. With appropriate treatment, most people experience significant relief from symptoms, although the condition can be chronic and may require ongoing management. In some cases, hyperhidrosis may improve over time or resolve in adulthood, particularly in cases that begin in childhood or adolescence. However, flare-ups may still occur, and relapse is possible even with successful treatment.
