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Sweating when you’re exercising, or during hot weather conditions is perfectly normal; this is how the body cools itself down. But excessive sweating in other circumstances can be problematic, and is called hyperhidrosis.

Although sweating is not a serious medical condition, it can be quite embarrassing and may cause stress or anxiety in the sufferer if they worry about body odour or stains on clothing. Sweating can also make us itch sometimes, and this can lead to dermatitis from scratching.

There are two types of hyperhidrosis: focal or primary hyperhidrosis is a chronic skin condition caused by a mutation in the genes which usually affects only the face, armpits (axillae), hands and feet. This is a hereditary condition, and there is no specific cause. It tends to start before the age of 25, and can be triggered by:

  • Certain odours and foods
  • Emotional stress, especially anxiety
  • Heat
  • Spinal cord injury.

Generalised or secondary hyperhidrosis is excessive sweating that occurs all over the body, and this may have several causes, the most common being, apart from high temperatures and exercise:

  • Menopause (hot flushes, night sweats)
  • Stress or anxiety
  • Infection with fever
  • Metabolic diseases and disorders, including hyperthyroidism, 

diabetes, hypoglycemia (low blood sugar) and gout 

  • Certain antidepressants (SSRIs)
  • Certain foods or preservatives
  • Alcohol
  • Certain cancers such as Hodgkins’ Lymphoma

Can hyperhidrosis be cured?

There is no cure for focal hyperhidrosis. Treatments focus on reducing symptoms and improving quality of life. Depending on the severity of the problem, healthcare providers may recommend one or more of the following:

  • Lifestyle changes: Changing your routine (such as showering more often, wearing natural/breathable fabrics, changing socks and shirts several times a day); using talc or baby powder on the feet, groin and underarms after showering can also help keep the wearer dry and reduce sweat odours.
  • Aluminum-based antiperspirants: antiperspirants work by blocking the sweat glands to stop your body producing sweat. Stronger antiperspirants, including those prescribed by a doctor, may help more. But they are also more likely to cause side effects, such as skin irritation. (Antifungal powders may help to reduce this and prevent or treat fungal infections resulting from excessive moisture in certain parts of the body).
  • Oral medications: certain drugs (glycopyrrolate and oxybutynin, which are anticholinergics) can make aluminum-based antiperspirants work better, but come with potential side effects such as blurred vision and problems urinating. An antidepressant may lessen sweating while also calming anxieties. Your doctor may also recommend Beta blockers. 

If these solutions are not effective, there are several more specialised therapies that may be available, for example: Iontophoresis; Botox® injections; Microwave therapy. You can read about these here.

As a last resort, surgeons can remove sweat glands in the underarm, or disconnect the nerves which send messages to the sweat glands (sympathectomy), procedures which might provide long term relief for some people with hyperhidrosis, but it is important to state that while surgery may offer a solution for those whose persistent sweating has not responded to other therapies, all surgical interventions carry risk, and there may be side effects which a GP or surgeon  should clearly point out before a decision is made.

For sufferers of generalised or secondary hyperhidrosis, treatments need to consider the underlying cause. Menopausal symptoms, for example, can be addressed with HRT (Hormone Replacement Therapy); psychological stress, anxiety and depression may be treated with oral medications and/or counselling therapy. The suggested lifestyle changes above may also be helpful in reducing the problem.

Sweating is a natural body response to overheating and is generally good for us, but if excessive sweating is an issue, it is advisable to talk to your doctor if basic lifestyle changes have not been effective.

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