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Handling Hyperhidrosis: Excessive Sweating

A Grip on the Drip

Is too much sweat something to sweat? Excessive sweating — hyperhidrosis — can cause social anxiety and depression. It can be painful, causing your skin to rub raw in certain areas. It can also be dangerous:

  • You may be at risk for hypothermia if you can’t control sweating in colder temperatures.
  • Your skin can get so irritated that it breaks down, which could lead to infection.
  • It can be a sign of underlying medical issues, like hyperthyroidism or diabetes.

“Hyperhidrosis can control your lifestyle,” says Northwestern Medicine Dermatologist Edidiong C. Kaminska, MD. “People change what they wear, feel uncomfortable in social scenarios and can experience health implications because of excessive sweating.”

More Than Skin Deep

Generalized hyperhidrosis starts with your nerves. You have sweat glands throughout your body, but they are concentrated in several areas: the hands, feet and armpits. Nerves control these sweat glands, telling them when to release sweat. In people with hyperhidrosis, these nerves are overactive, telling the body to release sweat more frequently than necessary.

Hyperhidrosis can control your lifestyle.
— Edidiong C. Kaminska, MD

“Because generalized hyperhidrosis is related to the nervous system, it’s also genetic and will typically appear during teenage years,” says Dr. Kaminska. “We’ll commonly see a parent or sibling with the same condition.”

Excessive sweating can also arise from changes in estrogen levels during menopause and can be managed with lifestyle changes and hormone therapy.

Treatment: Topical Is Typical

“The first line of hyperhidrosis treatment is a topical solution,” says Dr. Kaminska. Topical medications block sweat glands so they can’t produce as much sweat. Potential side effects can be stinging, irritation or rash. This solution is also available in wipes, which may be less irritating.

“If sweating doesn’t subside with topical solutions, I sometimes will prescribe an oral medication,” says Dr. Kaminska. “This is a more aggressive treatment approach, as it dries out all areas of your body — even your mouth and eyes.” Other side effects may include constipation and blurry vision.

The biggest breakthrough in treatment is Botox, says Dr. Kaminska: “It has changed lives.” Botox injections block the nerve synapse that stimulates the sweat gland. One treatment lasts up to six months.

When Is Perspiration Problematic?

Sweating helps regulate body temperature by releasing heat. Sweating is normal and healthy. So when does it become something to worry about?

“It’s normal for someone to have overactive sweat glands, but the average person doesn’t drench their clothing daily,” says Dr. Kaminska. “If you’re considering seeing a physician for excessive sweating, that means that you probably should.”

If clinical-strength antiperspirants are not effective in controlling your sweating, or if sweating is controlling your life, consult your dermatologist.