Hyperhidrosis is excessive sweating. Common places are the palms of the hands, soles of the feet, and the armpits.
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Primary hyperhidrosis does not have a cause. It may be triggered by:
- High emotional states, such as intense sadness, fear, anger, or stress
- Spicy foods
- Hot climates
- Certain medicines
Secondary hyperhidrosis is caused by an underlying health problem, such as:
Things that may raise the risk of hyperhidrosis are:
- A family history of hyperhidrosis
- Having any of the problems (listed above) that cause it
Problems may be:
- Excessive sweating of palms of the hands and/or soles of the feet
- Excessive sweating of the armpits, head, and/or face
- Increased amount of sweating
- Change in pattern of sweating
- Change in the sweat odor
- Stained, wet clothing
This problem can be embarrassing and affect relationships.
The doctor will ask about symptoms and past health. A physical exam will be done. This may be enough to make the diagnosis in some people.
Tests may be done to find out what may be causing the problem.
The goal is to manage symptoms. Treatment may depend on the severity. It may also depend on what part of the body is affected.
Treatments to help stop sweating may include:
- Special antiperspirants applied to the skin
- Prescription cloth wipes to reduce underarm sweating
- Iontophoresis—stimulation with electrical current
Habit changes may help reduce excess sweating. They may include:
- Avoiding spicy foods or alcohol
- Avoiding stressful situations and known emotional triggers
- Using antiperspirant spray instead of deodorant
- Wearing loose-fitting clothing made of natural fibers, like cotton
- Wearing shoes that allow the feet to get enough air
Hyperhidrosis can affect a person's social life. Counseling can help reduce anxiety and teach coping skills.
Medicines may be used to treat secondary hyperhidrosis. This is not common due to side effects.
Botulinum A neurotoxin injections can ease sweating in certain areas. It is often used on the palms of the hands and armpits. It can last 6 to 8 months.
If other treatments do not help, surgery can be done to remove sweat glands from the underarms. Surgery may include:
- Endoscopic thoracic or lumbar sympathectomy—to kill the nerves that stimulate sweating
- Curettage—to remove sweat glands with surgical scraping
- Liposuction techniques—to remove sweat glands
There are no current guidelines to prevent hyperhidrosis.
- Hyperhidrosis. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/hyperhidrosis.
- Hyperhydrosis. Johns Hopkins Medicine website. Available at: https://www.hopkinsmedicine.org/health/conditions-and-diseases/excessive-sweating.
- McConaghy JR, Fosselman D. Hyperhidrosis: management options. Am Fam Physician. 2018;97(11):729-734.
- Daniel A. Ostrovsky, MD
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