Excessive Sweating: Causes, Treatment and Prevention Tips

Excessive sweating, also known as hyperhidrosis, is a medical condition that affects up to 4.8% of people in the United States.¹ It can cause you to sweat from your armpits, hands, feet or head for no apparent reason.² The impacts of excessive sweating can lead to low confidence and social anxiety and impact your daily activities and quality of life.³

The good news is that while there is no single cure for excessive sweating, it is treatable. Here are some common causes, available treatments and tips for managing hyperhidrosis.²

What Causes Excessive Sweating?

There are two types of hyperhidrosis: primary and secondary. The type of excessive sweating you have can determine your treatment plan.²

Primary hyperhidrosis

Primary hyperhidrosis is excessive sweating that is not linked to medication or a medical condition. It typically involves one or two areas of the body (hands, feet, armpits, head).²

While the exact cause of primary hyperhidrosis is unknown, genetics can play a role, especially if you have a family history of excessive sweating.⁴

Primary hyperhidrosis usually starts in childhood or adolescence and can continue into adulthood, which can have a lasting impact on social development.⁵

Signs and symptoms of primary hyperhidrosis include:⁶

• A family history of excessive sweating
• Age of 25 years or younger
• Episodes that occur more than once per week
• Excessive sweating for six months or longer
• Impairment of daily living and quality of life
• Not sweating at night
• Sweating of the armpits, hand palms, soles of the feet and/or face

Secondary hyperhidrosis

Secondary hyperhidrosis is excessive sweating caused by a medication or a medical condition.⁶

Certain medications — such as antibiotics, antivirals, insulin or antidepressants — can cause secondary hyperhidrosis. Secondary hyperhidrosis can also be caused by common conditions, including:⁶

• Diabetes
• Heart failure or stroke
• Menopause
• Parkinson’s disease
• Rheumatoid arthritis
• Withdrawal from addictive substances

Unlike primary hyperhidrosis, people with secondary hyperhidrosis may sweat during sleep.⁶

Diagnosing the type of hyperhidrosis will include reviewing medical and family history and evaluating whether an underlying medical condition or medication may be contributing.⁶

When to Seek Help for Excessive Sweating

Perspiration due to changes in body temperature and emotions (anxiety, stress) can be a normal and healthy part of life.⁴

However, when you’re continuously sweating excessively for no apparent reason, and it is starting to affect your quality of life, it may be time to talk to a healthcare professional.

A good guideline for deciding when to seek help is asking yourself about the ABCs of hyperhidrosis.⁵

• Age of onset. Hyperhidrosis typically develops in those younger than 24 years old.⁶
• Bilateral. Does the sweating affect both sides of your body?
• Cessation when you sleep. Primary hyperhidrosis usually stops during sleep.
• Duration. Has excessive sweating been going on for six months or longer?
• Episodes. Do you experience two or more episodes of excessive sweating per week?
• Family. Do you have a family history of excessive sweating?
• Gets in the way. Does sweating get in the way of your daily life and relationships?

If excessive sweating is impacting your ability to work, socialize and maintain relationships, it can be a good idea to talk to a professional to see what treatments might be available to help minimize symptoms and boost your self-confidence.⁵

Medical Treatments for Excessive Sweating

There are several options for treating hyperhidrosis, ranging from medical intervention to lifestyle changes. Choosing the one that works best for you will depend on the type of hyperhidrosis and the location of excessive sweating (underarms, feet, hands, etc.).²

• If you have primary hyperhidrosis, you have several options to help stop excessive sweating. These may include prescription antiperspirants, BOTOX® injections, oral medications and surgery.²
• If you have secondary hyperhidrosis, treatment focuses on addressing the underlying cause, which may mean changing your medication or treating the medical condition causing the excessive sweating. Other treatments can include injections, prescription antiperspirants, or oral medications.²

Medical professionals often recommend starting with the least invasive treatment first to see how your body responds before surgery or injections are proposed.⁷

Prescription antiperspirants

Both over-the-counter (OTC) and prescription antiperspirants can be effective at reducing excessive sweating, though some people may experience side effects such as skin irritation. Antiperspirants can be used on the underarms, feet, hands, back, groin, chest and face.²

Metallic salts (aluminum chloride, aluminum chlorohydrate) are the active ingredients in antiperspirants that block sweat glands to help reduce hyperhidrosis.⁷

Clinical strength antiperspirants may be found at your local pharmacy and contain higher concentrations of the metallic salt active ingredient than the regular formula in standard antiperspirants.⁷

Prescription antiperspirants have a stronger active ingredient called aluminum chloride hexahydrate and could be tried if OTC antiperspirants don’t work.⁷

Prescription antiperspirants are applied daily to dry skin before bed and can take a week or two to start working. Once excessive sweating is under control, you can start using the product once or twice a week.²

BOTOX injections

If antiperspirants are not effective at stopping excessive sweating, a medical professional might suggest BOTOX (onabotulinumtoxin A) injections.⁸

In the U.S., BOTOX has been approved to treat eight different medical conditions, including hyperhidrosis. It can be used to curb excessive sweating of the underarms, hands, feet, head and face.⁸

BOTOX works by temporarily blocking the chemical that signals the body to secrete sweat. It takes a couple of days to show results, but it can last up to 12 months. Side effects might include:⁵

• Bruising
• Headache
• Mild itching
• Muscle soreness or weakness
• Pain at the injection site

If you are considering BOTOX injections to help stop excessive sweating, it is important to visit a medical professional who is experienced in giving BOTOX injections.⁸

Oral medications

Oral medications (pills or solutions you can swallow) from the anticholinergics family of drugs may be effective at treating excessive sweating, especially when combined with other treatments such as antiperspirants and BOTOX injections.⁹

Anticholinergics work by blocking nerve signals throughout the body that tell sweat glands to produce sweat.⁹

The most common anticholinergics prescribed to treat hyperhidrosis include glycopyrrolate and oxybutynin (available in pill form). These medications work while you are taking them and can vary in doses depending on what works for you.⁹

Common side effects of glycopyrrolate and oxybutynin may include:⁹

• Blurred vision
• Constipation
• Dilated pupils
• Drowsiness
• Dry mouth
• Headache
• Inability to fully empty bladder

Surgery

If the less invasive treatment options for hyperhidrosis aren’t successful, surgery may be recommended. The most common types of surgeries used to treat hyperhidrosis include sweat gland removal and sympathectomy.²

• Sweat gland removal is the process of surgically removing the sweat glands, primarily from the underarms.²

• Sympathectomy, also called endoscopic thoracic sympathectomy (ETS), is an invasive, permanent procedure that is recommended only for people with severe hyperhidrosis when other forms of treatment haven’t worked.¹⁰ The goal of ETS is to interrupt the sweat nerve signals in the spinal column. This procedure can target the palm, feet, underarms and facial nerves to decrease sweating in those areas. The procedure is done under general anesthesia and requires the temporary collapsing of a lung to access the nerve pathway.¹⁰ ETS can cause irreversible compensatory sweating, which means that sweat output will increase in other parts of your body to compensate for the blocked nerves.¹⁰

Lifestyle Changes to Help Stop Excess Sweating

Medication and surgery are not the only ways to combat hyperhidrosis. Making simple changes to your lifestyle and daily habits may help make an impact on reducing excessive sweating.

Be mindful of what you wear

Your wardrobe can play a factor in how much you sweat during the day. Here are some tips to minimize excessive sweating:¹¹

• Try underarm shields under your shirt to minimize sweat stains
• Use an antiperspirant/deodorant combo daily
• Wear light, breathable fabrics like cotton and linen

Minimize sweaty feet

If you consistently have sweaty feet, there are a few tricks you can use to help dry them out:¹¹

• Change your shoes and socks often.
• Use shoe insoles or foot powder designed to absorb moisture.
• Take off your shoes whenever you have the chance.
• Try moisture-wicking socks that help keep moisture away from your skin.
• Wear shoes made of natural materials, like leather or bamboo.

Watch what you eat and drink

Being mindful of what you eat and drink can help minimize excessive sweating.

Food and drinks known to increase sweating include:¹¹

• Alcohol
• Caffeine
• Chocolate
• Foods high in spice, salt, sugar and fat
• Soft drinks
• Teas that have caffeine

Drinking plenty of water and staying hydrated can also help keep your body temperature regulated and help minimize sweating.¹¹

Reduce stress

Stress and anxiety can be triggers for excessive sweating in social situations. Finding ways to reduce stressors on your mental health can include:¹¹

• Attending counseling
• Joining a support group
• Learning more about hyperhidrosis

Tips to Manage Your Sweating in Specific Situations

Hyperhidrosis can make people feel uncomfortable in social situations and negatively affect quality of life.¹ Here are some tips to help manage these social environments.

The workplace

Whether you’re worrying about someone seeing underarm sweat stains or shaking someone’s hand with sweaty palms, going to work with hyperhidrosis can be uncomfortable.

Some tips to help manage the workplace may include:¹¹

• Bringing an extra set of clothes to change into
• Dressing in layers of breathable fabric
• Taking steps to reduce workplace stress
• Wearing darker color clothes to hide sweat marks

Exercise and outdoor activities

While sweating is common during exercise, excessive sweating can interfere with your workout or physical activity.

Some tips on managing hyperhidrosis during exercise can include:¹¹

• Drinking lots of water
• Opting for lightweight, breathable clothes
• Using antiperspirant
• Wearing moisture-wicking socks and comfortable shoes

Special events and formal occasions

Getting dressed up for a night on the town or attending a wedding can cause a lot of anxiety for people with hyperhidrosis.

Like many of the social situations mentioned earlier, picking the right wardrobe is key to feeling comfortable at formal occasions. Some tips for attending these events can include:¹¹

• Drinking lots of water
• Taking steps to relax and reduce anxiety
• Wearing comfortable shoes
• Wearing dark clothes with breathable fabric

Common Treatment Mistakes to Avoid

Treating hyperhidrosis can be an effective way to help manage excessive sweating in your daily life. However, it’s important to take the appropriate steps when choosing and implementing your treatment option.¹¹

Mistakes to avoid when treating hyperhidrosis include not following antiperspirant directions as recommended by a dermatologist.¹¹

Overusing antiperspirants

Misusing antiperspirants is a common mistake when treating excessive sweating. It’s important to follow the product’s directions to avoid skin irritation.¹²

Skin irritation from antiperspirant use can also lead to postinflammatory pigment alteration, making your skin lighter or darker.¹²

Ignoring underlying medical conditions

Since secondary hyperhidrosis can be caused by an underlying medical condition, it is important to consult a medical professional to help you rule out possible causes.¹³

Delaying evaluation can prolong the negative impact excessive sweating can have on your life, including ongoing physical, emotional and social effects, if it is not addressed.¹³

Relying on natural remedies

While some people have stated that natural remedies (herbal substances, acupuncture, hypnosis and biofeedback techniques) have helped treat hyperhidrosis, there is not a lot of scientific evidence that these remedies are effective for managing excessive sweating.¹⁴

It’s important to consult your doctor before adding any natural substances to your routine to ensure they don’t interact with any current medications or underlying medical conditions.¹⁴

Finding the Right Treatment

There are effective ways to treat and manage hyperhidrosis, including prescription antiperspirants, BOTOX injections, oral medications and, in severe cases, surgery.

The first step in understanding hyperhidrosis is to consult with a doctor to determine what type of hyperhidrosis you have (primary or secondary) and figure out a treatment plan that works for you and your lifestyle, to help boost your self-confidence and feel comfortable in social situations.

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Author Bio

Amy Isler, M.S.N., R.N., has more than a decade of nursing expertise. She combines her nursing experience and journalism background to create engaging and educational healthcare content for leading brands and publications, including GoodRx, Verywell Health, Vision Center and more. Her mission in writing is to provide positive, accurate and informative articles for consumers.