Hyperhidrosis

Hyperhidrosis is a common condition that’s characterized by excessive sweating. It most often affects specific parts of the body, such as the armpits, palms, or feet, but in some people, it affects the whole body. This issue can arise on its own (primary hyperhidrosis), or it can be the result of a wide range of other factors, including cancer, medication side effects, as well as heart disease, lung problems, and infections.

Hyperhidrosis causes not only physical discomfort, but it can impact self-esteem and mental health as well. Luckily, medical treatments and therapies can help resolve the problem.

This article discusses the symptoms and causes of hyperhidrosis, as well as how it’s treated. You’ll also learn about the risk factors for this condition, as well as the testing used in diagnosis.    

Symptoms of Hyperhidrosis

Sweat is important because it works to cool the body down, and it’s a normal response to heat or physical exertion. However, the telltale sign of hyperhidrosis is persistent sweating when you don’t need it. Though perspiration can impact the whole body, it most often affects one or more specific areas of the body, especially the palms of the hands, feet, armpits, and head.

The characteristic symptoms of hyperhidrosis include:

• Visible wetness and beads of sweat
• Difficulty grasping objects, walking, or functioning due to the sweat
• Areas of soft, white, and/or peeling skin
• Skin infections, such as athlete’s foot, jock itch, or others

Notably, hyperhidrosis isn’t dangerous to your health; however, living with the condition can be difficult and contribute to depression and anxiety.

Causes of Hyperhidrosis

The exact cause of primary hyperhidrosis isn’t known; however, it’s believed to be related to disorders of the nervous system, which cause sweat glands in the skin to be overactive. Most cases, however, are secondary and are attributed to health conditions and status. Common causes of this type include:

• Chronic diseases, such as diabetes and cancer
• Hormonal shifts
• Infections and injury

A wide range of chronic diseases and conditions lead to excessive perspiration, especially type 2 diabetes, obesity, Parkinson’s disease, and hyperthyroidism (overactive thyroid gland). Cancers, especially lymphomas, are also associated with it.

Hyperhidrosis also often accompanies pregnancy and menopause. These are both characterized by changes in the levels of the sex hormone estrogen.

Additionally, viral and bacterial infections, such as tuberculosis and human immunodeficiency virus (HIV), also provoke this symptom. Furthermore, hyperhidrosis can be a sign of stroke (bleeding in the brain) or the result of a head or spine injury.

What Medications Can Cause Hyperhidrosis?

Excessive sweating can also be a side effect of certain classes of medications. These include drugs for depression, pain (analgesics), and heart and blood pressure problems, among others. Medications associated with hyperhidrosis include:

• Selective serotonin reuptake inhibitors (SSRIs) like Prozac (fluoxetine) and Lexapro (escitalopram)
• Tricyclic antidepressants like Norpramin (desipramine)
• Serotonin-norepinephrine reuptake inhibitors (SNRIs) like Cymbalta (duloxetine) and Effexor XR (venlafaxine)
• Salagen (pilocarpine)
• Stimulants like nicotine and caffeine
• Antipsychotics like Risperdal (risperidone) and Buspar (buspirone)
• Analgesics like Vicodin (hydrocodone and acetaminophen)
• Heart and blood pressure medications like Lopressor (metoprolol)

How to Treat Hyperhidrosis

A range of medications and treatment strategies can treat and even reverse hyperhidrosis. The specific approach depends on the location and severity of your case. Here’s a breakdown:

• Antiperspirants: For underarm sweating, using an antiperspirant, rather than a deodorant, blocks the sweat glands. Common brands containing 10% to 20% aluminum chloride hexahydrate may be recommended, or your dermatologist may prescribe a stronger formulation.
• Iontophoresis: Typically used for hand or foot sweating, iontophoresis is a therapy that uses electrical currents to temporarily stop sweat gland activity. Performed in the dermatologist’s office or using at-home devices, low-wattage electricity is delivered to skin submerged in water. Effects are seen after several sessions lasting 20 to 30 minutes each.
• Botox (botulinum toxin) injection: For underarm, foot, and palm sweat, injections of Botox, a protein produced by the Clostridium botulinum bacterium, temporarily paralyzes the nerves that regulate the sweat glands. Results are seen within five days, though additional treatment becomes necessary after four to six months.
• Medications: For facial hyperhidrosis, you may be prescribed topical glycopyrrolate, a gel that’s applied to the skin daily. Oral glycopyrrolate, also used for ulcers, may be prescribed. Another such option is oxybutynin, a treatment for overactive bladder.
• Surgery: In difficult-to-manage cases, several surgical techniques may be needed to manage the condition. These procedures include liposuction, removing or scraping off the sweat glands, or using lasers. Additionally, endoscopic thoracic sympathectomy (ETS), which aims to sever glands regulating sweating, is a minimally invasive option.

At-Home Management

While at-home strategies can’t reverse the causes of hyperhidrosis, they may certainly help you manage the condition. These include:

• Avoiding sweat triggers, such as alcohol, coffee, and spicy foods
• Wearing loose clothing
• Changing socks multiple times a day
• Wearing thicker, absorbent socks
• Wearing leather shoes

Are There Tests to Diagnose the Cause of Hyperhidrosis?

Several tests help healthcare providers determine what’s causing hyperhidrosis. Typically, diagnosis may involve:

• Physical examination: The first step will be for the provider to evaluate your condition and overall health. They’ll ask questions about the timing and location of your sweats, the medications you’re taking, and your medical history. They’ll also observe the affected areas.
• Starch-iodine test: Also known as a “sweat test,” the provider coats the affected area with iodine, waits until it dries, and then sprinkles starch on it. This combination turns dark blue or black in areas of excessive sweat.
• Blood tests: Clinical testing of blood samples can detect chronic diseases, such as the thyroid-stimulating hormone (THS) test for an overactive thyroid or the A1C test to detect diabetes.
• Imaging: If a cancerous tumor is suspected as a cause, you may undergo magnetic resonance imaging (MRI) or other kinds of imaging.

When to See a Healthcare Provider

While hyperhidrosis itself isn’t dangerous, it can be a sign of a more serious condition. Call your provider if you experience the following:

• You sweat excessively for prolonged periods of time due to unknown causes.
• You feel chest pain or pressure while sweating.
• Your sweats are accompanied by rapid weight loss.
• Your sweats occur mostly while you’re asleep.
• Fever, rapid heartbeat, or other signs of an overactive thyroid.

Summary

Hyperhidrosis is a common condition, characterized by excessive sweating from the underarms, hands, feet, face, or all over the body. This condition may arise on its own or be caused by chronic diseases or health conditions, hormonal shifts, as well as injury, or infection. Medications and medical treatments treat this issue and lifestyle changes can help manage it.  

A Word From Verywell

Hyperhidrosis is more than just excessive sweating. Not only can living with the condition be stigmatizing and affect your mental health, but it can be a sign of more serious—and potentially more dangerous—health conditions. This is why it's important to seek out medical help if you’re finding yourself unable to manage your sweating. The sooner you talk to your healthcare provider, the sooner you’ll be on track to reclaiming your life from hyperhidrosis.