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What Is Hyperhidrosis And How Is It Managed?



Hyperhidrosis is the medical term for excessive sweating, a condition that affects almost 3% of Americans. While hyperhidrosis can be embarrassing, it can also have more serious side effects, including dehydration and skin infections due to the chronically moist nature of the skin. Hyperhidrosis is not well understood, but there are treatments available that can help alleviate symptoms for affected individuals.

Types of Hyperhidrosis

Hyperhidrosis comes in many forms. There is a focal, primary form, in which patients sweat excessively from the time they are children or young adults. In this form, the sweating usually occurs only in certain areas of the body, such as the hands, the feet, or the armpits, where there are many sweat glands per square inch of skin. Doctors believe that this form of hyperhidrosis is inherited genetically. Another form of hyperhidrosis is the generalized form, which can start at any time during life and affects the whole body.

Generalized hyperhidrosis may be due to a poorly-understood over-activation of the nervous system, but it can also be a sign of an underlying disease, such as diabetes, hyperthyroidism, congestive heart failure, or one of many other diseases. Hyperhidrosis can also be a symptom of menopause. For this reason, people who develop excessive sweating later in life should be evaluated by a medical doctor to ensure that no underlying condition is present.


Regardless of the form, hyperhidrosis can be a devastating disease. Excessive sweat can show up as visible damp patches on clothing even in a cool room, causing embarrassment. Patients may become dehydrated, battle constant skin infections, or feel cold and clammy. Finally, profuse sweating may occur due to inappropriate stimuli, such as the smell of food, anxiety, or certain emotional states, further complicating the problem.

Medical Treatment

Fortunately, treatments for hyperhidrosis are available. Once a treatable, systemic condition like diabetes, menopause, or hyperthyroidism has been ruled out, treatments are based on relieving clinical signs of this bothersome condition. They are typically aimed at reducing either the activity or the number of functional sweat glands in the body. One of the most common treatments is prescription-strength antiperspirant. Over-the-counter antiperspirants contain aluminum chloride, which blocks the ducts of sweat glands to reduce their secretion of sweat.

However, the concentrations of aluminum chloride found in most deodorants are insufficient to treat hyperhidrosis. Prescription formulas contain more aluminum chloride and are more effective, especially for patients who sweat mainly in the armpit area. Other medical solutions include injections of Botox, which paralyzes the sweat glands and renders them nonfunctional for several months, and oral medications to reduce sweat gland activity.


For severe cases, surgical interventions are available to permanently reduce sweating. These include using suction or a laser to remove or destroy the sweat glands. Sometimes, surgery is performed to interrupt the communication of nerves that cause sweating with the rest of the body. This procedure is known as endoscopic thoracic sympathectomy, and it has a number of side effects, including compensatory sweating in other areas of the body, which can range from mild to severe. Surgical treatment is reserved for patients with severe cases that cannot be managed with medical therapy.

Hyperhidrosis not an uncommon disease, and it can have effects on a patient’s life that can be devastating. Treatment is available– consult your doctor to learn more about your options.