Hyperhidrosis

What is hyperhidrosis?

Hyperhidrosis means sweating more than the body needs to control its temperature. It can affect specific areas, such as the armpits, hands or feet, or the whole body. Sweating is controlled by the sympathetic nervous system, the part of the nervous system that works automatically, and in hyperhidrosis this system is overactive.

Who gets it?

Hyperhidrosis affects around 1 to 3 in 100 people. Primary hyperhidrosis, the most common type, usually starts in childhood or the teenage years. It is uncommon in older people. Secondary hyperhidrosis can start at any age, depending on its cause.

What causes it?

Primary hyperhidrosis has no underlying medical cause. It involves specific areas, usually the palms, soles, armpits, face or scalp. Heat, exercise, anxiety and stress can make it worse, but people with primary hyperhidrosis often sweat heavily even when they are calm and cool.

Secondary hyperhidrosis is caused by something else, such as an infection, hormonal changes including the menopause, diabetes, an overactive thyroid gland, or certain medicines, including some antidepressants. Rarely, nerve damage can cause increased sweating in one area. Secondary hyperhidrosis is more likely to affect the whole body or to cause sweating during sleep.

Is it hereditary or contagious?

Primary hyperhidrosis often runs in families, and up to 1 in 3 people with it have an affected relative. It is not contagious.

What does it look and feel like?

In primary hyperhidrosis, sweating usually affects both sides of the body evenly. Hands and feet may be visibly wet or feel cold and clammy, sweat may drip from the palms, and clothing can become soaked through, leaving visible patches. Sweating is usually not a problem during sleep.

Hyperhidrosis can make everyday activities difficult, such as shaking hands, writing, using a keyboard or phone, holding tools or playing an instrument. Many people feel embarrassed, and it can affect confidence, work, social life and relationships. Excess sweating of the feet can encourage bacterial growth, causing odour and skin problems.

How is it diagnosed?

Hyperhidrosis is diagnosed from the history and examination. Your doctor will ask where and when you sweat, whether it happens during sleep, and about any other symptoms, to work out whether it is primary or secondary. If secondary hyperhidrosis is suspected, blood tests or other investigations may be recommended to look for an underlying cause. Questionnaires are sometimes used to measure how much sweating affects daily life.

What are the treatment options?

Dr Mounsey will confirm whether you have primary hyperhidrosis or excessive sweating caused by another condition or medicine. First-line treatment is a strong antiperspirant containing aluminium chloride. Other options include iontophoresis for the hands and feet, which can be done at home with a device, botulinum toxin injections for the armpits, hands and feet, and tablets such as oxybutynin or propantheline, which reduce sweating throughout the body. Dr Mounsey can advise on which option suits you and arrange treatment where appropriate. Surgery is rarely needed.

What is the outlook?

Primary hyperhidrosis often eases with age and is unusual in older people. In the meantime, there are many effective options, so it is worth seeking advice rather than living with it. Secondary hyperhidrosis usually improves once the underlying cause has been identified and addressed.

More information

British Association of Dermatologists patient leaflet: https://www.bad.org.uk/pils/hyperhidrosis

This page gives general information only and is not a substitute for a consultation. Everyone's skin is different, and what is right for you will depend on your own circumstances. If you are worried about a skin problem, please book an appointment with Dr Mounsey or speak to your GP. If you have a mole or skin lesion that is changing, bleeding or growing quickly, please seek medical advice promptly.