Hyperhidrosis

What is hyperhidrosis?

Hyperhidrosis is a medical condition characterized by excessive sweating. It is thought to affect in excess of 5% of the global population, or approximately 365 million people worldwide. It can affect anyone regardless of factors such as age, sex, or ethnicity.

Hyper

excessive, above normal

Hidrosis

the action of sweating

Hyperhidrosis

Hyperhidrosis is the term used to describe excessive sweating beyond what is physiologically necessary. It can be localized or generalized, based on the distribution of sweat (certain areas of the body vs. full body, respectively), and is also classified as primary or secondary, based on the cause of the sweating. Primary = of primary origin (unknown cause). Secondary = secondary to another medical condition, or side-effect of a medication.

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What is primary hyperhidrosis?

Primary hyperhidrosis is a chronic condition of unknown cause. Hyperhidrosis is an exaggerated response of the sweat glands to release excessive amounts of sweat, in absence of appropriate stimuli. Those with hyperhidrosis can sweat anytime, anywhere, in any temperature, and up to 4-5x more than the average person or what is needed for thermoregulation. It is believed to be caused by an overactive sympathetic nervous system. Some research indicates that there may be a hereditary component to the condition, meaning it can be passed on through generations. Primary hyperhidrosis is of primary origin, meaning it is not a side-effect or secondary to another underlying condition. It is not caused by external stimuli, body temperature, or associated to any other conditions or medications. Primary hyperhidrosis is most commonly localized, meaning it typically affects certain areas of the body, most commonly the hands, feet, underarms, and craniofacial region. Those with hyperhidrosis will generally start experiencing symptoms in childhood to adolescence, particularly with the onset of puberty. In nearly all cases, symptoms (excessive sweating) will appear before the age of 25.

How is hyperhidrosis diagnosed?

A dermatologist can do a medical diagnosis for hyperhidrosis, but in the case of primary hyperhidrosis is not always necessary. Those with hyperhidrosis, that is excessive sweating in specific areas of the body, often self-diagnose, as the condition itself does not pose any direct threat to overall health. If you consider your sweating level to be excessive, experience excessive sweating in your hands, feet, and/or underarms, and sweating impacts your daily life and takes a mental toll on you, you’re likely suffering from hyperhidrosis. A diagnosis is not always necessary to begin treatment, but some treatment options are only available under clinical guidance or prescription, so speaking to a healthcare professional is recommended. There is no threshold or level of sweat that automatically determines if you have hyperhidrosis. In fact, hyperhidrosis is generally categorized as mild, moderate, or severe, though all levels are deemed excessive.

During a consultation with a dermatologist, they will generally do a physical examination (focusing on looking at the areas that sweat excessively) and ask you questions to determine if you have hyperhidrosis. The questions can range from physical symptoms to mental and emotional wellbeing. Sometimes, medical testing is necessary, and is done with a starch iodine test, also known as the “sweat test”. This test involves coating the skin with a powder that turns purple when the skin gets wet (sweat, in this case). This helps determine which areas are sweating excessively, and narrow down which sweat glands are the most hyperactive, as these areas will appear darkest. This kind of test is most commonly done prior to certain treatments such as injections and microwave thermolysis to better localize treatment. Hyperhidrosis can also be diagnosed via telemedicine, and in this case photos of your excessive sweating (in addition to your responses to questions) will generally suffice to make a diagnosis and get a prescription for your recommended or desired treatment.

Some questions to ask yourself when determining if you have hyperhidrosis, or that you may be asked if going in to a dermatologist for a consultation are the following:

Do you consider your sweating level to be excessive?
Do you often find yourself sweating excessively for no apparent reason?
Have you noticed certain areas of your body sweat more (hands, feet, underarms)?
Do you think about sweating all the time?
Do you plan your life around excessive sweating?
Have you ever canceled plans because of your sweating?
Do you often find yourself trying to conceal your sweat from others?
Do you suffer from anxiety and/or depression as a result of your sweating?
Do you think that your sweating will have a negative effect on the way people perceive you?
Has sweating made you less outgoing and more reserved?
Do you often have to change clothes or shower more than once a day on account of your sweating?
Do you carry anything to absorb/conceal sweat when you are out (tissues, changes of clothing, towels, antiperspirants, etc.)?
Has sweating had an impact on your studies, career path, or employment opportunities?

If you answered “yes” to any or all of the above, then you likely suffer from hyperhidrosis (excessive sweating). The first step would be to either consult a professional for more information, or open up to a trusted person (a partner, friend or family member) to ease the mental toll this condition has. We then recommend to start doing your own research, join a hyperhidrosis community, and look at the available treatment options. Note: If you experience a sudden onset of excessive full-body sweating, then it is recommended that you speak with your healthcare provider to rule out any underlying causes or medications that can have sweating as a side effect.

What are the symptoms of hyperhidrosis?

The symptoms of hyperhidrosis are excessive, uncontrollable sweating in the affected region(s) that disrupts daily life. Symptoms can easily be spotted if sweating is dripping down palms, leaving sweat marks on clothing, or dampening shoes. Those who suffer from hyperhidrosis may have “episodes” when they start sweating excessively for no reason (i.e. absence of appropriate stimuli). Most report this as a daily occurrence, with some experiencing this multiple times a day. A noticeably absent symptom that can help in diagnosis, is that those with primary hyperhidrosis tend to not sweat excessively while they sleep, and experience their symptoms during the day.

How is hyperhidrosis treated?

There is currently no cure for hyperhidrosis, but fortunately there are many treatments available.

Antiperspirants

Deodorants and antiperspirants are terms often used interchangeably, but they are not the same. Deodorants help prevent and conceal body odour, but do not have any “anti-sweat” properties. Antiperspirants, on the other hand, have properties (aluminum salts) that can temporarily halt the production of sweat. They come in different formulations such as gels, creams, sticks, powders, and wipes. The main active ingredient in antiperspirants is aluminum salts, generally in 12%-25% concentrations. Antiperspirants are applied directly to the skin (topical application). The purpose of the antiperspirant is to decrease the volume of sweating by creating “plugs” in the underarm (or region it is applied to). These plugs are made of aluminum salts, which dissolve into the skin with the help of perspiration. Essentially, the aluminum mixes with the sweat on your skin, dissolving the aluminum that is then absorbed into your pores, which creates “plugs”. These plugs are temporary (generally lasting up to 24 hours) and are washed away over time.

Iontophoresis

Tap water iontophoresis is often considered a first or second-line treatment option for hyperhidrosis, and is generally prescribed and/or recommended for those who traditional antiperspirants don’t work. It is a non-invasive, drug-free, and needle-free treatment that is generally done at home with a small, portable medical device. Tap water iontophoresis for the treatment of palmar (hand) and plantar (foot) hyperhidrosis can be traced back at least as far back as the 1940s. Since its introduction, it has undergone significant technological advancements and developments and now with the help of devices like Dermadry, treatment can be done at home. This technology works by directing a mild current through the skin, neutralizing the connection between the nerves and sweat glands. Iontophoresis treatment is done with a medical device, which is plugged into a power source that produces an electrical current that travels via tap water (the conductor), reaching the conductive electrodes that are submerged in water and touching the skin. A protective barrier, such as a towel or sponge is used to make treatment more comfortable by protecting the skin from coming into direct contact with the electrodes. In nearly all cases, this dramatically reduces excessive sweating. Iontophoresis is a non-invasive (doesn’t penetrate the skin), drug-free, and needle-free way to treat hyperhidrosis. Many doctors recommend and prescribe iontophoresis to those who have no luck with traditional antiperspirants. It is a safe and effective method to treat hyperhidrosis with limited minor side effects, such as temporary skin irritation and reddening. To learn more about iontophoresis as a treatment option, visit our dedicated iontophoresis page.
Looking for an at-home iontophoresis machine? Learn more and buy Dermadry here.

Microwave Thermolysis

Microwave thermolysis (also known commercially as Miradry) is a way to permanently treat excessive sweating of the underarms only. It uses thermal energy to permanently eliminate sweat glands in the underarm region. The procedure is done with a non-invasive handheld device that delivers electromagnetic energy beneath the underarm skin resulting in thermolysis (decomposition by heat) of the sweat glands. Microwaves target the layer where the sweat glands are, therefore not burning the surface of the skin. It can also help eliminate body odour emanating from the underarm region (bromhidrosis) and underarm hair permanently. It can require several treatments (generally 2, sometimes up to 3) and is a costly procedure.

Laser Therapy

Laser treatment exists for underarm sweating (axillary hyperhidrosis). The treatment is done with a targeted high heat laser that destroys the sweat glands. Prior to the procedure, tiny incisions are made on the surface of the skin, in order to facilitate the laser penetrating the skin. The device emits a highly targeted laser beam that can precisely heat and destroy the overactive sweat glands in the underarm region. The heat from the laser seals off blood vessels and reduces the risk of infection in the treatment area. Local anesthesia is used during the procedure, and some side-effects include swelling, bruising and numbness. There is not much research on the effectiveness of laser therapy for hyperhidrosis, however it is thought to significantly reduce sweating in the underarm region by permanently destroying the overactive sweat glands. Most patients require 1-2 treatment sessions. The second treatment is often done to target the sweat glands that have not been destroyed during the first session. The procedure is costly and has limited availability. As it is only offered in select dermatologists’ offices, those seeking laser treatment may struggle to find a clinic in their area that offers the treatment. Laser therapy is also only available for excessive underarm sweating. Not all laser therapy is the same, so consult your dermatologist to discover your options.

Neurotoxin Injections

Neurotoxin injections for hyperhidrosis are a common treatment option for the condition. It is a less common use of the substance that is known for its use in cosmetic procedures, such as reducing the appearance of wrinkles. Currently, the FDA has only approved this type of treatment for primary axillary (underarm) hyperhidrosis, however many specialists will use it “off-label” to treat other areas of the body. It is not always recommended for hands as it can cause temporary pain and weakness in the hands, nor the feet as they are too sensitive. It is most effective for the underarm region, and is also commonly used to treat the forehead and scalp regions. These injections contain a neurotoxin, which affects the structure or function of the nervous system. It's the same toxin that causes a life-threatening type of food poisoning called botulism. Doctors use it in small doses to treat health problems, such as hyperhidrosis. Neurotoxin injections alter the function of neurotransmitters, which are chemicals found in the body that are responsible for making the body react in certain ways (i.e. sweating when it’s hot). The injections block the nerves responsible for activating your sweat glands in the treatment area.

Antihydral

Antihydral is a cream containing an active ingredient used topically on the skin to treat excessive sweating, generally of the hands. This is commonly used by and marketed to rock climbers, as this cream builds a strong, thick callus on the skin. It makes the skin dry and rough, which is perfect for climbing. Some who suffer from hyperhidrosis have turned to these creams in an attempt to treat palmar hyperhidrosis. These creams come under many brand names, the most popular being Antihydral. The cream is applied to your skin, and once the active ingredient encounters the acid pH level on your skin, it reacts by producing formaldehyde and ammonia, which dries out the skin and builds a thick callus with consistent exposure. Formaldehyde is a known carcinogen that works as a potent antiperspirant. Pure formaldehyde is never to be used on the skin due to its links to cancer.

Systemic Drugs

There are an array of systemic drugs used to treat excessive sweating. These drugs block the action of acetylcholine, a neurotransmitter that transfers signals between certain cells to affect how your body functions. In the case of managing excessive sweating, these work by blocking the chemical messenger acetylcholine as it attempts to travel to receptors on the sweat glands that are responsible for triggering sweating. Because these medications work systemically, they cannot target one area of the body, unlike other hyperhidrosis treatments. That means that they decrease sweating and moisture all over the body, even where sweating is not a problem, this can cause a range of serious and unwanted side-effects.

Surgeries

Note: We strongly advise against surgeries for hyperhidrosis, due to the risks and side-effects they pose. Endoscopic thoracic sympathectomy (ETS) is a highly risky procedure that is only reserved for the most severe cases of palmar (hand) hyperhidrosis. Similarly, endoscopic lumbar sympathectomy (ELS) is used to treat the most severe cases of plantar (foot) hyperhidrosis, however it is not as common. While ETS and ELS are highly advised against due to the inherent risks they pose and the unwanted side-effects, other less risky surgeries exist for underarm sweating. These are "local surgeries", so generally the patient does not have to go under full anesthesia. The surgeries include excision, liposuction, and curettage. During ETS surgery, a surgeon will attempt to interrupt the transmission of nerve signals from the spinal column to the sweat glands to stop the sweating. The patient is under general anesthesia when the procedure is done, as the surgeon must temporarily collapse a lung in order to destroy the nerve paths associated with the overactive sweat glands. It is generally done to treat severe cases of palmar hyperhidrosis, when no other treatment options have worked. This is a permanent procedure, no successful reversals have ever been done. The procedure is highly risky and generally results in compensatory sweating all over the body, which is often even more excessive than the sweating the patient was experiencing before. While some patients may experience dryness in their hands, they will be sweating excessively everywhere else on their body, which can be even more life-altering than palmar hyperhidrosis. Some of the most serious side-effects include compensatory sweating, gustatory sweating, Horner’s syndrome, neuritis and neuralgia, brachial plexus Injury, extreme hypotension, heat intolerance, and arrhythmia. Additionally the risks associated with surgery and undergoing anesthesia must also be considered.

For a more in-depth look at the treatment options click here.

What are the side-effects of hyperhidrosis?

The side effects of hyperhidrosis are wide-ranging and life-impacting in more ways than one. While this condition is non-life-threatening, it can have considerable physical, emotional, and mental impacts, and can negatively impact someone’s occupational and social life. The condition can take a significant toll on its sufferer, leading them to live and plan their life around the condition, even leading them to avoid social interaction and situations. It is often referred to as the “silent handicap”, as people rarely talk about the condition nor seek medical help, leaving many to suffer in silence. There are a lot of misconceptions about hyperhidrosis — in fact, many sufferers don’t even realize that excessive sweating is a recognized, treatable medical condition, nor that there is a word for it.

Quality of Life

Hyperhidrosis can impact social and professional lifestyle, as well as mental and emotional health. These negative effects, which have been studied extensively, lead to an overall lower quality of life. Hyperhidrosis is reported to be the dermatologic condition with the greatest impact on quality of life, even greater than psoriasis and eczema. In a 2017 study analyzing the effects of hyperhidrosis on quality of life, nearly all those studied reported an effect on their quality of life and lifestyle.

Daily Life and Lifestyle

From taking public transport, to seeking out clothes and developing personal style, hyperhidrosis can affect every aspect of mundane life and simple everyday tasks. Some ways hyperhidrosis can affect daily choices and lifestyle include clothing choices (color and material), food and drink choices (staying away from foods and drinks that trigger a sweating response), performing household chores, using technology tools (fingerprint ID on touchscreens do not work with sweaty fingertips), and the completion of mundane tasks such as turning door knobs, opening jars, and driving.

Social and Professional

Those who suffer from hyperhidrosis are hyper-aware of their condition and are often in a state of constant fear that others may take notice. Besides experiencing discomfort from the sweating itself, they develop a sense of shame and embarrassment, exacerbated by social and professional situations (e.g. parties, job interviews, presentations, and dates). In extreme cases, they may seek complete social isolation and become incapable of going to work, attending school, or fulfilling any other obligations. Turning down invitations and avoiding social situations, may give those around them the sense they are unsociable when it is just an undesired side-effect of their hyperhidrosis, and a coping mechanism to hide their condition from those around them out of a fear of judgement and misunderstanding. Hyperhidrosis is the sole dermatologic condition with a functional impairment. It can have a negative impact on education and studies, and even alter career paths for those otherwise fully committed and capable of following certain career trajectories.

Physical

Hyperhidrosis can also lead to physical side-effects. Excessive sweating can cause constant skin dampness, which can lead to skin maceration that leads to conditions such as athlete’s foot and ingrown toenails. Skin dampness, especially when constricted by footwear or clothing also creates the ideal environments for fungus to spread, and can lead to recurring cases. A study found a 3.5-fold increase in risk for patients with athlete’s foot to also have hyperhidrosis. The risk of skin infections, dermatophytes, psoriasis, and/or warts is increased secondary to sweating. Hyperhidrosis is considered a predisposing factor for both bacterial growth and the dermatologic condition known as pitted keratolysis. Additionally, constant moisture from sweating can lead to skin maceration. This increases the risk of skin conditions such as athlete’s foot and more severe conditions such as bacterial infections or pitted keratolysis. The International Hyperhidrosis Society (IHHS) reports that those with hyperhidrosis have a 300% greater risk of skin infections than those not experiencing the disease. The link between plantar hyperhidrosis has been further analyzed in several clinical studies. A study found that the overall risk of any skin infection was increased in sites with hyperhidrosis. There is also an increased risk of fungal infections, with a particularly increased risk for dermatophyte infections (those responsible for athlete’s foot). In a recent German study, researchers noted a 3.5-fold increased risk for patients with athlete’s foot to have hyperhidrosis. This is caused by the maceration (softening) of the skin due to excessive sweating.

Mental Health and Emotional Wellbeing

Excessive sweating leads to embarrassment for many patients. Other feelings consistently reported by those suffering from excessive sweating include anxiousness, loneliness, sadness, anger, and hopelessness. Low self-esteem and confidence are also widely reported There is a significant association between hyperhidrosis and the prevalence of anxiety, depression and attention deficit disorder (ADD) across all age groups and genders. Compared to the nationally reported prevalence of anxiety, depression and ADD, hyperhidrosis patients have a statistically significant higher prevalence than the general public. One international study determined that the prevalence of anxiety and depression was 21.3% and 27.2%, respectively, in patients with hyperhidrosis compared with 7.5% and 9.7% in those without the disease. Another study concluded that patients with severe hyperhidrosis had a rate of social anxiety disorder was 47.1% compared with 13.8% in patients without hyperhidrosis. Social anxiety is one of the most common conditions reported and diagnosed in hyperhidrosis patients.

What are the side-effects of hyperhidrosis?

What causes hyperhidrosis?

The cause of primary hyperhidrosis is unknown. It is thought to be an over stimulated sympathetic nervous system response.

How common is hyperhidrosis?

It’s estimated that at least 5% of the global population suffers from hyperhidrosis—that’s over 365 million people worldwide. Rates vary by region and demographics, but the condition is widely believed to be under-reported and under-treated.

Who is most commonly affected?

People of all ages, genders, and ethnicities can be affected by the condition. Many first experience the symptoms of hyperhidrosis in childhood to young adolescence.

What areas are most commonly affected by hyperhidrosis?

The areas most commonly affected by hyperhidrosis are the hands, feet, and underarms.

Is there a cure for hyperhidrosis?

There is currently no cure for hyperhidrosis.

Is hyperhidrosis genetic?

While there is no known cause, there is thought to be a genetic component to the disease and it may be hereditary, meaning it can be passed down from one generation to the next. If you have hyperhidrosis, there is a good chance that someone from your immediate family also suffers from the condition.

Is hyperhidrosis dangerous?

Primary hyperhidrosis is not dangerous. It does not pose any direct danger, though it’s impact on mental health and quality of life should never be ignored, due to the truly damaging effects it can have.

How can I treat hyperhidrosis?

There are a multitude of treatments available aimed at treating the different types of hyperhidrosis. Some treatments include antiperspirants, injections, iontophoresis, systemic medications, and surgeries.

Hyperhidrosis Resources

Voices of Hyperhidrosis

Voices of Hyperhidrosis is an awareness campaign dedicated to de-stigmatizing hyperhidrosis and breaking the silence surrounding excessive sweating. The project aims to get people around the world to join in raising awareness of hyperhidrosis and its mental, physical, emotional, occupational, and social challenges. The goal is to amplify the voices of those living with hyperhidrosis and create visual and textual documentation that explores the individual lives of hyperhidrosis sufferers. Since its launch in mid-2020, the campaign has amassed hundreds of submissions from all over the world. These text and photo submissions put a face and voice to all those living with hyperhidrosis and aim to break the stigma surrounding the topic of sweat. The project also highlights the diversity of those living with the condition, truly proving that hyperhidrosis can affect anyone. Submit your story and browse through hundreds others at Voices of Hyperhidrosis!

Dermadry Hyperhidrosis Community

The Dermadry Hyperhidrosis Community is an online community for those suffering from hyperhidrosis to come together and share their thoughts, experiences, and stories. The group is a judgment-free zone that allows members to share their highs and lows, and discuss their tips and tricks.This is a place where you are free to vent, share your successes and struggles, and speak to others who can understand and relate to what you go through on the daily. Join the Dermadry Hyperhidrosis Community!

International Hyperhidrosis Society

The International Hyperhidrosis Society is a non-profit organization dedicated to improving the lives of those affected by excessive sweating. Founded in 2003 by a team of physicians and experts in hyperhidrosis research, it is the only independent, non-profit, global organization committed to raising awareness of hyperhidrosis worldwide. Their online network comprises vast resources for hyperhidrosis sufferers, medical professionals, and those wanting to learn more about sweat and its effects. Their mission is to “reduce the symptoms, anxiety, and social stigma associated with excessive sweating by improving the information, support, and treatment available to the millions of children, teens, and adults affected by hyperhidrosis worldwide”. They promote their mission by advocating for increased hyperhidrosis research, educating healthcare professionals, and raising awareness of the intricate impacts hyperhidrosis has on daily life and well-being. Lisa J. Pierretti, Executive Director and Founding Member of the International Hyperhidrosis Society

I am on a mission to end the stigma associated with excessive sweating; to validate that it is a bonafide disease and also to validate that it’s a spectrum, so not everyone who has hyperhidrosis or who is bothered by their sweating sweats exactly the same. You can have some people that sweat 4-5 times [the ‘normal’ amount] and it bothers them less than someone who sweats twice [the ‘normal’ amount], because of their profession, their personality, their makeup—you name it. I want to pull all the judgment off of it.
Palmar hyperhidrosis has the highest impact on quality of life of any dermatologic condition, full stop. This is the one dermatologic condition that has a functional impairment. If I have sweaty palms: I can’t write, I can’t hold a steering wheel, I can't get fingerprinted for my teaching job or for my nurse job. There’s so many impacts that it has in your life overall, it's not just uncomfortable, it's so much more than that, and I think that's what puts it in another class, a class of its own.

Dermadry Hyperhidrosis Scholarship

Launched in 2019, Dermadry’s Hyperhidrosis Scholarship is the first and only of its kind, that is a scholarship exclusively for students with hyperhidrosis. Every year, Dermadry asks students affected by hyperhidrosis to come forward and share their stories. Student life is stressful, and living with hyperhidrosis adds an extra layer of stress and unique challenges to an already stressful experience and life stage. Sweating through school uniforms, trying to hide sweat marks by not raising your hand in class, shying away from social activities, and ruining books, papers, and technology tools because of excessive sweating are just some of the daily challenges students face. In addition to these unique challenges, hyperhidrosis can also lead to an increase in stress levels, anxiety, isolation, and bullying. Dermadry wants to break the stigma and get more people talking about hyperhidrosis so it can be normalized and more students feel comfortable seeking help. Every August, Dermadry encourages students to come forward and share their hyperhidrosis story by creating a video that explores the impact hyperhidrosis has on their studies and daily life. The scholarship is granted to one student every year to help with the extra costs associated with being a student who suffers from excessive sweating. Browse through past entries to the Dermadry Hyperhidrosis Scholarship!

How to approach your doctor about hyperhidrosis

Dr. Ramin Fathi, MD

I see patients who are impacted professionally from their hyperhidrosis and who suffer socially from their hyperhidrosis. It impacts their quality of life because it stops them from doing the normal things that you should be doing. There’s no medical condition that should be holding you back to live your life at its fullest.
Hyperhidrosis is a big deal for those who suffer from it. What is considered “mild hyperhidrosis” can still have a significant difference in their day-to-day life. There's so many different areas of your life it can affect.

Dr. Hope Mitchell, MD

Hyperhidrosis is that it actually was more common than people led us to believe in medical school. And even back then, and still today with hyperhidrosis, a lot of the diagnosis is made incidentally. What I find in my practice is that people come in for another thing, and I'm the one that notices that they have hyperhidrosis.
There are still many people that don't know that it's a medical condition. A lot of people suffer in silence. I know that there may be adolescents that may say something to their parents, but their mom or dad may say “your body is changing” or “that's normal, that will go away”. I also know that although it runs in families, it's not discussed—it's a condition that I think a lot of people live with in silence, unfortunately.
I know that it can be embarrassing, I know that it can be dismissed. Luckily, today we have a lot of information online and more and more people are figuring it out.

Watch our full interview with Dr. Hope Mitchell, MD.

Dr. Amy Shah, MD

If you're suffering from hyperhidrosis, don't be embarrassed. There are many thousands of people just like you. The incidence is between five and 14%. There are so many more people that have it that don't even talk about it. So make sure you feel that you're not alone. Make sure that you talk to someone, a provider, a physician, that you feel comfortable with. Please, the only way you can get help and improve this condition is by talking about it.
Another thing is to know that there are solutions. I think one of the big misnomers is that you can't do anything. I think that a lot of people feel helpless, and should know that there's a solution like tap water iontophoresis and various other solutions to this problem. It should empower you to go and seek this out, talk to someone you trust about it, see what your options are and choose an option. You don't have to live like this.

Watch our full interview with Dr. Amy Shah, MD.

Dr. Robert Strimling, MD

My first experience with hyperhidrosis was learning about it during my dermatology training, where I met a young man who was just beginning his professional career and suffered from idiopathic palmar hyperhidrosis and extreme social anxiety, due to his affliction. Since then, I have always been motivated to seek out the best possible solutions for this not-so-uncommon problem.

Read our full interview with Dr. Robert Strimling, MD.

Dr. Leona Yip, MD

Commonly social disruptions that affect personal relationships and work e.g. too embarrassed to hold or shake hands, avoidance of meeting people and public speaking for fear of looking drenched with sweat, need to change drenched clothes every few hours throughout the day. Psychological effects are also very common e.g. lack of self-confidence, anxiety and depression. Ongoing high costs of replacing damaged clothing is another very common complaint. Lastly, functional issues e.g. inability to hold pens/pencils properly, unable to grip sports equipment, increased skin infections e.g. fungal, warts, bacteria.
People with hyperhidrosis are at higher risk of skin infections e.g. bacterial, fungal and warts; as well as worsening of skin conditions e.g. eczema, seborrheic dermatitis, acne etc. Treating hyperhidrosis often helps improve treatment outcomes of these skin issues.

Read our full interview with Dr. Leona Yip, MD.

What is secondary hyperhidrosis?

Excessive sweating can be the result of an underlying medical condition or can be a side effect of a medication. If that is the case, then it is referred to as secondary hyperhidrosis, as it is secondary to another (primary) condition or a secondary effect to a medication. Secondary hyperhidrosis is typically generalized, meaning it affects the entire body and is not localized to certain body parts, as is the case with primary hyperhidrosis. In some cases, it can be localized to certain body parts, but this is less common, and is generally the result of traumatic injury to one part of the body that results in compensatory sweating in another part. Infections, diabetes, heart failure, obesity, menopause, and alcoholism are some of the conditions that can cause excessive sweating. Some common medications that can cause excessive sweating are antidepressants, migraine medications, pain relievers, opioids, and diabetes medications. The best course of treatment is to consult a medical professional to identify and treat the underlying condition or identify the medication causing excessive sweating.

Other Sweating Conditions

Compensatory Hyperhidrosis

Compensatory hyperhidrosis happens when you completely stop sweating in one area, and your body compensates by sweating more in another. It is generally the result of trauma to a part of the body, and is also the most common side-effect of endoscopic thoracic sympathectomy (ETS).

Gustatory Hyperhidrosis

Gustatory hyperhidrosis, also known as Frey’s syndrome, is sweat triggered by food. Eating, seeing, dreaming, thinking, or talking about food can trigger a sweating response in those affected. It is generally the result of surgical trauma to the parotid gland. Following surgery, a mix up causes your body to secrete sweat, rather than saliva when needed. Read more about gustatory hyperhidrosis.

Chromhidrosis

Chromhidrosis is a very rare medical condition characterized by the presence of colour in sweat. It can occur by the presence of lipofuscin (a yellowish-brown pigment found in several organs and cells of the human body) that mistakenly makes its way into the sweat glands, where it oxidizes and can cause black, blue, green, brown, red, and yellow sweat. This is called apocrine chromhidrosis. Eccrine chromhidrosis can be caused by the ingestion of certain dyes, chemicals, or drugs, which then find their way into the eccrine glands and where they are excreted with the sweat. Sometimes sweat can come into contact with pigments and dyes externally (e.g. hair dye and clothing dyes), which can give the appearance of coloured sweat but this is not considered chromhidrosis and sometimes referred to as pseudochromhidrosis. Read more about chromhidrosis.

Bromhidrosis

While everyone suffers from occasional body odour, some have it a lot worse than others, and in these severe cases, it’s called bromhidrosis. Sweat is an odorless liquid, but when it comes in contact with the bacteria on your skin, it can release unpleasant odours. Most people deal with body odor, however, this can be managed by following an adequate hygiene routine. In the case of those with bromhidrosis, they will suffer from a very strong pungent smell, even just minutes after showering in some cases, making it very difficult to manage. Bromhidrosis is common in those who suffer from hyperhidrosis. Read more about bromhidrosis.

Anhidrosis

Anhidrosis is the complete absence of sweating. It can affect a specific area of the body (e.g. following a burn injury) where the sweat glands are damaged and can no longer function. If anhidrosis is present in several large areas of the body, it poses serious life-threatening risks, as the body can overheat if not able to control core body temperature through sweat excretion.

Hypohidrosis

Hypohidrosis is a decreased ability to sweat. It is a less severe form of anhidrosis, which is when a person is completely unable to sweat. Someone who suffers from hypohidrosis is less able to sweat, meaning their body cannot cool down as efficiently, which exposes them to a higher risk of developing heat-related illnesses.

Hematidrosis

Hematidrosis is an extremely rare medical condition that is characterized by blood found in sweat. It happens when blood vessels that feed the sweat glands rupture, and traces of blood are excreted through the sweat glands. It’s the result of severe mental anxiety and anguish to a degree that causes hemorrhage of the blood vessels supplying the sweat glands. It is not pure blood that is excreted through the sweat glands, but rather traces of blood that give the sweat a red-tinged hue.

Sources + Further Reading

Atkins JL, Butler PE. Hyperhidrosis: a review of current management. Plastic and Reconstructive Surgery. 2002 Jul;110(1):222-228. DOI: 10.1097/00006534-200207000-00039.

Connolly, M., de Berker, D. Management of Primary Hyperhidrosis. Am J Clin Dermatol 4, 681–697 (2003). https://doi.org/10.2165/00128071-200304100-00003

David R Strutton, Jonathan W Kowalski, PharmD, Dee Anna Glaser, Paul E Stang, US prevalence of hyperhidrosis and impact on individuals with axillary hyperhidrosis: Results from a national survey,Journal of the American Academy of Dermatology, Volume 51, Issue 2,2004, Pages 241-248, ISSN 0190-9622, https://doi.org/10.1016/j.jaad.2003.12.040.

Kamudoni, P., Mueller, B., Halford, J. et al. The impact of hyperhidrosis on patients' daily life and quality of life: a qualitative investigation. Health Qual Life Outcomes 15, 121 (2017). https://doi.org/10.1186/s12955-017-0693-x

Moraites E, Vaughn OA, Hill S. Incidence and prevalence of hyperhidrosis. Dermatol Clin. 2014 Oct;32(4):457-65. doi: 10.1016/j.det.2014.06.006. Epub 2014 Jul 19. PMID: 25152338.

Lenefsky M, Rice ZP. Hyperhidrosis and its impact on those living with it. Am J Manag Care. 2018 Dec;24(23 Suppl) S491-S495. PMID: 30589248.

Lewis P. Stolman, Treatment of Hyperhidrosis, Dermatologic Clinics, Volume 16, Issue 4,1998, Pages 863-869,ISSN 0733-8635, https://doi.org/10.1016/S0733-8635(05)70062-0.