Hyperhidrosis Explained
Hyperhidrosis is excessive sweating beyond what the body needs for temperature control.
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Primary: Usually affects the palms, feet, underarms, or face and often begins in childhood or adolescence.
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Secondary: Caused by medications or an underlying condition and may involve the whole body or occur during sleep.
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Treatment: Antiperspirants, topical medications, iontophoresis, Botox injections, oral medications, and, rarely, surgery.
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Evaluation: New, sudden, generalized, or nighttime sweating should be assessed for an underlying cause.
Main types
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Primary focal hyperhidrosis: Usually begins in childhood or adolescence and commonly affects the palms, soles, underarms, or face. It often occurs on both sides and may run in families. Sweating typically decreases during sleep.
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Secondary hyperhidrosis: Caused by another condition, medication, or substance. It may involve much of the body and can occur during sleep.
Possible secondary causes include thyroid disorders, diabetes or low blood sugar, infections, menopause, neurologic conditions, and certain medications.
Treatment depends on the location and severity:
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Prescription-strength antiperspirants — commonly aluminum chloride
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Topical medications — such as anticholinergic treatments
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Iontophoresis — particularly useful for sweaty hands and feet
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Botulinum toxin injections (Botox) — can temporarily reduce sweating in areas such as the underarms, palms, and soles
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Oral medications — anticholinergic drugs can reduce sweating
It's worth getting evaluated if sweating is new, generalized, occurs during sleep, suddenly becomes much worse, or is accompanied by symptoms such as fever, unexplained weight loss, chest pain, dizziness, or a racing heartbeat. A clinician may look for an underlying cause before treating the sweating itself.
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Michael Tee, MD, PhD
Clinical Director & Founder
Dr. Michael Tee focuses on helping patients manage a comprehensive range of skin conditions that can significantly impact daily comfort and confidence. He works extensively with patients experiencing skin changes during pregnancy, helping them navigate the complex dermatological shifts that occur during this important time. His practice also centers on mole evaluation and management, including atypical moles that require careful monitoring and assessment. Dr. Tee regularly treats patients dealing with acne, seborrheic dermatitis, and various forms of eczema, conditions that can affect both appearance and quality of life.