The Ultimate Guide to Hyperhidrosis: All You Need to Know

Everyone sweats. It’s a natural bodily function. However, if you find yourself dripping with sweat for no apparent reason, there’s a good chance you could have hyperhidrosis. Also informally referred to as "excessive sweating," hyperhidrosis is a health condition that impacts 4% to 5% of the population, causing them to sweat as much as four to five times more than the average person.

Living with excessive sweating creates feelings of embarrassment and emotional pain, yet this disorder often goes untreated because people don’t realize they have a medical condition with conventional treatments available.

In this article, you'll learn everything you need to know about hyperhidrosis – what causes it, how to manage it, and more.

This article was originally published in February 2019, and updated in May 2020 and April 2021.

Table of Contents

1. What is Sweat & Why Do We Sweat?
2. What is Hyperhidrosis?
1. Quiz: "Do You Sweat 'Too Much?'"
3. What Causes Hyperhidrosis?
4. The Signs & Symptoms of Hyperhidrosis
5. Hyperhidrosis Treatment Options
1. Home Remedies
2. Wardrobe Changes
3. Antiperspirant Tips
4. Dietary Adjustments
5. Hyperhidrosis Medications
6. Hyperhidrosis Surgery & Medical Procedures

What is Sweat & Why Do We Sweat?

While it's hard to remember it when you're suffering from excessive sweat, sweat helps maintain a consistent temperature by cooling your body as the moisture evaporates.

Two types of sweat glands make up the 4 million glands in the human body:

• Apocrine glands secrete sweat through hair follicles located in specific areas such as the underarms and groin.
• Eccrine glands make up a large majority of our glands and are located across the entire body. 

The eccrine glands are most affected by hyperhidrosis. Your nerves activate sweat glands based on triggers including body temperature, physical activity, emotional distress, and hormones. If you’re struggling with hyperhidrosis, you’ll sweat regardless of your surrounding conditions or your emotional state. 

What is Hyperhidrosis?

So what exactly is hyperhidrosis? Hyperhidrosis is a medical condition characterized by excessive and unstoppable sweating. Worldwide, one in 20 people experience excessive sweating. It is estimated that about 3% of Americans suffer from either axillary hyperhidrosis (excessive sweating in the armpits) or palmoplantar hyperhidrosis (excessive sweating on the palms of the hands and soles of the feet).

Both cases of hyperhidrosis typically surface during adolescence, with palmoplantar hyperhidrosis beginning around age 13 and axillary hyperhidrosis typically starting out later in adolescence.

There are also two types of hyperhidrosis:

1. Primary focal hyperhidrosis: Excessive sweating occurs in “focal” areas of the body, such as the hands, feet, underarms, face, or head. It causes equal sweating on both sides of the body. Most people will have more than one area of the body affected, such as both their hands and feet. This condition appears during childhood or adolescence and is often hereditary. Sweating rarely occurs during sleep.
2. Secondary generalized hyperhidrosis: Excessive sweating is either a symptom of another medical condition or a side effect of medications to be secondary hyperhidrosis. The sweating is over the entire body, not just specific areas. Unlike primary hyperhidrosis, you can experience night sweats and will have developed excessive sweating in adulthood.

If you’re uncertain whether you have primary or secondary hyperhidrosis, we've put together a quiz to help you try and understand what to bring up with your doctor. Our quiz is based on informal self-diagnosis questions suggested by Dr. Dee Anna Glaser, St. Louis dermatologist and President of the International Hyperhidrosis Society.

Unfortunately, there is no permanent treatment for hyperhidrosis; so symptoms may continue throughout a person’s lifetime. Depending on the area(s) of the body affected by the sweat, it can drastically affect a person’s ability to confidently address a group or even perform the simplest of tasks, such as gripping a pen or steering wheel.

Why Haven’t I Ever Heard of Hyperhidrosis Before?

People with hyperhidrosis consider it a deeply personal condition and embarrassing. It’s also not commonly known that excessive sweating is a recognized disorder, so more than half of those with the condition fail to seek diagnosis or treatment.

Also, many medical professionals are not as informed as they could be about the condition, which results in hyperhidrosis going undiagnosed or even misdiagnosed.

What Causes Hyperhidrosis?

Hyperhidrosis can be hereditary, and it affects both men and women, with approximately 1 in 20 people suffering.

Excessive sweating tends to start in childhood or adolescence with underarm issues beginning in the late teens. Palm and sole sweating often begin around the age of thirteen. However, some people struggle with excessive sweating from a younger age, or notice it doesn't develop until later in their teenage years.

Hyperhidrosis is a lifelong condition with treatments and products available to help you manage life with the discomfort of excessive sweating.

Signs & Symptoms of Hyperhidrosis

If you’ve been worried about your sweating and what can be considered "excessive sweating," you’re likely producing an irregular amount of sweat.

The most obvious symptom of hyperhidrosis is uncontrollable, excessive sweating in one or more areas of your body for a prolonged period of time.

Complications from excessive sweating may include:

• Experiencing interruptions to your daily routine.
• Feeling anxiety about crowded spaces, physical closeness, shaking hands.
• Withdrawing from social occasions and activities.

So start by asking yourself:

• Do you carry “supplies” to help manage your sweat?
• Do you change clothes several times a day?
• Do you ever change your social plans due to excessive sweating?
• Does sweating in public cause distress?
• Have you lost friends or a job due to excessive sweating?

All of these issues and extra considerations are commonly reported by people who have hyperhidrosis.

Where Most People Notice Excessive Sweating

Excessive sweating tends to occur most in the following areas:

• Armpits: Sweaty armpits, also called Axillary hyperhidrosis, leads to soaked clothes and sweat dripping down your sides regardless of external or emotional factors.
• Hands & Palms: Palmar hyperhidrosis causes sweating of your palms and can be so extreme that your hands drip with sweat or are chronically damp.
• Feet & Soles: Plantar hyperhidrosis causes severe sweating of the soles of your feet. It can be so excessive that your feet slip as you walk barefoot and in shoes.
• Face and Head: Craniofacial hyperhidrosis causes beads of sweat to pour from your scalp, face, and head.
• Groin: Inguinal hyperhidrosis causes sweating to leak through your undergarments and pants.
• Back: Back sweat, also called Truncal hyperhidrosis, is sweating in the back that leads to uncomfortable dripping and staining.
• Buttocks & Back of the Legs: Excessive sweating on the buttocks and the back of the legs leads to sweating through your clothes.

Hyperhidrosis Treatment Options

The best way to approach hyperhidrosis treatment is to first determine your symptoms, including the area on your body most affected by sweat. Think about how it affects your routine, and look for ways to improve your daily life. While there is not a hyperhidrosis cure, below we examine some of the tried-and-true ways to treat and manage it.

There are many ways you can learn to cope with excessive sweating. Of those who have hyperhidrosis, 97% try multiple different methods to prevent or reduce sweating, including:

• Keeping a towel handy (37%)
• Wearing or avoiding certain clothing (74%)
• Avoiding situations that cause sweating (47%)
• Holding a tissue in hands to avoid sweat (44%)

But these aren't permanent fixes or treatments for hyperhidrosis – they're just ways to cope without trying to improve the situation. There are many treatments and products designed to help with excessive sweating; let's dive into what your treatment options are and how much they cost.

Home Remedies

There are many hyperhidrosis remedies that can be implemented at home. In concert with these all-natural remedies, there are also simple lifestyle changes you can implement to help manage your symptoms.

Look in your pantry and bathroom for natural home remedies. Some examples include:

• Apple Cider Vinegar: As a natural astringent, you can apply it to your skin to control sweating and reduce odor-causing bacteria.
• Sage and Black Tea: Teas can work well as they contain tannic acid, which constricts and shrinks pores, reducing sweat and killing bacteria that can lead to odor.
• Baking Soda: It can be used to absorb sweat, lower pH levels, and block odors but will not control sweating. It requires several applications each day to be effective.
• Chamomile Tea: Sip some for its calming effects to help manage stress and anxiety.
• Witch Hazel: As with teas and apple cider vinegar, this natural astringent will shrink pores.
• Lemon Juice: Fresh lemon juice can be applied to your underarms at night. Once absorbed, it fights sweat and also smells pleasant.

Wardrobe Changes

To keep your feet from sweating, wear shoes made from a natural material, such as leather, or a breathable fabric. Avoid shoes made with synthetic materials. Pair with EJIS antimicrobial dress socks to keep feet dry and odor-free.

Allow shoes to dry completely before wearing again. Many people benefit from alternating shoes every other day.

As with shoes, avoid clothing made from synthetic fabrics such as polyester and acrylic. Instead, look for clothes made from natural fibers and that are breathable in nature.

Look into clothing specifically designed for people with hyperhidrosis. If your problem areas are your underarms or buttocks, try out EJIS sweat proof undershirts and boxer briefs. EJIS sweat proof basics act as invisible shields between sweat and your clothes... and they keep you smelling fresh with odor-fighting silver.

Properly Apply Antiperspirant

It's hard to believe, but you could be misusing your antiperspirant (here's how to do it right). Start a night-time regime with a shower and then an application of antiperspirant to dry skin. Since you’re less active during sleep, an antiperspirant can do its job overnight. Reapply in the morning and throughout the day as you wish.

For starters, make sure you are using the most effective antiperspirant. There are many clinical-strength formulas you can get without a prescription. Apply antiperspirant to completely dry skin in the morning and at night. Make sure the application dries completely before getting dressed.

For best results, it is also advisable to apply it to smooth skin; you might also consider shaving your armpits to get the most from your antiperspirant. Don’t apply antiperspirant directly to freshly shaved skin, and test new antiperspirants in a small area first to avoid skin irritation. 

Dietary Adjustments

Avoid processed and fatty foods. They are harder to digest, which means your body will sweat more during the digestive process. Hot, spicy foods are also known to increase sweating. (Here's a list of foods that cause more sweating.)

Avoid caffeine as it stimulates your nervous system, which activates your sweat glands. Also avoid drinking alcohol. It causes your body temperature to rise, which triggers your sweat glands to try to cool it down.

Instead, eat easily digested foods, such as fresh greens. (Here's a list of foods that reduce sweating.) Increase your water intake to ensure you stay hydrated. Your body sweats more when it is dehydrated. 

Hyperhidrosis Medications

If you decide on medical intervention to treat your hyperhidrosis, your doctor might decide to provide the following to help reduce sweating:

• Prescription hyperhidrosis antiperspirants: Options such as Drysol contain up to 20% aluminum chloride (with at least 14% recommended). 
• Prescription creams: Glycopyrrolate lotion is prescribed for those with head and face sweating issues. 
• Anticholinergic drugs (Nerve-blocking medications): These oral medications are used to block the chemicals that lead to sweating. 
• Antidepressants: This medication will not only decrease sweating but can also reduce anxiety caused by HH. 
• Botulinum toxin (Botox) injections: This treatment can last up to 12 months. It can be painful, even when your skin is anesthetized, and can also cause temporary muscle weakness.

If this is something you're open to, we've got a comprehensive breakdown of hyperhidrosis medications including all of the options and price estimates for each.

Hyperhidrosis Surgery & Medical Procedures

If you don’t see the desired results from medications, your doctor may suggest a more dramatic option to try and stop your hyperhidrosis for good. Some of the elective surgical treatments that have been successful in treating hyperhidrosis include:

• miraDry (Microwave therapy): miraDry uses electromagnetic energy to “zap” sweat glands, which basically kills them. This is a permanent and painful procedure. However, it can reduce armpit sweat by 83%. So, it might be something you’re willing to endure. Therapy requires sessions every three months and can cause discomfort and changes to your skin’s sensitivity. It is also less readily available and can be quite expensive at $2,500 to $4,500.
• Curettage: This surgical procedure removes sweat glands from your armpits by first scraping and then sucking them out. It costs between $4000 to $7,000.
• Nerve surgery (Sympathectomy): This procedure is for sweaty palms and involves the cutting, burning, or clamping of spinal nerves. It can lead to “compensatory sweating,” meaning it moves the sweating to another area of your body. It is a complicated treatment as it destroys nerve endings. Pricing varies based on the area treated.
• Liposuction: A fat removal procedure performed on underarms that costs $3,500.
• Endoscopic Thoracic Sympathectomy (ETS) surgery: ETS is only used for severe cases of sweaty palms as it can cause permanent damage and compensatory sweating. Price ranges from $10,000 to $25,000.
• Iontophoresis/Iontoderma: This treatment blocks sweat from reaching the skin’s surface by applying a low electrical current to hands and feet when submerged in water. Each treatment takes about 20 minutes and is performed a few times a week. This treatment can stop sweating, but it often requires maintenance appointments to keep sweating from reoccurring. You can even purchase a machine for home use for about $399.

Although hyperhidrosis can be challenging to live with, these are a few of several remedies you can try to limit the adverse effects of excessive sweating. Now you're all set with everything you need to know about hyperhidrosis!