Excessive sweating: Causes, treatment and when to see a doctor

Sweating is normal. It’s how your body cools down when you’re hot, nervous or active. But if you often soak through your shirt, it may be time to talk with a doctor.

Excessive sweating is called hyperhidrosis. If you’re wondering, “Why do I sweat so much?” you’re not alone. This condition is treatable. Here’s why it happens and what may help.

What is hyperhidrosis?

Hyperhidrosis is a condition in which your body makes more sweat than it needs to cool down. It’s more than being a “sweaty person.” Sweating can happen without warning and make daily activities harder.

There are two main types of hyperhidrosis.

Primary hyperhidrosis usually affects the underarms, hands, feet, face or scalp. It often starts in childhood or the teen years and can run in families. It also usually stops while you sleep.

Secondary hyperhidrosis happens because of another cause, such as a medicine or health condition. Unlike primary hyperhidrosis, it can affect your whole body. It may also happen when you’re resting or sleeping.

What causes excessive sweating?

Primary hyperhidrosis

Most people with excessive sweating fall into the primary category. Experts think it happens because the nerves that control your sweat glands are too active. They send signals to make you sweat even when your body doesn’t need to cool down. Experts don’t fully understand why this happens. But having a close family member with excessive sweating may raise your chances of having it too.

It usually starts before age 25, but it can affect people at almost any age.

Secondary hyperhidrosis

When sweating is caused by something else, such as a medicine or health condition, the cause may be easier to find. If you start sweating more after starting a new medicine, tell your doctor. Don’t stop taking the medicine unless your doctors tells you to. Stopping suddenly can cause problems.

Withdrawal from alcohol or certain substances can also cause sweating all over the body. Night sweats can have many causes, including medicines, infections, hormone changes or other health conditions. If you often wake up drenched in sweat, talk with your doctor.

How is hyperhidrosis treated?

The good news: excessive sweating can often be treated. The best treatment depends on what’s causing it and where you sweat the most.

Possible treatments include:

• Antiperspirants. Prescription antiperspirants are stronger than the regular ones you find at the drugstore. They work by temporarily blocking sweat glands. You apply them to dry skin, usually at night. Over a few weeks, they may reduce sweating enough that you only need to use them once or twice a week.
• Prescription medicines. These are usually for the underarms. Glycopyrronium wipes (brand name Qbrexza) and sofpironium gel (Sofdra) work by reducing the amount of sweat the glands can produce, kind of like antiperspirants. Both are approved by the U.S. Food and Drug Administration for people 9 years of age and older.
• Botulinum toxin injections (Botox). Botox is FDA-approved for hyperhidrosis. It can be effective for the underarms, hands, feet and face. Results can last several months before treatment is needed again.
• Iontophoresis. Iontophoresis is a treatment that delivers ions to the skin. A gentle electric current passes through water or a medicated solution to help reduce sweating in the hands and feet. It’s cleared by the FDA for hand and foot sweating and usually requires daily sessions to start, tapering to weekly maintenance once sweating is controlled.
• Oral medicines. Glycopyrronium or oxybutynin can lower whole-body sweating. Doctors may use these when other treatments don’t work or when sweating affects many areas of the body.
• Microwave thermolysis. This treatment is specifically for hyperhidrosis. It’s also called MiraDry. It uses microwave energy to stop the sweat glands in the underarms from making sweat.
• Surgery. Surgery may remove sweat glands from the underarms or interrupt nerve signals that trigger sweating in the hands and underarms. It’s often reserved for when other treatments haven’t worked.

When should you see a doctor for excessive sweating?

Many people live with excessive sweating for years, because they don’t know treatment can help. If sweating affects your daily life, such as causing you to avoid social situations or change clothes often, consider making an appointment with a doctor.

See a doctor as soon as possible if you have:

• Sudden sweating that gets worse
• Heavy sweating all over your body
• Waking up drenched in sweat
• Sweating after starting a new medicine
• Other symptoms, such as weight loss, fever or a racing heart

These signs may point to secondary hyperhidrosis. Treating the cause may help reduce sweating.

A dermatologist can diagnose the type you have, look for underlying causes and create a treatment plan based on where and how much you sweat.

Takeaway

You don’t have to ignore sweating that gets in the way of daily life. Hyperhidrosis is a recognized medical condition. Whether you sweat in one area or all over your body, your doctor can talk with you about treatment options that may help.

At Crystal Run, our dermatologists diagnose and treat conditions and diseases of the skin, scalp, hair, and nails with both medical and surgical interventions. Our dermatologists treat a wide variety of dermatologic conditions, from acne and psoriasis to rosacea and shingles. At Crystal Run Dermatology, we counsel our patients on skin and sun safety and encourage annual skin cancer screenings. Our dermatologists treat all forms of skin cancer and perform several in-office dermatologic procedures.