Hyperhidrosis: causes and Treatments

Causes and Types of Hyperhidrosis
Hyperhidrosis Treatment

Hyperhidrosis is a medical condition that causes excessive sweating. The word “hyperhidrosis” means too much (hyper) sweating (hidrosis). People of all races and ages can develop this condition.

While sweating is necessary to cool the body and prevent us from overheating, people who have hyperhidrosis sweat when the body does not need cooling. Most people with hyperhidrosis sweat from one or two areas of the body, typically from their palms, feet, underarms, or forehead.

This excessive sweating can interfere with daily activities. Sweaty hands can make it difficult to turn a doorknob, hold a pen, or use a computer. Sweat from the underarms often soaks through clothes, causing embarrassing sweat marks. Because the skin is often wet, skin infections such as jock itch, which are fungal infections, can develop.

If excessive sweating interferes with your life, the practitioners at Water’s Edge Dermatology can help find an effective treatment for you.

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Causes and Types of Hyperhidrosis

Certain nerves tell the body when to sweat. In hyperhidrosis, the nerves responsible for triggering your sweat glands overreact, causing excessive sweating. The problem becomes even worse when stressed or nervous.

Primary focal hyperhidrosis: When there is no underlying cause of heavy sweating, this condition is called primary focal hyperhidrosis. It typically begins during childhood or adolescence. Genetics may play a role, as those who have a family member with primary hyperhidrosis are more likely to develop the condition.

This type of hyperhidrosis usually affects one or a few areas of the body, like the underarms, palms, feet, or forehead, and occurs on both sides of the body.

Sweating may begin soon after the person wakes up. Most people experience at least one episode a week, but for others it occurs much more often.

Secondary hyperhidrosis: “Secondary” means that there is an underlying cause for the excessive sweating. The cause could be a medical condition or side effect of taking a medicine or food supplement.

Medical conditions that can cause excessive sweating include:

  • Diabetes
  • Frostbite
  • Gout
  • Injury, such as head trauma caused by an accident
  • Menopause
  • Obesity
  • Overactive thyroid (hyperthyroidism)
  • Tumor

Unlike primary hyperhidrosis, secondary hyperhidrosis is more likely to cause excessive sweating all over the body. In addition, sweating typically occurs while asleep.

This type of sweating usually begins when the person is an adult. Many medicines or food supplements also may cause this type of hyperhidrosis.

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Hyperhidrosis Treatment

Your Water’s Edge dermatologist can recommend a treatment to control excessive sweating and greatly improve your quality of life. Treatment depends on the type of hyperhidrosis and where the excessive sweating occurs on the body. Possible treatments include:


Clinical-strength antiperspirants are the first line of treatment for excessive underarm sweating. They typically contain 10% to 20% aluminum chloride. There are many affordable over-the-counter choices available. Antiperspirants work by plugging your sweat glands as you sweat, preventing perspiration from reaching the skin’s surface.

If these antiperspirants are not effective, your Water’s Edge Dermatology practitioner can prescribe one with a higher dose of aluminum chloride. Instead of wearing it during the day, this stronger antiperspirant is applied to the affected skin at night before bed and washed in the morning when you wake up. Prescription-strength antiperspirants may also be applied to the hands, feet, or hairline.


This at-home treatment uses low-voltage electricity to temporarily turn off the sweat glands. It is most effective for excessive sweating of the hands, feet, or both areas.

With your hands or feet placed into a shallow pan of water, the iontophoresis device delivers a gentle electrical current through the water. You should gradually increase the strength of the current until you feel a light tingling sensation.

Your Water’s Edge dermatologist will teach you how to use the device and let you know how often to use it. Most people need about 6 to 10 treatments to shut down the sweat glands. At first, you may need 2 or 3 treatments per week for several weeks. A treatment session usually takes 20 to 40 minutes.

Once you see results, you can repeat the treatment as needed to maintain results. This can range from once a week to once a month.

You may also obtain a prescription so that you can buy an iontophoresis device.

Botulinum Toxin Injections

BOTOX® injections may be used to temporarily treat the underarm area. Your Water’s Edge dermatologist can inject very small amounts of a weak form of this medicine into many areas of your underarms.

Botulinum toxin injections work by temporary blocking the nerves that trigger sweat glands. Most patients notice results 4 to 5 days after receiving treatment.

Reduced sweating lasts about 4 to 6 months. When the excessive sweating returns, you can be retreated.

Prescription Medicine

Your Water’s Edge dermatologist may recommend a prescription medication that temporarily prevents you from sweating. These medicines can effectively treat sweating that involves entire body. They may also be an effective treatment for post-menopausal women who sweat excessively only from their head.


If other treatments fail to bring relief, your Water’s Edge dermatologist may recommend surgery. One surgical option to treat the underarms is to remove the sweat glands. This can be performed as a simple office-based procedure. Only the area to be treated is numbed, so you remain awake during the surgery.

Your dermatologist may use laser surgery, curettage (scraping), excision (cutting), or liposuction (suctioning out) to remove sweat glands from the underarms.

Endoscopic thoracic sympathectomy is mainly used to treat severe cases of hyperhidrosis that affect the palms. During this minimally invasive procedure, the surgeon will cut or destroy the nerves that control sweating in the hands.

To find these nerves, the surgeon inserts a mini surgical camera into the chest just beneath the underarm. The patient’s lung must be temporarily collapsed. This is major surgery and is performed in an operating room under general anesthesia.

Non-surgical Treatment Using Electromagnetic Energy

This noninvasive, outpatient treatment option was approved by the FDA in 2011. It may be used to treat excessive sweating under the arms.

If your Water’s Edge Dermatology practitioner recommends this option, he or she will use a handheld device that emits electromagnetic (microwave) energy, which destroys the sweat glands under the arms.

The treatment takes about an hour for both arms, with a second treatment needed in three months. Most patients experience an average 85 percent sweat reduction after treatment and the results may last forever.

This device can only treat the underarms because this area of the body has enough underlying fat to protect itself. This device cannot be used to treat the hands and feet because these areas do not have enough fat.

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