• Overview
• Causes and risk factors
• Signs and symptoms
• Impact on quality of life
• Treatment and management
• Diagnosis

Heavy sweating may be normal and helpful, as is the case when you exercise; it’s part of the body’s natural cooling system. But it can be most unwelcome, often when you’re feeling anxious – during an important work presentation or a first date, for example. In some people, the sweat glands overreact and cause excessive sweating for no apparent reason. The medical term for excessive sweating is hyperhidrosis¹

The exact causes of excessive sweating are often not known. People who experience excessive sweating don’t have more sweat glands than normal, but the nerve that controls sweating is overly sensitive and stimulates the sweat gland to produce too much perspiration.²

Excessive sweating is divided into two types to help understand its cause and decide on appropriate management:³

Primary focal hyperhidrosis is the more common type. Here, the causes of excessive sweating are not fully understood, but it tends to run in families.⁴

 Secondary generalised hyperhidrosis: causes of excessive sweating are due to underlying medical conditions, including:

• Nervous system conditions e.g. Parkinson’s disease
• Metabolic conditions e.g. overactive thyroid, diabetes.
• Gout
• Menopause
• Alcoholism
• Infections e.g. tuberculosis.
• (Certain cancers may cause “night sweats” – excessive sweating during sleep.)
• Stress or anxiety

Some medications may cause excessive sweating e.g. certain painkillers, zinc supplements, antidepressants, insulin.^3,4

Common signs of excessive sweating include:

• Visible sweating (beading or dripping sweat, wet clothing).
• Sweaty hands causing difficulties with e.g. holding pens, turning door knobs or using a computer.
• Skin that stays wet for long periods, becoming soft and peeling.
• Skin irritation and infection in sweat-prone areas.
• Body odour.
• Sweat-stained clothing.

Symptoms suggest whether excessive sweating is primary or secondary.

Primary focal hyperhidrosis typically:

• Affects one area of the body, or just a few.
• Occurs on both sides of the body e.g. both hands.
• Starts after waking up.
• Occurs at least once a week.
• Begins before age 25.

Secondary generalised hyperhidrosis usually starts in adulthood, and may affect the whole body. It may occur during sleep.^1,4

Controlling excessive sweating can be challenging. Some people keep a towel with them because of constantly sweaty hands, or change their clothes several times daily.

In addition to the practical nuisance aspect, it may be frustrating and embarrassing to have sweat visibly dripping from your face or palms, or wet patches on your clothes. Sweat can develop a pungent odour if it mixes with bacteria on the skin, making it difficult to stay feeling fresh throughout the day.¹

People with excessive sweating may feel they should avoid touching others with sweaty hands or worry about causing offence with body odour and damp clothing. They may even withdraw and become socially isolated, giving up activities they enjoy. This can negatively impact relationships and careers, and raises risk for depression and anxiety.²

The first step is to find a truly effective antiperspirant and follow some straightforward sweat management tips.²

Many deodorants and antiperspirants are insufficient for dealing with a debilitating excessive sweating problem.

However there is a specialist aluminium-based antiperspirant range designed for people who struggle with excessive sweating; it works by sealing the sweat glands and drying the skin. Its effective formulation, while comfortable to wear, is clinically proven to be potent and durable, providing up to five days’ protection against sweat and odour.

The range includes roll-on antiperspirants of different strengths, as well as hand and foot lotion, to tackle all kinds of sweat problems, and can often be purchased through medical aid – find out if your scheme covers this.

Aluminum-based antiperspirants, which work by sealing sweat glands and drying the skin, are very effective e.g. the Perspirex range.

Perspirex is specifically designed for people who experience excessive sweating; its formulation is comfortable, and provides potent, long-lasting (up to five days) protection against sweat and odour.

The range includes roll-on antiperspirants of different strengths, as well as hand and foot lotion, to tackle all kinds of sweat problems.

Another advantage of this brand is that Perspirex can often be purchased through medical aid – find out if your scheme covers this.

Together with a hard-working antiperspirant, you may well be able to manage your excessive sweating with these tips:

• Shower more frequently.
• Wear breathable, loose-fitting natural fabrics.
• Wear absorbent socks; change them often.
• Avoid enclosed boots and sports shoes; swap shoes out daily.
• Try armpit sweat shields to protect clothing.
• Try foot powder for sweaty feet.
• Identify and avoid triggers that worsen your sweating e.g. alcohol, spicy food.⁵

If you find these initial measures aren’t sufficient, you and your doctor can look into further options:

Oral medications called anticholinergics cause a drying reaction and can make aluminum-based antiperspirants work better. These may be useful for excessive sweating in multiple areas of the body.

Your doctor may recommend an antidepressant or other anti-anxiety medication if stress or anxiety seem to cause excessive sweating.^2,4

Iontophoresis uses a weak electrical current to block the sweat glands.

Botox injections temporarily block the nerves that make you sweat, reducing sweating for three to six months.

Microwave thermolysis uses microwave energy to destroy the underarm sweat glands. Only 2% of sweat glands occur in the armpit, so the body’s cooling ability isn’t affected.

Surgery can remove sweat glands or disconnect the nerves that control the sweat reaction, in severe cases that don’t respond to other therapies.^1,2,3

Psychotherapy can be helpful in reducing negative emotional reactions that cause stress and anxiety, which in turn may be causes of excessive sweating.²

If you’re sweating excessively and it’s negatively impacting your daily life, causing you to avoid activities or people you care about, you should try a specialist aluminium based anti-perspirant range designed specifically to address this problem and talk to your pharmacist. 

You should only consult your GP for  excessive sweating if:

• It persists for at least six months.
• It occurs at night.
• You have a family history of excessive sweating.
• You’re taking medication for another condition.⁵

Your doctor will likely do a physical exam and take your medical history, and may also do a non-invasive test to measure the level of sweating, e.g. using a device called a vapometer to measure the amount of sweat from hands, underarms, feet and scalp.^2,4

You may need other tests if an underlying condition is suspected.⁵