What is Excessive Sweating (Hyperhidrosis)?

Hyperhidrosis is heavier than normal sweating that is unrelated to heat or exercise. Hyperhidrosis or bothersome sweating often occurs on the face, axillas, palms and soles.

Hyperhidrosis or bothersome sweating is not uncommon, affecting 1-5% of people.

Hyperhidrosis or bothersome sweating can cause anxiety or embarrassment at work and in in social settings, as well as frustration due to having one's clothes ruined by sweat stains.

What causes Hyperhidrosis?

There are two types of hyperhidrosis: 

• Primary (focal) hyperhidrosis and 
• Secondary (generalized) hyperhidrosis

Primary hyperhidrosis has no known cause, but is sometimes inherited.  Generally, onset is in childhood or adolescence or before the age of 25 and is usually focal, affecting the face, axillas, palms and / or soles. Also, primary focal hyperhidrosis is usually bilateral and symmetrical, affecting both axillas, palms and / or soles and episodes occur at least weekly.

Secondary (generalized) hyperhidrosis is caused by another medical condition or a medication side effect.  Secondary hyperhidrosis is often generalized (involving large areas) and starts after adolescence in adulthood. Evaluation starts with your primary care physician to determine if you may have any underlying causal medical condition that may be treated or a medication side effect requiring an alternative medication. 

What treatments are available for Hyperhidrosis?

Treatment options for hyperhidrosis include:

• Topically applied over-the-counter and/or prescription antiperspirants, including: 
• Drysol, Qbrexa (topical glycopyrrolate)‍
• Iontophoresis (for hands and feet) 
• Botulinum toxin injections (Botox)‍
• miraDry for axillary hyperhidrosis (microwave technology)‍
• Oral medications [anticholinergics, including glycopyrrolate (Robinol) and others]
• Endoscopic thoracic sympathectomy (a last resort for palmar/hand sweating)