Hyperhidrosis: when perspiration becomes excessive

Sweating is your body’s way of controlling its temperature, so it’s natural to perspire when you’re hot.

Sweat glands – found all over the body but in larger numbers on the forehead, armpits, palms and soles of the feet – are activated by the nervous system and release a fluid made mostly of water and salts. When it evaporates, this fluid cools the skin.

A variety of things can trigger the sweat glands into action, including hot temperatures, exercising, eating hot or spicy foods, having a fever and emotional stress.

If you sweat excessively, however, the condition is known as hyperhidrosis. And while it may not be life-threatening, hyperhidrosis can be distressing, not to mention embarrassing, for the one to three in every 100 people thought to be affected by it in the UK.

What causes it?

Primary hyperhidrosis has no obvious cause, though secondary hyperhydrosis is thought to be related to an underlying health problem or can be a side effect of taking certain medicines.

Experts believe some people with primary hyperhidrosis are affected because the condition runs in their family. If you have secondary hyperhidrosis, however, there are several common causes, including menopause, an overactive thyroid gland, low blood sugar, taking recreational drugs and drinking excessive amounts of alcohol. Parkinson’s disease, infections such as HIV or tuberculosis, and blood cell and bone marrow disorders such as leukaemia or lymphoma can also cause secondary hyperhidrosis, as certain medicines such as some antidepressants.

If you think you may have hyperhidrosis, it’s a good idea to see your GP to rule out any of the above underlying causes. Most importantly, you don’t have to just put up with it, and there are several things that could help:

Pharmacy products   Whether or not you have been diagnosed with hyperhidrosis, your local pharmacist can help. Ask about effective strong antiperspirants that are available over the counter, as well as absorbent powders that soak up excessive sweat. Many experts also believe soap can make hyperhidrosis worse, so ask your pharmacist to recommend an emollient wash and moisturiser to use instead. Many pharmacists may also stock sweat pads that absorb underarm moisture.

Prescription antiperspirants   If over-the-counter products don’t work for you, your GP may be able to prescribe a more powerful antiperspirant that contains aluminium chloride. The disadvantage of prescription antiperspirants is that they can cause mild skin irritation. If that happens, however, ask your pharmacist to recommend a cream or lotion that can provide relief. Meanwhile, if you do use a prescription antiperspirant, ask your pharmacist to explain how to use them, as they aren’t applied in the same way as over-the-counter antiperspirants.

Prescription medicines   Drugs that block the effect of a chemical used by the nervous system to active the sweat glands – called anticholinergics – may also help some people, though these aren’t widely used for hyperhidrosis.

Hospital treatments   Further treatments are available if your condition is severe and your GP refers you to a hospital dermatologist, including iontophoresis (which passes a low-intensity current through your hands, feet or armpits), Botox (which works by blocking the nerve endings in your armpits), prescription drugs and, as a last resort, surgery to remove your sweat glands.

Self-help tips

If some of the things that make you sweat a lot can be avoided – such as spicy food, alcohol, smoking or caffeine – it’s a good idea to steer clear of them. Meanwhile, there are some other steps you can take to keep sweating to a minimum:

  • Use antiperspirant spray rather than deodorants (deodorants simply mask the smell of odour, whereas antiperspirants minimise sweat production).
  • Choose cool, loose clothing and avoid man-made fibres that make you sweat, such as nylon and polyester (ask your pharmacist about sweat pads that help protect your clothing).
  • If your feet are affected, wear leather, canvas or mesh footwear and avoid anything made from synthetic materials (including trainers).
  • Make sure your socks are made from cotton and other natural fibres, or wear sports socks that are designed to absorb moisture. Change your socks at least twice a day, and avoid any made from synthetic materials.

To find your nearest local pharmacy, use our Pharmacy Finder. Meanwhile, to find out more about hyperhydrosis, visit the Hyperhidrosis Support Group’s website.