Hyperhidrosis (excessive sweating): treatment, causes and symptoms

The NHS says you can see a pharmacist about excessive sweating and buy stronger antiperspirants instead of deodorant, armpit or sweat shields to protect clothing, foot powders and soap substitutes that are gentler on the skin. BAD explains that an antiperspirant reduces sweating while a deodorant reduces smell.

If these fail and the sweating is troublesome, ask your doctor for advice. BAD says the doctor will assess whether there is an underlying cause and may start treatment, and refer you to a dermatologist if necessary. Stronger aluminium chloride preparations can be prescribed; they should be applied at night only to dry skin, and sore red skin is a common problem that hydrocortisone cream can help.

The NHS says a dermatologist may recommend tablets that reduce sweating, a cream you put on your skin, iontophoresis (a weak electric current passed through water or a wet pad), botox injections for sweating under the armpits (which may not be available on the NHS), or surgery such as removal of the sweat glands.

NHS inform says often there is no obvious cause, which is known as primary hyperhidrosis. Secondary hyperhidrosis is when a cause can be found, such as certain medications, menopause, pregnancy, obesity, hormonal conditions like an overactive thyroid, diabetes, infection or low blood sugar. It says secondary hyperhidrosis often starts more suddenly and usually affects the whole body.

BAD says the cause of the common focal type is not known. Sweating all over can have no cause or be caused by illnesses including infections, and by hormonal conditions including the menopause, diabetes and an overactive thyroid. Some medicines can cause it, including fluoxetine and similar antidepressants, and rarely nerve damage. Anxiety can worsen sweating, and worrying about it can make it worse.

BAD adds that up to a third of people with hyperhidrosis may have a family member with it.

NHS inform describes visible sweat, wet clothes and clammy palms. It may affect the whole body or only certain areas such as the hands and feet, and both sides of the body are usually affected equally. BAD says it can be embarrassing and affect work and personal relationships. Sweaty hands can cause problems with shaking hands, writing on paper, using keyboards, playing musical instruments and playing racquet sports.

Excessive sweating is not usually serious, but NHS inform says it can increase the risk of fungal infections such as athlete's foot or fungal nail infections, and can make people more vulnerable to skin conditions like warts. It can also make you feel self-conscious and anxious, which can worsen the sweating in a cycle.

The NHS suggests wearing loose-fitting clothes to minimise signs of sweating, wearing socks that absorb moisture and changing them at least twice a day, wearing leather shoes and different shoes day to day. It suggests not wearing tight clothes or synthetic fabrics such as nylon, or enclosed boots or sports shoes that may make feet sweat more, and not doing things that make sweating worse, for example drinking alcohol or eating spicy food.

The NHS says to see a GP if you are sweating excessively and things you can do yourself are not helping, it has lasted at least 6 months, it stops you getting on with daily activities, it happens at least once a week, it happens at night (night sweats), you have a family history of excessive sweating, or you are taking medicine for another condition.

The GP may refer you for tests if they think another condition may be causing it. BAD says the doctor may rarely suggest tests for an infection, diabetes, thyroid overactivity or other conditions. If there is no obvious cause and nothing is helping you may be referred to a dermatologist.

BAD says hyperhidrosis seems to get better with increasing age and is uncommon in the elderly. There are many treatments that help reduce sweating, and surgical treatment such as sympathectomy can help some people but is often associated with serious side effects, so it is not usually recommended.

The NHS likewise says sometimes it gets better with age but there are things you can do and treatments that can help.

Start with a pharmacist and your GP. The NHS says botox for armpit sweating may not be available on the NHS, and BAD says it is widely available privately but rarely on the NHS, while miraDry is not usually an NHS procedure. Hyperhidrosis UK is named by the NHS as a source of further information.

If you pay privately, ask about risks and how long benefits last. BAD says the effect of botulinum toxin usually lasts 2 to 6 months, although some people benefit for up to 12 months, and that the treatment can be repeated.