Patient information · Dermatology and aesthetics
Excessive sweating
a treatable medical condition, not a personal failing
Hyperhidrosis is sweating far beyond what the body needs for temperature control. It affects roughly one to three people in a hundred, commonly begins in adolescence, and has a substantial effect on work, clothing, relationships and confidence. It is treatable at every level, and most people never ask.
Seek assessment rather than treating it as simple hyperhidrosis if sweating
- started suddenly in adulthood, or has changed recently
- occurs mainly at night, drenching the bedding
- comes with weight loss, fever or swollen glands
- comes with palpitations, tremor or heat intolerance
- is one-sided, or in an unusual distribution
- comes with flushing, headaches or very high blood pressure
Night sweats with weight loss need investigating for infection, lymphoma and other serious causes. Sudden onset in adulthood suggests a secondary cause — thyroid disease, diabetes, menopause, infection, anxiety disorder, or a medication side effect — and treating the cause treats the sweating.
Primary or secondary
- Primary hyperhidrosis — begins in childhood or adolescence, affects specific sites (underarms, palms, soles, face or scalp), is usually symmetrical, occurs at least weekly, stops during sleep, and often runs in families.
- Secondary hyperhidrosis — begins later, is generalised rather than focal, often occurs at night, and has an underlying cause worth finding.
Treatment, in order
Almost everyone uses antiperspirant wrongly
Aluminium chloride antiperspirant must be applied to completely dry skin, at night before bed, and washed off in the morning. Sweat glands are least active overnight, which is when the product can plug them. Applied to damp skin in the morning it does very little and causes irritation. Start with two or three nights a week and reduce frequency as it takes effect. If it stings, apply a bland moisturiser the following morning or use a lower concentration — do not simply abandon it.
- Iontophoresis — a weak electrical current passed through water, mainly for hands and feet. Effective, requires several sessions weekly at first then maintenance, and machines can be used at home.
- Botulinum toxin injections — highly effective for underarm sweating, blocking the nerve signal to the sweat glands. Results appear within one to two weeks and last around four to six months, sometimes longer. Also used for palms and face, though injections there are more uncomfortable.
- Oral medication — anticholinergics such as oxybutynin or glycopyrronium reduce sweating throughout the body. Dry mouth, blurred vision and constipation are common and dose-limiting.
- Topical glycopyrronium for facial sweating.
- Surgery — sympathectomy is a last resort. It is effective but carries a significant risk of compensatory sweating elsewhere, which can be worse than the original problem and is not reversible.
Day to day
Helps
- Natural fabrics; black or white shows sweat least
- Underarm shields or moisture-wicking undershirts
- Changing socks twice daily, with moisture-absorbing insoles
- Antibacterial soap, and treating athlete's foot
- Reducing caffeine, alcohol and spicy food if they trigger it
Worth knowing
- Sweating attracts no odour until bacteria act on it
- Deodorant masks smell; antiperspirant reduces sweat — they are different products
- Anxiety about sweating increases sweating, which is why treatment often helps mood too
- Some antidepressants cause sweating and can be switched
- It frequently improves in later adulthood
Why come to us. Hyperhidrosis is rarely raised and easily helped. We assess whether there is a secondary cause — checking thyroid function, glucose and other bloods in-house — and then treat the sweating properly: prescription-strength antiperspirants, oral medication where appropriate, and botulinum toxin injections for underarm sweating performed here by our medical aesthetics team. Discreet appointments, seven days a week, with published fees and no referral needed.
Botulinum toxin and prescription treatment here
Discreet appointments, published fees, seven days a week.
Tower Bridge Hospital London
97–99 Whitechapel Road, London E1 1DT
WhatsApp 07903 284 189
info@mhwclinic.co.uk
Open Mon–Sat, 9am–7pm (closed Sundays until September)
In an emergency
Call 999, or go to the Royal London Hospital Emergency Department, Whitechapel Road, London E1 1FR.
When we are closed and it is not an emergency
Call NHS 111 or visit 111.nhs.uk.