Excessive Sweating

What is it?

Hyperhidrosis is sweating that exceeds the physiological need for thermoregulation. Primary focal hyperhidrosis — sweating of the palms, soles, underarms, or face — affects 3–5% of the population and has no identifiable cause, typically starting in adolescence. It is thought to involve overactivity of the eccrine sweat glands driven by sympathetic nervous system hyperactivation. Secondary hyperhidrosis (generalized sweating) results from an underlying medical condition or medication. The distinction is important: focal primary hyperhidrosis is a quality-of-life condition, while generalized sweating may signal serious disease.

Common causes

When to see a doctor

• 1Sudden onset of generalized sweating without a clear trigger
• 2Drenching night sweats with fever, weight loss, or lymph node swelling
• 3Sweating with chest pain, rapid heart rate, or high blood pressure (pheochromocytoma)
• 4Sweating significantly impacting work, social life, or mental health
• 5Generalized sweating in a diabetic that may represent hypoglycemia
• 6Sweating beginning in older age without a prior history

What you can do

• ✓Apply high-strength antiperspirant (aluminum chloride) at night to dry skin
• ✓Wear breathable, moisture-wicking fabrics (merino wool, synthetic performance materials)
• ✓Practice stress management — anxiety significantly amplifies primary hyperhidrosis
• ✓Avoid known triggers: spicy food, caffeine, alcohol, and hot environments
• ✓Iontophoresis (mild electrical current passed through water) is effective for palmar/plantar sweating
• ✓Botulinum toxin injections for underarms last 6–12 months and are covered by many insurance plans

Conditions that cause this symptom

Medications that may help

Treatment depends on the underlying cause. Always consult your provider before starting any medication.

Frequently asked questions