Why Do I Sweat So Much?

Sweating is the body’s natural way to cool down.

You can try to avoid underarm stains and body odor with antiperspirant and deodorant, but your body will find another outlet to help prevent overheating. For some people, though, sweating is more than a nuisance. Persistent, excessive sweating — even when you’re not exercising and the air conditioner is blowing, for instance — is called hyperhidrosis. Left untreated, this condition can be embarrassing and physically uncomfortable, especially at work and in social situations.

Treatments for hyperhidrosis are safe and effective.

“Reducing sweating can be safe when done appropriately,” says Katlein França, M.D., MSc, Ph.D., a dermatologist at the University of Miami Health System. “It’s crucial to ensure that the body can still cool itself effectively. If the body is unable to dissipate heat properly, this can lead to overheating or heat-related illnesses. So, treatments for hyperhidrosis usually target localized sweat glands and cannot shut down the body’s overall ability to cool itself completely.”

Your healthcare provider can determine the best approach for you that enables your body to safely regulate its temperature while reducing unwanted excessive sweating.

Do you have hyperhidrosis or just sweat a lot?

You can usually tell if you have hyperhidrosis by noticing excessive, visible sweating that tends to interfere with daily life for at least six months. This type of perspiration has no obvious trigger (like intense environmental heat or significant physical exertion). And, it doesn’t stop after the body has had time to cool off or calm down.

Sudden bouts of stress or anxiety can worsen this condition. But, sweating when experiencing acute stress is a normal bodily response and not necessarily a sign of hyperhidrosis.

If you’re dealing with uncontrollable, excessive sweating, Dr. França recommends seeing a dermatologist to determine if you have hyperhidrosis and if there’s an underlying medical cause. A qualified dermatologist can perform a physical exam, a blood and/or urine test, and sweat tests (iodine-starch test, thermoregulatory sweat test or a skin-conductance test) to give you an accurate diagnosis.

What are the types of hyperhidrosis?

Primary (focal) hyperhidrosis

The condition is called primary hyperhidrosis when sweating:

• begins early in life without a clear cause
• occurs mostly in specific areas (such as the hands, feet or underarms)
• is bilateral (occurs on both sides of the body)
• symmetrical (occurs in the same spots on both sides of the body)

Secondary (generalized) hyperhidrosis

When this condition is caused by an underlying health issue, medications or surgery, it’s called secondary hyperhidrosis.

In these cases, excessive sweating:

• starts later in life
• occurs all over the body
• might be accompanied by other symptoms

Finding an effective treatment for your excessive sweating

“To determine the right treatment, you and your doctor must consider the severity of your condition, the location of the excessive sweating, any previous treatments that failed you, and your preference for invasive or noninvasive methods,” Dr. França says.

Prescription antiperspirant is the first course of treatment. These topical products typically contain aluminum chloride. Your dermatologist may recommend applying a prescription antiperspirant before you go to bed and washing it off in the morning.

Nerve-blocking medication, which is taken by mouth, blocks the chemicals that allow certain nerves to communicate with each other.

Some antidepressant medications, such as those with anticholinergic properties, may help reduce sweating. However, others can increase it, so medication choice should be carefully tailored.

Botox (Botulinum Toxin) injections (typically administered in the armpits) can help reduce sweating by blocking the nerves that trigger the sweat glands. Each Botox treatment is effective for 6 to 12 months.

Iontophoresis, which can be helpful for the hands and feet, uses a mild electrical current to temporarily block the activity of sweat glands.

Microwave technology (such as miraDry) is a noninvasive treatment for underarm sweating that targets and reduces sweat glands with energy-based methods. This option requires local anesthesia and may not be available from all dermatology providers.

Fractionated microneedle radiofrequency uses radiofrequency energy to target sweat glands in the underarms.

Surgical options (such as sympathectomy) can be considered in severe cases. The sympathectomy procedure involves cutting the nerves responsible for sweating.

Managing sweat without a prescription

“Managing unwanted sweating requires a combination of lifestyle adjustments and environmental strategies,” says Dr. França.

Try these tips to help you stay drier and more comfortable:

• Avoid common sweating triggers, such as spicy foods, caffeine and alcohol.
• Opt for loose, breathable or moisture-wicking clothing. Dress in light layers that are easy to remove when you suddenly start to sweat.
• Stay well-hydrated to help regulate your body temperature.
• Practice stress-reduction techniques, like meditation or yoga, to help manage anxiety-related sweating.
• Use an air conditioner or carry a portable fan.
• At night, use a lightweight blanket or a mattress cover, if you tend to sweat through your sheets.

If you live in hot and humid South Florida, and would like to see a dermatologist, UHealth providers can diagnosis and treat hyperhidrosis.

To make an appointment, call 305-243-6704 or request an appointment online.

Written by Dana Kantrowitz, a contributor for UHealth’s news service.

Tags: hyperhidrosis excessive sweating, Katlein Paola De Franca, Sweat management tips, Sweat reduction techniques, sweating in other areas