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Hyperhidrosis Key Facts

(Current Version)
Hyperhidrosis (excessive sweating) is a common condition affecting millions of people around the world. Sweating more than the body needs to regulate temperature can significantly impact daily life, confidence, and wellbeing.
What is Hyperhidrosis?
Hyperhidrosis is when you sweat excessively and unpredictably, often beyond what is needed to cool the body. It can affect the entire body or specific areas such as the hands, feet, armpits, or face, and can occur even when you are not hot or exercising.
Types of Hyperhidrosis
Hyperhidrosis can be classified into two main types:
- Primary (Focal) Hyperhidrosis is the most common form and typically affects specific areas of the body. It is not caused by an underlying medical condition or medication and often begins in childhood or adolescence.
- Secondary (Generalised) Hyperhidrosis affects the whole body and is caused by an underlying medical condition or as a side effect of medication. It tends to occur in adults and often presents during sleep.
Primary and Secondary causes of Hyperhidrosis
Primary Hyperhidrosis is thought to be related to overactivity of the nerves that stimulate sweat glands, and may have a genetic component. Secondary Hyperhidrosis is linked to conditions such as diabetes, menopause, thyroid disorders, infections, or the use of certain medications.
Diagnostic process and sweat assessment
Diagnosis involves a medical review, an assessment of your sweating patterns, and an evaluation of any underlying conditions. Tests such as the starch-iodine test or thermoregulatory sweat test may be used to identify the affected areas and severity.
Causes of Hyperhidrosis
Several risk factors can increase your risk of developing Hyperhidrosis. These include:
- Overactive sweat glands triggered by the nervous system
- Underlying medical conditions such as diabetes, thyroid disorders, or infections
- Hormonal changes including menopause, pregnancy, or puberty
- Certain medications such as antidepressants, beta-blockers, or opioids
- Anxiety, stress, or emotional triggers
- Obesity or being overweight
- Excessive consumption of alcohol, caffeine, or spicy foods
- Family history of Hyperhidrosis
- Hot weather or physical activity
- Neurological conditions
Impact on physical and mental health conditions
Chronic Hyperhidrosis can lead to skin infections such as athlete’s foot or fungal nail infections. It is also strongly associated with anxiety, social withdrawal, depression, and a reduced quality of life, as sufferers may avoid social situations or physical contact due to embarrassment.
Treatments for Hyperhidrosis
Prescription antiperspirants containing aluminium chloride are usually the first-line treatment and are applied directly to the affected areas. For those with severe primary axillary Hyperhidrosis, Axhidrox (glycopyrronium 2.2 mg/pump actuation cream) is a prescription-only topical treatment applied directly to the underarms. Axhidrox works by competitively blocking muscarinic acetylcholine receptors in the sweat glands, inhibiting the nerve signals that trigger perspiration. The recommended dose is two pump actuations per armpit, applied once daily in the evening for the first four weeks; from week five onwards, frequency can be reduced to twice weekly depending on response. Clinical studies showed Axhidrox produced approximately twice the sweat reduction of placebo after four weeks, with continued improvement in symptoms and quality of life over up to 72 weeks of use. Axhidrox is for adults only and is for use in the underarm area exclusively — it should not be applied to hands, feet, face, or other areas. Common side effects include dry mouth, dry eye, nasal dryness, application site reactions, and headache. It should be used with caution in patients with glaucoma, urinary retention, myasthenia gravis, or cardiovascular conditions. Other anticholinergic medications such as tricyclic antidepressants or antihistamines may increase the risk of anticholinergic side effects if used at the same time.
Other medical treatments include broader anticholinergic oral medications, which reduce the signals that trigger sweat glands, and should be taken as prescribed by a healthcare professional as they can cause side effects. Botulinum toxin (Botox) injections are also used for localised sweating, particularly in the armpits.
Skincare and lifestyle changes
Good skincare routines and making lifestyle changes can help manage symptoms and reduce the impact of Hyperhidrosis on daily life:
- Wearing loose, breathable clothing made from natural fibres
- Using clinical-strength antiperspirants regularly
- Showering daily and after physical activity
- Avoiding known triggers such as spicy foods, alcohol, or caffeine
- Keeping cool and managing stress levels
Cognitive behavioural therapy for Hyperhidrosis
Cognitive behavioural therapy (CBT) can help patients manage the anxiety and psychological distress associated with Hyperhidrosis. It aims to identify and modify thoughts and behaviours that worsen anxiety around sweating, and can significantly improve quality of life alongside medical treatment.
Relaxation and mindfulness
Deep breathing exercises, progressive muscle relaxation, and meditation can all help to calm the nervous system, reduce anxiety-related sweating triggers, and improve overall emotional wellbeing for those living with Hyperhidrosis.
Hyperhidrosis in certain age groups
Common causes of Hyperhidrosis in children and teenagers include hormonal changes during puberty and a genetic predisposition. It can cause significant distress and social anxiety in young people, making early diagnosis and treatment important.
As we get older, Hyperhidrosis may develop or worsen due to hormonal changes such as menopause, the onset of new medical conditions, or medications prescribed for other health issues.
Preventing Hyperhidrosis
- Maintain good personal hygiene and use appropriate antiperspirant products from an early age to manage symptoms.
- Identify and avoid personal triggers. Keeping a diary of when sweating worsens — noting food, stress levels, and activity — can help you and your clinician find patterns and adjust treatment.
- Manage stress and emotional wellbeing. Exercise, mindfulness, and speaking to a therapist can reduce anxiety-related sweating and improve confidence.
Skincare routines
Washing affected areas daily with an antibacterial soap and ensuring the skin is thoroughly dry before applying antiperspirant will help prevent skin infections and improve the effectiveness of topical treatments, including Axhidrox.
Regular exercise
Regular exercise helps to manage body weight, reduce overall stress, and improve cardiovascular health — all of which can positively influence the severity of sweating. Low-intensity, low-heat activities such as swimming or yoga may be particularly beneficial.
Dietary choices
Avoid spicy foods, caffeine, and alcohol, as these are common triggers that stimulate sweat glands. Staying well hydrated with water and eating a balanced diet can also help regulate body temperature more effectively.
When to consult a healthcare provider
Consult a healthcare provider if sweating is affecting your daily life, causing skin infections, or if it starts suddenly without a clear cause, as this may indicate an underlying condition requiring treatment. Prescription treatments such as aluminium chloride-based antiperspirants, Axhidrox, or anticholinergic medications can be prescribed following a consultation.
Finding a specialist or dermatologist
Dermatologists and specialist clinicians can offer a range of treatments for Hyperhidrosis when first-line options have not been effective, including Axhidrox, Botox injections, iontophoresis (a treatment using mild electrical currents), or in severe cases, surgical options such as sympathectomy.
Conclusion
Understanding the causes, symptoms, and treatments available for Hyperhidrosis is essential to managing the condition effectively. With the right support and access to modern prescription treatments such as Axhidrox, most people are able to significantly reduce symptoms and improve their quality of life.
Sources
- NHS – Hyperhidrosis
- Mayo Clinic
- Cleveland Clinic
- WebMD
- American Academy of Dermatology
- British Association of Dermatologists
- medicines.org.uk – Axhidrox Summary of Product Characteristics (SmPC)
NowPatient has taken all reasonable steps to ensure that all material is factually accurate, complete, and current. However, the knowledge and experience of a qualified healthcare professional should always be sought after instead of using the information on this page. Before taking any drug, you should always speak to your doctor or another qualified healthcare provider.
The information provided here about medications is subject to change and is not meant to include all uses, precautions, warnings, directions, drug interactions, allergic reactions, or negative effects. The absence of warnings or other information for a particular medication does not imply that the medication or medication combination is appropriate for all patients or for all possible purposes.
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