Everyone sweats from their head and neck sometimes, but for some people this type of sweating can be persistent and relentless. This is when it becomes a problem. Excessive sweating of the face, head, and neck is medically known as href="/blogs/sweatopedia/craniofacial-hyperhidrosis-causes-and-treatment-optionshtml">craniofacial hyperhidrosis. This type of sweating is most often a symptom of a skin condition called primary focal hyperhidrosis that causes people to sweat excessively from specific areas of their body for no apparent reason. However, it can also be caused by secondary generalized hyperhidrosis, a different type of hyperhidrosis that has a known underlying cause. If you are struggling with facial sweat, it can be hard on your confidence. Your face is crucial to your social interactions and it is critical that you feel comfortable in your own skin. Thankfully, there are several effective treatments that can help you reduce your sweating and improve your quality of life. The type of treatment that will work best for you depends on which type of hyperhidrosis you have and what your problem areas are.[1].

Treatments for Head and Neck Sweating Caused by Primary Focal Hyperhidrosis

It may be comforting to know that there are a lot of people who struggle with excessive head and neck sweating. According to one retrospective study published in the Journal of Dermatologic Clinics, about 5% of people with primary focal hyperhidrosis (PFH) have craniofacial involvement. While this may seem like a relatively small percentage, because there are so many people with PFH, it is actually a large amount of people.[1] It is also thought that somewhere between 30% and 50% of people with excessive facial sweating have other people in their family with the same problem.[2] This means you are not alone! Due to the fact that craniofacial hyperhidrosis can cause such debilitating symptoms it is important that you have access to treatment. It can make an enormous difference. There are several treatments you can explore which range from minimally invasive methods to very invasive treatments like surgery. Here is a breakdown of the treatments that are currently available:

  • Antiperspirant - Over-the-counter topical treatments for hyperhidrosis are the first-line treatment a doctor will prescribe. This means that they are a dermatologists first choice when beginning to treat a patient for hyperhidrosis. Antiperspirant is safe to use on the face, head, and neck, but it is always wise to speak with a doctor before trying a new product. There are some antiperspirants made specifically for the face that can be useful for those with sensitive skin. Be careful when selecting an antiperspirant for your face because the active ingredients in antiperspirant can easily irritate sensitive skin.[1]
  • Botox injections - Botox is approved by the FDA for the treatment of axillary hyperhidrosis, but it can also be used to reduce sweating on other areas of the body, like the face. When used correctly, Botox can be a very effective treatment for craniofacial hyperhidrosis as it has such high success rates. However, you need to be careful when selecting a doctor as the injections can be difficult to administer and require specific knowledge. There can be side effects, like mild facial paralysis, associated with treatment.The risks associated with Botox injections are much lower if it is administered by an experienced doctor.[1]
  • Oral medications - There are some oral medications for hyperhidrosis that can be helpful in the treatment of head and neck sweating. They are usually recommended after local treatment options have already been tried because they have the potential to cause systemic side effects. Oral medication is often helpful when used in combination with other therapies, but some find them effective on its own. Typically, a type of medication called an anticholinergic, like glycopyrrolate or oxybutynin, is used to treat hyperhidrosis. Sometimes, less frequently, doctors may use beta blockers, clonidine, or benzodiazepines (anxiety medication) to treat the symptoms of hyperhidrosis. If your hyperhidrosis is exacerbated by chronic anxiety or depression your doctor may also choose to try an antidepressant medication.[1]
  • Endoscopic thoracic sympathectomy (ETS) - This is a type of surgical treatment for primary focal hyperhidrosis. ETS should not be considered unless sweating is severe and greatly impacts a patient’s quality of life. It is usually used to treat palmar hyperhidrosis but it can also improve sweating of the head and neck. When performing ETS, a surgeon will cut or disrupt nerves that cause the head, neck, and hands to sweat in order to reduce the symptoms of hyperhidrosis. Unfortunately, a complication of ETS surgery called compensatory sweating may occur, in which sweating begins to happen on the trunk of the body rather than the areas that were treated by the surgery. Compensatory sweating is a common side effect and should be taken into consideration when someone is contemplating surgery.[1]
  • Most people with primary focal hyperhidrosis have to learn to manage their symptoms and adapt because it is an ongoing condition. However, treatments make it possible to thrive despite the difficulties hyperhidrosis can cause. There is some research that suggests that hyperhidrosis improves with age, so most people find that symptoms improve naturally with time, experience, and treatment.[1]

    If you find that none of the above treatments are working you might want to consider being part of a research trial. This can allow you to try innovative treatment options, often at no cost to you.[2] However, this can be risky as unapproved treatments have less research to back them up and side effects are not well studied.

    Treatments for Head and Neck Sweating Caused by Secondary Generalized Hyperhidrosis

    If your doctor suspects that your symptoms are caused by secondary hyperhidrosis, then your course of treatment will be significantly different. Secondary generalized hyperhidrosis begins suddenly during adulthood and it has a definitive cause. This makes the symptoms of secondary hyperhidrosis easier to treat. In order to treat secondary hyperhidrosis doctors simply need to find the factor that is causing it and fix it. Once the causative agent is removed people stop experiencing the symptoms of hyperhidrosis. Most of the time secondary hyperhidrosis is caused by certain common medicines. If this is the case, the person just needs to stop taking the medication that’s causing the issue. Other times, secondary hyperhidrosis is caused by a physiological condition or disease. Treating the underlying medical issue will clear up secondary hyperhidrosis.[2]

    It is important that you discuss secondary hyperhidrosis with your doctor in case it is caused by a serious disease. Sometimes, a serious infection or cancer is responsible for excessive sweating. Other conditions and diseases that can cause secondary hyperhidrosis include heart disease, diabetes, menopause, stroke, spinal cord injury, and several others.[2] However, diseases that cause secondary hyperhidrosis usually affect a larger area of the body rather than just the head and neck. If you experience all over body sweating and increased sweating at night in addition to excessive head and neck sweating then you are more likely to be suffering from secondary generalized hyperhidrosis and should be treated by a doctor. Try not to worry, but do seek medical attention if you have other new symptoms in addition to craniofacial sweating.[1]

    Lifestyle Adjustments Can Help

    Whether you have excessive head and neck sweating caused by primary focal hyperhidrosis or secondary hyperhidrosis, there are certain factors that will make your symptoms worse. Avoiding some of these triggers, in addition to other treatments, may help you to reduce the amount of sweat you produce. The main triggers that cause sweating to worsen are weather conditions like high humidity and high heat. Other triggers include things that you can ingest like spicy food, alcohol, and caffeine. Exercise can also trigger extra sweating, but sweating is probably not a good reason to forgo a workout. Finally, emotional triggers can also cause sweating to be worse, especially when you feel stress, anxiety, anger, or fear.[2] It has been shown that hyperhidrosis and anxiety are related and that higher anxiety levels often lead to an increase in sweating.[1] In order to combat sweating related to stress and anxiety you may want to try a calming practice like yoga or meditation.

    In addition to avoiding triggers, you can make some basic lifestyle changes that can help reduce and manage sweating in general. If you have found that antiperspirant is helpful, try applying it to dry skin at night so that it is most effective. It is also important to stay well hydrated and eat small spaced out meals to aid in digestion, as digestion produces body heat which can worsen sweating. It may be valuable to limit exercise before social encounters or work as sweating is often worse for a while even after you're done exercising. Finally, clean the skin on you head and neck frequently to keep it healthy and to avoid build up that can lead to breakouts. while these particular strategies won’t eliminate your sweating they can help you to prevent and manage it so that is has less of an impact on your day to day life.[2]

    Excessive head and neck sweating can be devastating, but seeking out treatment can dramatically improve symptoms and lead huge improvements. Don’t be afraid to seek out treatment and advocate for your needs!

    1. Pariser, D. M. (2014). Hyperhidrosis (4th ed., Vol. 32). Philadelphia, PA: Elsevier.
    2. Dix, M. (2018, October 31). How to Curb Excessive Head and Face Sweat. Retrieved April 25, 2019, from https://www.healthline.com/health/how-to-stop-sweating-face