7 Effective Tips to Stop Sweaty Hands
Not sure how to stop sweaty hands and excessive sweating? You aren’t alone! Whether you’re working from home, gaming, or just trying to get your phone to recognize your thumbprint, it can get pretty dang annoying to constantly worry about how to stop having sweaty hands. In this article, we’ll cover 7 effective ways to help you stop sweaty hands:
- Reduce your stress
- Try (the right) antiperspirant
- Check with your doctor about underlying conditions
- Give a Botox shot
- Take a more surgical approach
1. Reduce your stress
This one is often easier said than done - but it can help a lot. Research has shown that higher levels of anxiety cause sweat glands to become more active . This is particularly true for hand sweating.
Figuring out how to stop sweaty hands looks different for each person, but there are some relaxing activities that can either prevent sweat or help control it once it’s begun. Some possible activities to reduce your stress include listening to your favorite music, getting enough sleep, and exercising daily. Other helpful techniques include deep breathing and stretching. Everyone is different, so try some of these other tips to find what works best for you.
2. Try (the right) antiperspirant
You’re relaxed, but maybe you’re still trying to work out how to stop having sweaty hands? While reducing stress is a beneficial home remedy, it should be combined with other easy-to-use remedies. Some home remedies, such as baking soda or apple cider vinegar, may help with hyperhidrosis, but the next best step is over-the-counter antiperspirant.
Antiperspirants are great at preventing clam hands and often work better than deodorants to stop excessive sweating. Antiperspirants for hands are especially important in how to stop sweaty hands. Others prefer anti sweat wipes. Finding the right hand antiperspirant is an important step to combat sweaty hands.
Hate needles? Need to figure out how to stop sweaty hands? Iontophoresis may be for you. This method uses mild electrical currents to treat your hands while they’re submerged in water. And although iontophoresis sessions may be performed at a doctor’s office, some people choose to purchase their own iontophoresis machines for at-home treatment .
While this method can be a bit harder on the wallet, if you can pay upfront for a machine, you may save by avoiding paying for every visit to the doctors. However, if you don’t see progress after a few weeks, talk to your doctor to discuss how to stop your sweaty hands from affecting your daily life.
4. Check with your doctor about underlying conditions
It can be easy to write off sweaty hands as a reaction to anxiety or nervousness. But sometimes sweaty hands can be caused by underlying conditions. These conditions might include diabetes, low blood sugar, overactive thyroid, infections, and other issues. To learn more on how to stop sweaty hands that may be connected to underlying conditions, it is best to talk to a medical professional about your hyperhidrosis needs.
In addition to talking about your underlying conditions, a medical professional may also suggest a prescription to help with sweaty hands. More specifically, your dermatologist may prescribe an oral medication for hyperhidrosis like a series of pills known as anticholinergics, which help your body produce less sweat. Like pills, topical creams may also be prescribed to help reduce excessive sweating. These creams are made up of solutions that will decrease the amount of sweat released, including hand sweat. If medications don’t cut it for you, you may need to take one of the two steps below.
6. Give botox a shot
You may be thinking, I’m not sure how to stop sweaty hands, so why are you recommending botox? While many may not associate botox with hyperhidrosis, it can significantly reduce excessive sweating, including in your hands  . While botox may solve how to stop having sweaty hands, this method can cause temporary pain or weakness of the hands, so it is crucial that you consult a medical professional for appropriate botox delivery.
7. Take a more surgical approach. This one is only for serious sweaters who have tried everything else.
If you can’t figure out how to stop having sweaty hands after trying these first six tips, you might consider surgical treatment for primary focal hyperhidrosis. While botox is a less invasive surgery, significantly more invasive procedures include endoscopic thoracic sympathectomy or an endoscopic lumbar sympathectomy. These names may be hard to pronounce, but these surgeries can provide significant relief for people with certain kinds of severe hyperhidrosis. Of course, try less invasive options first, and talk to a medical professional before deciding to take a more surgical approach.
- Huddle, J. R. (2014). Hyperhidrosis: Causes, Treatment Options and Outcomes. New York, NY: Nova Science.
- Pariser, D. M. (2014). Hyperhidrosis (4th ed., Vol. 32). Amsterdam: Elsevier Pub. Co., 2014. Retrieved from <a href=https://www.elsevier.com/books/hyperhidrosis-an-issue-of-dermatologic-clinics/pariser/978-0-323-32607-0>https://www.elsevier.com/books/hyperhidrosis-an-issue-of-dermatologic-clinics/pariser/978-0-323-32607-0</a>
- Lakraj, A. A., Moghimi, N., & Jabbari, B. (2013). Hyperhidrosis: anatomy, pathophysiology and treatment with emphasis on the role of botulinum toxins. Toxins, 5(4), 821–840. https://doi.org/10.3390/toxins5040821
What Is Hyperhidrosis?
Hyperhidrosis, or excessive sweating, is characterized by sweat that is produced in excess of what is necessary for thermoregulation (the ability to maintain a healthy temperature). Sweating is a perfectly natural and necessary function the body uses to cool itself down. However, if you have hyperhidrosis, you’ll start sweating even when your body isn’t overheating. Sweating that has no apparent cause is known to doctors as diaphoresis.
If you have hyperhidrosis, you can experience sweating on several parts of the body, including in the hands, underarms, face, scalp, and feet. Some people even experience excessive groin sweat and sweating under the breasts. The type of hyperhidrosis you have will determine whether you experience sweating all over your body or if it is just in specific areas. Some people with hyperhidrosis sweat in several different areas simultaneously, while others only experience excessive sweating at one location - it is a highly individualized condition. Hands, feet, and underarms are the parts of the body that are most likely to be affected by hyperhidrosis.
People who suffer from hyperhidrosis have the same number and size of sweat glands as people who don’t have the condition. Their sweat glands are just overactive, compared to what they would normally be.
What Are the Symptoms of Hyperhidrosis?
If you’re wondering how to tell whether you have hyperhidrosis , here is a checklist of symptoms for you to review.
- Noticeable sweat:Even when you’re sitting down and taking it easy, you’ll notice your clothes are wet. On your bare skin, you’ll often see beads of sweat.
- You leave a trail in your wake:You might not just see sweat on your clothes and skin. You might be transferring it to everything you touch, including door knobs, keyboards, and papers that you touch.
- Your skin is white and peeling:You might notice white and peeling skin from the constant moisture.
- You have skin infections:Skin infections can happen to people who don’t have hyperhidrosis. However, if you have repeated skin infections due to constant moisture, like athlete’s foot, you might suspect hyperhidrosis.
Different dermatologists characterize hyperhidrosis in various ways. What’s important is the fact that if you are uncomfortable with the level of sweat that your body produces (wherever it’s being produced), there are solutions that are available. You have access to over-the-counter topical treatments, prescription options, and medical procedures that can help. If you are interested in medical solutions, you can book an appointment with your dermatologist and learn how to manage hyperhidrosis with a dermatologist.
Now that we’ve answered the question “what is hyperhidrosis?”, It’s important to understand the different types of hyperhidrosis. The approaches used to understand and treat hyperhidrosis are very different depending on the type you have.
The Two Main Types of Hyperhidrosis
There are two main types of hyperhidrosis. There are a few other types that are much less common, but the vast majority of people will either have primary focal hyperhidrosis or secondary generalized hyperhidrosis. Let’s look at each type of hyperhidrosis and what they entail.
Primary Focal Hyperhidrosis
Primary Focal Hyperhidrosis (PFH) is by far the most common type, affecting up to 90 percent of people who have hyperhidrosis. The cause is not well understood, but it is thought to have a genetic component.
People with primary focal hyperhidrosis only sweat in particular areas like the hands, feet, armpits, face, and groin. Sweat will occur on both sides of the body in the same place. For example, if someone has one sweaty hand it is likely their other hand will also be sweaty. Additionally, the sweat will usually occur in more than one area — one common problem with PFH is that the sweating occurs on hands and feet simultaneously. It can also affect other body parts individually or simultaneously, it just depends on a person’s specific situation.
Symptoms usually begin in childhood or adolescence and tend to last for a person’s entire lifetime. There is evidence that primary focal hyperhidrosis is hereditary, meaning it has a genetic component and often runs in families.
Secondary Generalized Hyperhidrosis
While primary focal hyperhidrosis appears to be something you’re born with,secondary generalized hyperhidrosis (SGH) is a condition that shows up during adulthood. Think of SGH as an uninvited guest who arrives on your doorstep with no warning. Unfortunately, it may be a little harder to get rid of than an uninvited guest.
You might suddenly wonder why you’ve been so sweaty lately. And you’d be right to wonder, because this type of hyperhidrosis can point to an underlying problem.
When someone has secondary hyperhidrosis the biggest problem isn’t the hyperhidrosis – it’s the disease or condition that might be causing it. That’s why it’s known as secondary hyperhidrosis. The true cause may be a medical condition and the symptom of that condition is hyperhidrosis.
Before you panic that you’re suffering from a mysterious disease, keep in mind the source of this type of hyperhidrosis can also be a medication. Many common medications can cause hyperhidrosis as a side effect.
Unlike primary focal hyperhidrosis, the sweating from secondary hyperhidrosis tends to occur all over the body. This is a telltale sign of the condition.
Unlike primary hyperhidrosis, this condition doesn’t have to be permanent. If the instigating condition is found and treated, it can fix the hyperhidrosis. It may take a little work, but you CAN kick this guest off your porch.
If you are concerned that your hyperhidrosis might have an underlying cause, schedule an appointment to talk to your doctor and find out.
The Impact of Hyperhidrosis
While hyperhidrosis isn’t particularly dangerous physically, it can be embarrassing for those who suffer from it. It won’t just give you clammy skin – the sweat can literally drip off. That can cause a great deal of anxiety for those who experience it.
Shaking hands can become a nightmare because you may be so self-conscious about how sweaty your palms are. Your socks can become wet even if you don’t do any exercise. It can make basic human experiences extremely stressful.
Unfortunately, hyperhidrosis is more serious than just uncomfortable sweating. Up to a third of people who deal with excessive sweating from hyperhidrosis say that they are constantly bothered by their sweating. One study done in the US found that 75% of respondents reported that hyperhidrosis negatively impacted their social, emotional, and mental health. That’s a lot of people who are suffering! Due to these issues, hyperhidrosis and anxiety often go hand in hand. Many people find it helpful to utilize anxiety reduction methods that are known to lessen excessive sweating.
Hyperhidrosis is hard for adults to deal with, so it is especially important to find help for kids with hyperhidrosis.
Some people refer to hyperhidrosis as a silent handicap because of the impact it has upon the lives of those who live with it. It can deeply impact their confidence and hyperhidrosis can even keep people from doing the things they love most.
Is Hyperhidrosis Common?
It is thought that about 3% of the US population struggles with hyperhidrosis. In other countries the percentage of the population that has it is even higher. Other sources have stated that up to 5% of the population might even have it! This means that hyperhidrosis is a very common issue.
While most doctor’s offices are familiar with managing hyperhidrosis, they generally don’t see a lot of patients who suffer from it. However, because hyperhidrosis is such an embarrassing and overlooked condition, many individuals avoid reporting the issue to their doctor. This means that the number of people who have hyperhidrosis might even be higher than we currently think.
Those with family members who have this ailment are more likely to get it – making it an inherited condition. If you have a family member teased for their sweaty hands constantly, there could be a chance they have hyperhidrosis. 
What Causes Hyperhidrosis?
Doctors don’t truly understand what causes primary focal hyperhidrosis yet. One theory is that particular nerves that control the amount of sweat overreact or malfunction. That malfunction can cause the excessive sweating that can be life-changing for those who suffer from it.
Since hyperhidrosis affects so many people, researchers are now shifting into full gear to discover the causes of excessive sweating so they can develop better treatments. Future treatments and research for hyperhidrosis are being developed more rapidly than ever before.
What Conditions Can Cause Secondary Generalized Hyperhidrosis?
Many diseases and medical conditions can cause hyperhidrosis. However, just because you have one of the conditions listed below this paragraph doesn’t mean you’ll develop hyperhidrosis.
Here are some of the more common conditions that may be causing the hyperhidrosis you have developed as an adult.
- A febrile illness
- Heart failure
- Alcoholism - Alcohol can cause excessive sweating when someone is intoxicated, withdrawing, or in someone with an intolerance.
- Lymphoma and some other cancers and tumors.
- Parkinson’s disease
- Rheumatoid arthritis
There are also several types of common medications that cause hyperhidrosis as a side effect. So, if you are on medication and you begin experiencing new or increased amounts of sweating mention it to your doctor. Some of these medications include antidepressants, painkillers, blood pressure medications and many others.a 
If you think you might have secondary generalized hyperhidrosis it is very important that you speak to a doctor. Many of the things that cause it can be resolved, and it could be a sign of a more serious problem. Don’t panic, but it is wise to look into the reason you are sweating more.
What Are the Treatments for Primary Focal Hyperhidrosis?
If you are diagnosed with primary focal hyperhidrosis, there are many things you can do.These are the existing treatments for hyperhidrosis, but new treatments are currently being explored by scientists:
- Antiperspirants:There are many over-the-counter antiperspirants that can be very useful when trying to curb sweat. If a regular antiperspirant isn’t cutting it for you, ask your doctor to write a prescription for a stronger one. You can apply antiperspirant to places other than just your underarms. Use it on your hands, hairline, or feet as well. There are even antiperspirants for the face and groin that are made specifically for sensitive areas.
- An Iontophoresis machine:This medical device sends low-voltage currents into a pan of water where your hands or feet are sitting. The electricity can lessen the activity of your sweat glands, at least for a while. However, it can take up to 10 sessions with the iontophoresis machine to deactivate your sweat glands. You may need to use this machine up to three times a week in the beginning and one treatment can take up to 40 minutes. Although iontophoresis as a treatment for palmar and plantar hyperhidrosis may give your hands and feet a much needed break, the iontophoresis machine is anything but convenient. Iontophoresis really does work, but patients have to be willing to keep up with a regular treatment regimen for it to work successfully.
- Botox:If other treatments aren’t enough in your, you might need Botox injections. Botox can be particularly useful for axillary hyperhidrosis, but botox can also be a treatment for palmar and plantar hyperhidrosis. Botox can provide up to 6 months of reduced sweating. If you’re going to pursue this route, you should look for someone who is experienced at doing Botox injections in the underarms to ensure the right area is targeted.
- Anticholinergics:A few oral medications can for hyperhidrosis can reduce the amount of sweat you produce by stopping your sweat glands from working. Most commonly patients are prescribed anticholinergics like glycopyrrolate or oxybutynin as a treatment for hyperhidrosis. These medications also have several side effects, including heart palpitations, blurry vision, and dry mouth.
- ETS Surgery:An endoscopic thoracic sympathectomy (ETS) is a surgical treatment for primary focal hyperhidrosis. It is an operation where an individual actually has the nerve endings that transfer sensory information to the sweat glands destroyed. Since no known successful reversal of an ETS surgery has ever been recorded, this option isn’t usually on the table unless the other treatments have failed. As with any surgery, it can be risky. There is also a type of surgery called an endoscopic lumbar sympathectomy which is used to treat plantar hyperhidrosis, but this surgery can be very dangerous and is almost never recommended.
Undoubtedly, hyperhidrosis can be a hard condition to cope with. Until recently, the lack of research into hyperhidrosis had made hyperhidrosis difficult to manage. Thankfully, however, new treatments and awareness has made hyperhidrosis much easier to handle. Keep trying treatments until you find what works for you and remember that you are not alone in suffering with this condition. It’s just a matter of figuring out what you can do to control your sweat instead of your sweat controlling you!
- MedicineNet Medical Journal. (2016, May 13). Definition of Hyperhidrosis. Retrieved May 14, 2018, from https://www.medicinenet.com/script/main/art.asp?articlekey=16272
- Diaphoresis: What causes excessive sweating? (n.d.). Retrieved May 20, 2020, from https://www.medicalnewstoday.com/articles/321663#overview
- Pariser, D. M. (2014). Hyperhidrosis (4th ed., Vol. 32). Amsterdam: Elsevier Pub. Co., 2014. Retrieved from https://www.elsevier.com/books/hyperhidrosis-an-issue-of-dermatologic-clinics/pariser/978-0-323-32607-0
- Lenefsky, M., & Rice, Z. P. (2018). Hyperhidrosis and Its Impact on Those Living With It. AJMC. Retrieved from https://www.ajmc.com/journals/supplement/2018/hyperhidrosis-managed-markets-update-treatments/hyperhidrosis-and-its-impact--on-those-living-with-it
Nordqvist, C. (2017, December 21). Hyperhidrosis: Symptoms, causes, diagnosis, and treatment. Retrieved May 14, 2018, from https://www.medicalnewstoday.com/articles/182130.php
Doolittle, James, et al. “Hyperhidrosis: an Update on Prevalence and Severity in the United States.” Archives of Dermatological Research, vol. 308, no. 10, 2016, pp. 743–749., doi:10.1007/s00403-016-1697-9. Retrieved from https://pubmed.ncbi.nlm.nih.gov/27744497/
Huddle, J. R. (2014). Hyperhidrosis: Causes, Treatment Options and Outcomes. New York, NY: Nova Science. Retrieved from https://www.bookdepository.com/Hyperhidrosis-Janine-R-Huddle/9781633215160
Glycopyrrolate and Oxybutynin are both anticholinergic medicines used to treat hyperhidrosis, a skin condition that causes excessive sweating. A patient must be actively managing their hyperhidrosis with a doctor in order to obtain these types of medications, as they are only available by prescription. Both Glycopyrrolate and Oxybutynin are most often used as oral medications to treat hyperhidrosis, although they can be given in other forms. Neither drug is specifically approved by the FDA for use in the treatment of hyperhidrosis, but they are commonly used off-label for this purpose.
Anticholinergics agents comprise a group of medications that work by affecting how the body is able to use the neurotransmitter acetylcholine. Specifically, anticholinergics interrupt acetylcholine from being used at muscarinic receptors throughout the body by binding with it. This action is called competitive inhibition. Muscarinic receptors are located throughout the autonomic nervous system, and spread out over the whole body, which is why anticholinergics are responsible for such widespread effects. The autonomic nervous system is the part of the nervous system that governs involuntary actions, like the movement of smooth muscle, breathing, heart rate, and many other functions. It is also responsible for regulating sweat production, which is why anticholinergic medications can be useful in the treatment of hyperhidrosis.
There are several types of anticholinergics, although most are not used in the treatment of hyperhidrosis. Glycopyrrolate and Oxybutynin are the two most common anticholinergic medications used to treat excessive sweating. Other types of anticholinergic medicines, like scopolamine and atropine, can cross the blood-brain barrier and cause more unwanted neurological side effects than glycopyrrolate. While there are other anticholinergics that can be used to treat hyperhidrosis, they are not available in the United States. The most studied anticholinergic agent, other than glycopyrrolate and oxybutynin, is called methantheline bromide, and it has had some promising results in Germany.
The Specifics of Each Medication
Glycopyrrolate (sold under the brand name Robinul) is one of the anticholinergics used most often in the treatment of hyperhidrosis, although this varies widely between doctors and studies. Patients are usually given glycopyrrolate in pill form and instructed to take 1 to 2 mg twice a day. If needed, patients can increase the dose by 1 mg per day at two-week intervals until the therapeutic dose is reached. The normal dosage range is usually between one and eight mgs per day. Many times patients are limited in the amount of glycopyrrolate they are able to take due to side effects that increase as the dose increases. There are several possible side effects, but the most common is dry mouth. This is because glycopyrrolate dries up bodily secretions, which is beneficial when attempting to reduce sweat production but can lead to aggravating side effects. Glycopyrrolate can also cause dry eyes, constipation, nausea and several other issues. Patients can drink more water, use mints, take eye-drops and increase fiber consumption to fight address side effects. Another limiting factor for the use of glycopyrrolate is its high cost.
The effectiveness of glycopyrrolate is often related to the dose a patient is able to handle. One study on the effectiveness of glycopyrrolate found that out of 19 patients 80% responded to treatment. However, one third of the patients had to stop treatment due to side effects. Other studies have found that the drug is effective in reducing sweating but that side effects often hinder treatment. Glycopyrrolate is often chosen as a second, or third line therapy for hyperhidrosis that causes excessive sweating of the palms, soles, and armpits. It is one of the first line treatments for craniofacial hyperhidrosis. Many times, using glycopyrrolate in conjunction with other therapies increases patient satisfaction.
Oxybutynin (brand name Ditropan) is the other most commonly used anticholinergic used in the treatment of hyperhidrosis. When being used orally to treat hyperhidrosis, oxybutynin is typically prescribed in 5 to 10 mg doses and taken daily. It can be used in amounts of 15 to 20 mgs a day if needed. It is also available as a topical gel, slow-release tablet, and as a transdermal patch. Oxybutynin has similar side effects when compared to glycopyrrolate. However, it is able to penetrate into the central nervous system (CNS) more easily so it can also have some added CNS side effects. These include dry mouth, constipation, somnolence, confusion and other potential effects. Oxybutynin is a relatively inexpensive drug so that can sometimes make it more accessible to patients.
Oxybutynin is found to be effective in treating the symptoms of hyperhidrosis but, like other anticholinergic drugs, it is limited by side effects. One study of 50 patients using oxybutynin to treat palmar and axillary hyperhidrosis found that 70% of patients reported improvements in those areas. Interestingly, 90% of the patients also reported improvement of plantar sweating. Side effects were noted as moderate to severe in 35% of the patients by the six week mark of the study. This indicates that oxybutynin is effective in reducing sweat production, but that, when used orally it can be limited by the side effects it can cause. Another study found that 60% of their patients showed improvement in their quality of life compared to only 27% in the placebo group, when low doses of oxybutynin were given. If patients can find relief at lower doses than this can mitigate the drawbacks caused by side effects.
Local Treatments that Use Glycopyrrolate and Oxybutynin
All oral medications for hyperhidrosis will cause systemic side effects throughout the body because of how they work. This can often make them less desirable treatment options. Sometimes, this is necessary, like in the case of a patient who has generalized all-over sweating instigated by a medication that causes hyperhidrosis as a side effect. However, both glycopyrrolate and oxybutynin are available in other forms that allow them to be used locally. Both drugs are available to be used in conjunction with an iontophoresis machine when being used to treat palmar and plantar hyperhidrosis. The electrical current from the iontophoresis machine aids the skin in absorbing the medications locally. Topical creams are available containing both medications but their effectiveness is currently unclear as the medications may have trouble penetrating the skin barrier in this form. A new product called Qbrexza uses glycopyrrolate on a medicated wipe that can be used once a day to prevent sweating.
Future Uses in the Treatment of Hyperhidrosis
There are various future treatments and research for hyperhidrosis that involve the use of both glycopyrrolate and oxybutynin. The most notable of these future treatments is the use of glycopyrrolate in a topical form which would be able to penetrate into eccrine glands. The cream would contain 1% or 2% glycopyrrolate. Oxybutynin is also being studied and potentially developed into a topical cream. Researchers are also looking into developing a glycopyrrolate pad to relieve sweating symptoms.
Recently, a product called Qbrexza (created by Dermira) was released and it uses Glycopyrronium Tosylate, a topical form of anticholinergic medication, on a wipe to reduce sweating. It is only marketed for underarm use, but it may have interesting implications for the future of hyperhidrosis treatment. For those who are interested in medicated antiperspirant wipes, but who don’t want to deal with prescription medications like Qbrexza, there are now over-the-counter antiperspirant wipes available from brands like Carpe.
- Pariser, D. M. (2014). Hyperhidrosis (4th ed., Vol. 32). Philadelphia, PA: Elsevier.
- Autonomic nervous system. (2018). Retrieved September 6, 2018, from https://www.merriam-webster.com/dictionary/autonomic nervous system
- Huddle, J. R. (2014). Hyperhidrosis: Causes, Treatment Options and Outcomes. New York, NY: Nova Science.
- Dahl, M. V. (2016). Oxybutynin for Hyperhidrosis. NEJM Journal Watch. Dermatology. doi:10.1056/nejm-jw.NA39817
- Walling, H., & Swick, B. L. (2011). Treatment Options for Hyperhidrosis. . American Journal of Clinical Dermatology, 12(5), 285-295. Retrieved September 5, 2018, from http://ezproxy.co.wake.nc.us/login?url=https://search.proquest.com/docview/1467836763?accountid=14867
- Qbrexza. (2018). Retrieved February 20, 2019, from https://dermira.com/our-medicines/
Hyperhidrosis and anxiety go hand in hand, one is often both the cause and result of the other. However, it needs to be understood that a mental disorder does not cause hyperhidrosis, rather anxiety produces worsened symptoms of the disease in people that already have it. Historically, hyperhidrosis was actually thought to be a psychiatric condition, but that has been proven to be untrue. Anxiety is often a cause of excessive sweating in those with hyperhidrosis but it is not the only reason it occurs. It is important to understand that anxiety is a symptom of hyperhidrosis because of the uncomfortable experiences the disease produces. Hyperhidrosis is not dangerous, but the anxiety and stress that can result from it are detrimental if they are not treated.
Ways Hyperhidrosis Causes Anxiety
Hyperhidrosis has a profound impact on a patient’s quality of life. In some cases, it is a specific situation like public speaking, that will worsen hyperhidrosis symptoms, but often, daily situations produce the most anxiety for those suffering. Here are some ways in which hyperhidrosis impacts quality of life and creates anxiety for those affected:
- It creates a feeling of social stigmatization that causes sufferers to feel isolated and, therefore, anxious about social interactions. For example, a person suffering from palmar hyperhidrosis may find it anxiety-producing to shake hands because of sweaty palms.
- It can cause anxiety about intimate relationships as patients may worry that their significant other may find them unattractive or unclean.
- Worries surface in relation to personal hygiene. It creates anxiety when a person feels that they cannot stay clean or must perform daily hygiene routines constantly throughout the day.
- Self-esteem is often low in hyperhidrosis patients, which creates feelings of anxiety and inadequacy.
- Professional success and performance are often hindered by either the condition, or often, the anxiety perpetuated by the condition.
These are just some of the ways that hyperhidrosis can cause anxiety and lower the quality of life for those suffering. Fortunately, there are various ways of managing sweat and certain specific treatments that have been shown to greatly reduce the anxiety produced by hyperhidrosis.
How to Deal with Anxiety Caused by Hyperhidrosis
There are several non-medical ways to manage the symptoms of both hyperhidrosis and anxiety. Often, by decreasing the stress caused by hyperhidrosis on a daily basis patients can greatly reduce psychological symptoms. In some cases, the use of relaxation techniques, like deep breathing exercises, meditation and yoga can be greatly beneficial. Anxiety reduction methods can lessen excessive sweating if practiced on a regular basis. This is because hyperhidrosis is thought to be caused by an overactive sympathetic nervous system, so calming the nervous system down also reduces sweat production. These practices do not entirely eliminate symptoms of hyperhidrosis but can help to manage the distress caused by its symptoms, which can range from uncomfortably clammy hands and feet to a person not wanting to go to social events due to fear of social embarassment. In many cases, the most effective way to decrease significant anxiety caused by hyperhidrosis is to treat the actual condition. This often means managing hyperhidrosis with a doctor. There are some at-home management options like iontophoresis and OTC topical treatments that patients can try prior to visiting a doctor if they prefer. However, these treatments may not provide enough relief for a patient suffering from both severe hyperhidrosis and anxiety.
Medical Treatment Options for Hyperhidrosis to Decrease Anxiety
Increased anxiety is especially prevalent among those who have primary focal hyperhidrosis. These are people who typically begin noticing symptoms during adolescence and who often have sweating on specific areas of the body. It is especially common to find anxiety in patients who have palmar and plantar hyperhidrosis. Therefore, treatment for sweaty hands and treatment for sweaty feet are particularly effective in reducing anxiety symptoms. The most effective and well-studied methods which have been shown to reduce anxiety are surgical treatments for primary focal hyperhidrosis. These procedures include botox treatments for palmar, plantar and axillary hyperhidrosis as well as a surgical procedure called endoscopic thoracic sympathectomy (ETS). Both treatments reduce sweating to specific areas of the body and thus greatly reduce the amount of anxiety for those suffering. Patients should be weary of a surgical procedure called endoscopic lumbar sympathectomy as it has been shown to have potentiall serious and detrimental side effects. Patients should also be aware that endoscopic thoracic sympathectomy surgery also carries a high risk of ceratin side effects, like compensatory sweating, that can be difficult to handle. Most doctors maintain the idea that endocopic thoracic sympathectomy is still a safe treatment, despite some of the risks.
There is also the option to treat hyperhidrosis with oral medications, specifically anticholinergic drugs like glycopyrrolate or oxybutynin, which can reduce sweating and thus anxiety. This has more recently been shown as a treatment which can potentially reduce anxiety, although surgical treatments are more commonly associated with improvements. Of course, psychiatric medications can always be used to treat anxiety if needed, but if anxiety is specifically caused by the symptoms of hyperhidrosis then it makes sense to first treat the hyperhidrosis. If a patient decides to use psychiatric medications to manage their anxiety, they should be aware that benzodiazepines, which are used to treat acute anxiety, can be habit forming and have a sedating effect.
If a patients is suffering anxiety due to hyperhidrosis, and more conservative measures have not improved symptoms, then managing hyperhidrosis with a doctor is an important, and often life-changing, next step.
How Hyperhidrosis and Anxiety Have Been Studied
There have been several studies examining the relationship between anxiety, stress and hyperhidrosis. Although there have been some mixed results concerning which areas of sweating are most stress-producing (palmar, plantar or axillary) most studies show a correlation between anxiety and hyperhidrosis. One study, used both psychological evaluations (Beck Depression Inventory and Trier Inventory of Chronic Stress) and measured stress hormone levels to see if there was a cause between stress and hyperhidrosis. The cortisol levels remained similar to the control group but the hyperhidrosis patients reported higher levels of stress and depression. There are many other assessments used to determine the quality of life for those suffering from hyperhidrosis including the Dermatology Quality of Life Index, Hyperhidrosis Impact Questionnaire, Skindex and more. These tools are can be used by either researchers or doctors to determine how and to what extent patients are suffering psychologically from hyperhidrosis. Due to the fact that there is a strong correlation between excessive sweating and stress, some people suffer from stress sweating, or sweating that is greatly worsened when a person is in an acutely stressful situation.
It makes sense that hyperhidrosis, stress and anxiety are so closely related as the symptoms of hyperhidrosis cause both physical, social and emotional discomfort. However, there are many available solutions and ways to manage the condition so that patients feel better and experience an improved quality of life.
- Ruchinskas, R. (2007). Hyperhidrosis and Anxiety: Chicken or Egg? Dermatology, 195-196. doi:10.1159/000099581
- Pariser, D. M. (2014). Hyperhidrosis (4th ed., Vol. 32). Philadelphia, PA: Elsevier.
- Ghorpade, V. (2009). Idiopathic unilateral focal hyperhidrosis with social anxiety disorder. Indian Journal of Psychiatry, 51(3), 214-215. doi:10.4103/0019-5545.55094
- Gross, K. M., Andrea, B., Schneider, K. K., Schulz, A., & Meyer, J. (2014). Elevated Social Stress Levels and Depressive Symptoms in Primary Hyperhidrosis. PLoS One, 9(3). doi:10.1371/journal.pone.0092412
Secondary generalized hyperhidrosis is often a surprise, people who have otherwise been healthy adults suddenly have a significant sweating problem. This is called diaphoresis, or excessive sweating with no apparent cause. This is unlike primary focal hyperhidrosis, which often begins in adolescence and is a problem patients struggle with for the majority of their lives. A review in 2011 found that 93% of people diagnosed with hyperhidrosis struggle with the primary type - that means that only 7% of cases are comprised of secondary hyperhidrosis. However, when patients are diagnosed with secondary hyperhidrosis, it is imperative that the cause is found because it can often be a dangerous medical condition. This is because secondary hyperhidrosis can be caused by several medical conditions and diseases. Ironically though, medication side-effects are the most common cause of secondary generalized hyperhidrosis. That means that most people who are diagnosed with secondary hyperhidrosis are being treated for another condition and the medication they are taking caused them to begin sweating in excess of what is considered normal. It is vital that a patient who suddenly displays hyperhidrotic symptoms starting in adulthood manage hyperhidrosis with a doctor to determine whether it is caused by a medication or another underlying medical condition.
If a patient suspects that the cause of their excessive sweating is a result of a medication then it is important to discuss this with a qualified doctor and discuss a plan of action. Below is a list of common medications that can cause secondary hyperhidrosis:
Types of Medication that Cause Secondary Hyperhidrosis
There are many types of medication that can potentially cause hyperhidrosis that treat a variety of conditions. Here is a list of medicines that can potentially cause excessive sweating:
Most of the pain medications that can cause hyperhidrosis as a side-effect are prescription drugs. However, in some instances, excessive sweating has been caused by the over-the-counter medicines Tylenol and Aleve. Here is a list of several prescription pain medications that can cause excessive sweating:
- Opiates like: Hydrocodone/Vicodin, Morphine, Oxycodone/Roxicodone, Fentanyl/Duragesic, Ultra/Tramadol
- NSAIDs like: Toradol/Ketorolac, Celebrex, Relafen/Nabumetone
- Other pain medications: Marinol (made from cannabinoids)
Many psychiatric drugs can have secondary hyperhidrosis as a possible side effect. These medications include SSRIs, antipsychotics, ADHD medications and anxiolytics. Here is a list of these medications:
- Antidepressants, antipsychotics and anxiolytics: Elavil/Amitriptyline, Buspar/Buspirone, Tegretol/Carbamazepine, Celexa/Citalopram , Clozaril/Clozapine, Norpramin/Desipramine, Migranal/Ergotamine, Aricept/Donepezil, “Cymbalta/Duloxetine, Lexapro/Escitalopram, Lunesta/Eszopiclone, Prozac/Fluoxetine, Haldol/Haloperidol, Sinemet/Levodopa, Provigil/Modafinil
- ADHD medication: Adderall/Amphetamine
Hormonal medicines, including many birth controls for women, can cause excessive sweating as a side effect. This list also includes steroids and other agents. Here is a list:
- Birth Control: Depo-provera,
- Other hormonal medications: Calcitonin/Fortical, Syntrhoid/Thyroid (for hypothyroidism), Evista/Raloxifene, Genotropin/Somatroin, Testoterone/Androgel, Antibodies/Tositumomab (cancer therapy)
- Diabetes Medications: Glucotrol/Glipizide, Insulin/Humilin, Vasopressin/Pitressin
- Common Steroid Medications: Prednisone/Orapred
There are several types of skin medication used to treat a variety of conditions, some of which cause hyperhidrosis as a side effect, these include:
- Topical steroids
- Acne Medicine: Accutane/Isoltretinoin
- Numbing Medicine: Lidocaine/Carbcaine
- Other: Selsun/Selenium sulfide
Antibiotics are used to treat bacterial infections, and despite being commonplace and saving lives, can cause hyperhidrosis. Here is a list of antibiotics that may do this:
- Acyclovir/Zovirax, Rocephin/Ceftriaxone, Cipro/Ciprofloxacin, Sustiva/Efavirenz, Foscavir/Foscarnet, Tequin/Gatifloxacin, Avelox/Moxifloxacin, Ketek/Telithromycin, Ribavirin/Copegus, Retrovir/AZT
The list above is not a complete list of all the medications that can cause secondary hyperhidrosis, just the most common. There are several other classes of medications that have certain drugs which can cause diaphoresis including certain cancer medications, heart and blood pressure medications, GI medications, blood and immune medications, lung medications, and genitourinary medications. The specific names of these medications was not included as they are less common, but if a patient is on a medication to treat one of these conditions and they suspect secondary hyperhidrosis they should consult a doctor.
Options for Dealing with Medication-induced Hyperhidrosis
The most obvious solution for treating hyperhidrosis caused by a medication is to stop taking it. However, that is not always a viable option for certain patients. Some patients may need to continue taking the offending medication because it will be further deleterious for their health to stop taking it. For example, a psychiatric patient may find it necessary to take medicine which causes hyperhidrosis in order to continue functioning. In this situation, discontinuing the causative drug is not in the best interest of the patient. This type of patient may benefit from taking another oral medication used to treat hyperhidrosis. While there are other therapies for treating hyperhidrosis, they are targeted at specific problem areas, and typically secondary hyperhidrosis occurs all over the body so a systemic approach is more appropriate. The medications most often used to treat excessive sweating in this situation are called anticholinergics. Most commonly doctors use either glycopyrrolate or oxybutynin if they are going to prescribe an anticholinergic. There are many other situations like the example given above in which a patient may be at a higher risk from discontinuing their medication than from treating its side-effect.
Withdrawal from Medication or Drugs
In some cases, secondary hyperhidrosis is not caused directly by taking a medication but by not taking it. This occurs after a person becomes physically dependant on a drug or medication. Most commonly people can experience hyperhidrosis symptoms due to withdrawing from alcohol, and occasionally other substances. It can also be a symptom of intoxication from alcohol as alcohol is known to exaggerate excessive sweating.  Withdrawal can be a challenging and it is important to get medical supervision.
It is important for patients to manage hyperhidrosis with a doctor, especially if they suspect the onset may be due to a medication. The positive thing about hyperhidrosis induced by a medication is that there may be a simple solution to fix it, and for those who cannot stop taking their medications there are other drugs which can alleviate their symptoms.
- Pariser, D. M. (2014). Hyperhidrosis (4th ed., Vol. 32). Philadelphia, PA: Elsevier.
- Common Drugs/Medications Known to Cause Diaphoresis Listed by Therapeutic Class. (n.d.). Retrieved August 7, 2018, from https://www.sweathelp.org/pdf/Diaphoretic_Class.pdf
- Cheshire, W. P., & Fealy, R. D. (2008). Drug-induced hyperhidrosis and hypohidrosis: Incidence, prevention and management. Drug Safety, 31(2), 109-126. Retrieved August 6, 2018, from https://www.ncbi.nlm.nih.gov/pubmed/18217788.
- Paisly, A. N., & Buckler, H. M. (2010). Investigating secondary hyperhidrosis. BMJ : British Medical Journal, 341. doi:DOI:10.1136/bmj.c4475
Do you struggle with excessive facial sweat? You’re not alone! When someone sweats excessively from their face for no apparent reason it’s called craniofacial hyperhidrosis. This type of hyperhidrosis can cause the scalp, nose, chin, and cheeks to produce more sweat than they typically should. Primary focal hyperhidrosis, a form of hyperhidrosis that has no apparent cause and affects people over a lifetime, is the most common reason that people develop excessive craniofacial sweating. About 3% of the population struggles with primary focal hyperhidrosis, and of those people, around one in five will develop symptoms of facial sweating. That means that there are a lot of people with this problem! It also tends to affect men more frequently than women. Unfortunately, craniofacial hyperhidrosis can have a negative impact on a person’s quality of life if it’s left untreated. For example, many women are unable to keep makeup on, and sufferers can become very self conscious about their appearance. Many with craniofacial hyperhidrosis go on to develop anxiety because the face is so integral to social interactions and excessive facial sweating leaves people feeling self conscious about one of their most prominent features. It’s a problem that needs to be taken seriously, and treated with respect. Luckily, there are treatments available that can lessen the burden of sweat, and reduce both a person’s sweating and anxiety.
There are two main subtypes of hyperhidrosis that can cause excessive facial sweating: primary focal hyperhidrosis and secondary hyperhidrosis. It’s important that you know which type is causing your sweating because secondary hyperhidrosis is caused by specific underlying factors that can affect how your condition is treated.
If your doctor determines that your craniofacial sweating is caused by primary hyperhidrosis then it means that your condition has no well understood cause. Doctors are unsure why, but primary focal hyperhidrosis causes eccrine (sweat) glands to be overactive. People with hyperhidrosis have sweat glands that look and function the same as normal sweat glands, but they produce much more sweat. It’s known that stress can cause sweating on the face and neck to worsen, as can heat. It’s also more likely to occur in men and typically begins in early adulthood. While some triggers of facial sweating are understood the cause of primary focal hyperhidrosis is not.
If your doctor suspects that your craniofacial sweating is caused by secondary hyperhidrosis it means that there is an underlying problem causing you to sweat excessively. There are a host of conditions and diseases that cause secondary hyperhidrosis which may be responsible for facial, scalp, and neck sweating. These can include anything from infections, endocrine disorders, ,the use of some medications, and even very serious issues like cancers. If you have secondary hyperhidrosis, don’t panic. In most cases your doctor can treat the underlying problem so that your symptoms improve. Even if it sounds scary, receiving the medical treatment you need is in your best interest. The most common cause of secondary hyperhidrosis is a medication side effect, so make sure you inform your doctor about all the medications and supplements you are currently taking
Many people find that their facial sweating is worse during times of high anxiety. Often those who experience craniofacial sweating also suffer from stress sweating. If this is the case, then measures to reduce anxiety may also help to reduce the amount of sweating you experience. However, it’s important to understand that hyperhidrosis is not typically caused by an anxiety disorder. Therefore, treatment of hyperhidrosis along with stress reduction techniques will be the most effective to minimize symptoms.
The type of treatment each patient requires depends on the cause of their craniofacial sweating. For those with primary hyperhidrosis, the goal is to reduce facial sweating and manage their symptoms via treatment. If a patient has craniofacial sweating caused by secondary hyperhidrosis, then the goal is to eliminate the underlying issue, or to manage symptoms if the causative agent can’t be reversed.
Antiperspirants, Creams, and Oral Medications
The first line of treatment when attempting to stop facial sweating is to use topical antiperspirant creams. There are over-the-counter topical creams for hyperhidrosis that contain aluminum chloride, a substance that reduces the amount of sweat eccrine glands produce. If this does not work then patients can move on to the use of a prescription topical cream that contains an anticholinergic, usually glycopyrrolate. According to the most recent research 2% glycopyrrolate cream seems to be an effective treatment for excessive facial sweating.
If topical creams do not work then doctors often move on to a type of oral medication called an anticholinergic. This type of medication works on the entire body to reduce sweat production by interfering with the binding ability of a neurotransmitter called acetylcholine. There are not many studies on the efficacy of this treatment specifically for craniofacial hyperhidrosis. However, the studies that do exist show that oral medication does tend to help, but can come with side effects. The main side effect that bothered patients in the studies available was dry mouth, although others can occur
Botox injections are a third line treatment for craniofacial hyperhidrosis. This means that they are used after topical therapies and oral medications have failed to help someone. Botox injections are used for the treatment of axillary hyperhidrosis most frequently, but they are used for facial sweating on occasion. However, there is no current consensus on the amount and type of botulinum toxin that should be used. Issues can also occur regarding aesthetic concerns due to Botox injections causing facial asymmetry and brow ptosis (drooping). When Botox injections have been studied for the treatment of craniofacial hyperhidrosis Botulinum toxin A was used and it was shown to be a relatively safe and effective treatment. More studies need to be performed to demonstrate the safety and effectiveness of this treatment over time, and in a larger group of people.
Endoscopic Thoracic Sympathectomy
This is a type of surgery in which the nerves of the sympathetic ganglia are disconnected from eccrine sweat glands. The sympathetic ganglia is the part of the nervous system that connects to sweat glands to the rest of the nervous system and which is responsible for the flight or fight response. When these nerves are disconnected it prevents the body from being able to sweat in a particular area of the body because it can no longer communicate with the sweat glands in that location. This is a viable treatment option for those suffering from craniofacial hyperhidrosis. Usually, to get rid of sweating on the head and neck, a surgeon will have to work on the T2 or T3 area of the spine. The nerves can be blocked by various means including clipping, transection, ablation and clamping. While ETS is very effective at stopping excessive sweating of the face, it can come with some serious side effects. ETS comes with a potential complication called compensatory sweating, in which the body sweats excessively in areas the surgery was not performed on. Compensatory sweating can be so distressing that some patients decide to have the surgery reversed. There is a type of surgery called a needlescopic thoracic sympathetic block which essentially does the same thing as ETS but the nerves are just clipped. This way, if a patient experiences compensatory sweating, the procedure can more easily be reversed. Surgery should be reserved as a last resort for severe cases of craniofacial hyperhidrosis.
Excessive facial sweating can be an extremely burdensome form of hyperhidrosis. The good thing is that new treatments are being developed each year and many effective treatments are already available. If you are struggling with this, then please, don’t give up! Keep trying treatments to see what works for you - there is hope!
- Craniofacial hyperhidrosis can usually be managed pharmacologically, but surgery may sometimes be needed. (2016). . Drugs & Therapy Perspectives, 32(5), 191-194. doi:10.1007/s40267-016-0282-9
- Huddle, J. R. (2014). Hyperhidrosis: Causes, Treatment Options and Outcomes. New York, NY: Nova Science.
- Lin, T. S., & Chou, M. C. (2002). Needlescopic thoracic sympathetic block by clipping for craniofacial hyperhidrosis. . Surgical Endoscopy, 16(7). doi:10.1007/s00464-001-8231-6
- Nicholas, R., Quddus, A., & Baker, D. M. (2015). Treatment of Primary Craniofacial Hyperhidrosis: A Systematic Review. American Journal of Clinical Dermatology, 16(5), 361-370. doi:10.1007/s40257-015-0136-6
- Pariser, D. M. (2014). Hyperhidrosis (4th ed., Vol. 32). Philadelphia, PA: Elsevier.