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.
What Causes Underarm Sweat (Axillary Hyperhidrosis)
Are you curious about why your underarms are always sweaty? It’s a pretty common problem, but most people don’t know the reason for it. Excessive underarm sweat is due to a condition called axillary (aka armpit) hyperhidrosis. This is a form of primary focal hyperhidrosis - a condition that causes people to produce excessive sweat on specific parts of the body. The excessive sweating from axillary hyperhidrosis is believed to be caused by a combination of genetics and other factors. Hyperhidrosis is thought to cause overactive sweat glands in the underarm areas to produce more sweat than is necessary to regulate body temperature. For people with axillary hyperhidrosis, the overactivity of their sweat glands can be an uncomfortable and embarrassing problem. Fortunately, there are several specific solutions and treatments you can use to learn how to stop your underarm sweat.
Why Standard Antiperspirants may Not Help Underarm Sweat
Regular antiperspirants are designed to reduce the amount of sweat an average person produces due to environmental conditions, like heat. However, a person with hyperhidrosis sweats significantly more than a person without hyperhidrosis (often regardless of the presence of heat), so people with the condition often need specialized antiperspirants. If you think you might have this hyperhidrosis, it will help to learn everything you need to know about hyperhidrosis.
How to Stop Underarm Sweat
Unsure of how to stop underarm sweat? There are several very effective methods you can use to control your sweat!
Over-The-Counter vs. Prescription Strength Antiperspirants
Many people with hyperhidrosis wonder if they should use antiperspirant or deodorant, or both. The answer is "yes". A good first step to combat axillary hyperhidrosis (underarm sweat) is to apply a stronger antiperspirant specifically tailored to manage hyperhidrosis. It is necessary to understand what antiperspirant does and that it is different from deodorant in order to see why antiperspirant is so important for those with hyperhidrosis.
Antiperspirant reduces the amount of sweat a person produces by blocking sweat glands, while deodorant merely masks the smell of body odor. There are two categories of antiperspirants that can help with excessive underarm sweat: over-the-counter antiperspirants and prescription strength antiperspirants. The biggest difference between the two groups of antiperspirants is the percentage of the active aluminum compounds that work to reduce sweat. Currently, almost all antiperspirants utilize one of these many aluminum compounds to keep the pores from producing sweat. In most cases, an antiperspirant with more than 20-25% aluminum requires a prescription to purchase.
It can be confusing when attempting to choose the right over-the-counter antiperspirant, but understanding the type of active ingredient and its strength for each product can make the process easier. Certain deodorants are better for hyperhidrosis then others and many people benefit from using antiperspirant deodorants, which combine the properties of each product.
Many people begin treating their hyperhidrosis with an over-the-counter topical solution, then seek a prescription from a dermatologist if that method does not reduce their underarm sweat. To help you decide which antiperspirant is going to be most effective we recommend managing your hyperhidrosis with a doctor.
When antiperspirant alone is not enough to curb underarm sweat, botox injections can be a helpful treatment. Botox for axillary hyperhidrosis is an effective treatment for axillary hyperhidrosis that was approved by the FDA in 2004.
Although it is typically associated with cosmetic surgeries, botox is a compound with an impressive ability to reduce underarm sweat. When botulinum toxin (Botox) is injected into the dermis of the underarms, the neurotransmitters that control the reception and execution of neural messages are essentially paralyzed. Botox is widely used for a myriad of treatments and surgeries, but it is important to realize that botox is actually a very strong toxin that can easily paralyze human cells. For this reason, it is important to make sure that you get botox treatments from an experienced doctor. Repeat Botox injections are needed every 6 or 12 months to maintain results. Botox can also be used as a treatment for palmar and plantar hyperhidrosis.
Electromagnetic Energy (MiraDry)
One of the newest technologies to emerge in the fight against excessive underarm sweat are electromagnetic energy treatments like MiraDry. These treatments utilize electromagnetic energy to eliminate sweat glands in the underarms. They are one of the local permanent treatment options for axillary hyperhidrosis, meaning that results should last forever. The treatment works by cooling the epidermis (the first and most exterior layer of the skin) while using the electromagnetic energy to heat and destroy the sweat glands found in the dermis (the second layer of skin). Electromagnetic treatments are emerging as one of the more effective treatments for individuals with axillary hyperhidrosis. Most people undergo either two to three treatment sessions over the course of a year in order for the electromagnetic treatments to be most efficacious. As this technology was developed within the last decade, the long-term results are still unknown. However, all current tests, studies, and uses have shown that electromagnetic energy treatments appear to be a legitimate and safe operation.
If one type of treatment is not entirely effective, it can be combined with other treatments to make it more effective. In some cases, doctors may prescribe oral medications for hyperhidrosis alongside one of the more targeted treatments.
It may also be helpful to look into new products that have come out recently, like Qbrexza, made by the company Dermira. Qbrexza is a medicated wipe that can be used to prevent sweat production on certain areas of the body. It is known to be especially effective for treating underarm sweat. Future treatments and research are actively being developed, and hopefully, in the next several years there will be even more comprehensive treatment options for people who have hyperhidrosis.
Oftentimes, people with axillary hyperhidrosis struggle with armpit stains, which can be hard to get rid of. There are some effective ways to remove armpit stains that can keep clothes from being destroyed. If you prefer to use synthetic fabrics, there are specific ways to get pit stains out of polyester. It can also be difficult to remove antiperspirant from skin if you don't know how, but by using a paste in the shower which can be easily washed off, it is simple to do.
Excessive underarm sweat is highly treatable; in fact, it’s one of the easiest types of hyperhidrosis to get under control! So, don’t give up, explore your options, and you will see results.
- 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
- MiraMar Labs, O'Shaughnessy, K., & Melkerson, M. (2011). 510(k) Summary. Division of Surgical, Orthopedic And Restorative Devices. Retrieved May 23, 2018, from https://www.accessdata.fda.gov/cdrh_docs/pdf10/K103014.pdf.
- Qbrexza. (2018). Retrieved May 13, 2020, from https://dermira.com/our-medicines/
Hyperhidrosis is a disorder that causes excessive sweating. It often creates a sense of discomfort and embarrassment for sufferers and it affects millions of people. According to an article in the journal of Dermatological Clinics, approximately 2.8% of people have some form of hyperhidrosis. That is an estimated 7.8 million people in the US alone! Other sources suggest that hyperhidrosis is even more prevalent than the current estimates show..
Fortunately, many medical solutions are currently available to help reduce excessive sweating. Antiperspirant, which can be found over-the-counter, is one of the most effective treatments for hyperhidrosis. It is also the first solution that most dermatologists will recommend for their patients. This is because antiperspirant contains an active ingredient that reduces sweat production. Antiperspirants are available over-the-counter and there are even prescription strength antiperspirants you can buy without a prescription.
Many people don’t realize what antiperspirant is or how it differs from deodorant, but they are quite different. The FDA regulates antiperspirant because the active ingredients in it are considered to be drugs, while deodorant is not as strictly regulated. Deodorant is made up of an antibacterial component and a scent which is used to mask the smell of body odor. This can be helpful, especially because deodorant kills bacteria on the skin that cause sweat to smell bad, but it won’t prevent excessive sweating. Sometimes, people find prescription strength deodorant helpful, but they don’t actually reduce sweating. Often, deodorants for hyperhidrosis are combined with an antiperspirant, these are called antiperspirant deodorant. These combination products work well for some, but in certain situations it’s necessary to use separate products, especially in cases that involve moderate to severe hyperhidrosis.
What is in Antiperspirant?
Antiperspirant is a substance that can be applied to the skin in order to reduce sweating. It can be challenging to choose the right over-the-counter antiperspirant because there are so many different options available. However, understanding the active ingredients in antiperspirant can make the decision easier. Most antiperspirants use a type of metallic salt as an active ingredient. This is because they form a superficial plug inside of sweat glands which stops sweat from escaping to the surface of the skin. Aluminum chloride is the most common active ingredient found in antiperspirants and it is usually quite effective. Newer, clinical strength, products often use aluminum chloride hexahydrate or zirconium trichlorohydrex as an active ingredient. These are usually used when aluminum chloride has not provided enough relief or if it causes too much irritation. All of these active ingredients reduce sweating in a similar way, but the clinical strength antiperspirants are thought to be slightly more powerful and less irritating.
Antiperspirants Available Over-the-Counter
For many, physician or dermatologist intervention may not be necessary. Instead, simply purchasing a clinical strength antiperspirant over-the-counter can be a good first step to address your hyperhidrosis. To help decide which antiperspirant may be right for you, we have compiled information on five of the most popular antiperspirants specifically made to address hyperhidrosis. The purpose of this review is to provide an unbiased review of hyperhidrosis treatments, and no organization has paid or otherwise endorsed us to comment on their product. These products are all antiperspirants and don’t contain prescription strength deodorant. For each product, we will present information on five categories:
- Treatment Area: Which area of the body this product is supposed to be applied?
- Type: Is the product in stick, roll-on, lotion, or wipe form?
- Application Instructions: how often to apply the product, when to apply the product, what to avoid when applying the product.
- Active Sweat-Reduction Ingredients: What form of aluminum is in the product? What is the percentage of the aluminum in the product?
- Price: How much is the product? How long will the product last until I must purchase it again?
Carpe is an antiperspirant designed to reduce excessive sweating on specific parts of the body for people with hyperhidrosis. Originally, Carpe had both a hand solution and a foot solution. Both solutions are identical in terms of chemical composition. They have more recently come out with sweat solutions for the face, breast, underarms, and groin. The traditional solutions are lotions, and each lotion utilizes the active ingredient aluminum sesquichlorohydrate. The mixture of 15% aluminum sesquichlorohydrate with 85% moisturizing creams works to reduce sweat while avoiding irritating the hands and feet. Although Carpe is specifically bottled for the 
CertainDri (Prescription Strength)
Certain Dri is designed as a treatment for axillary hyperhidrosis (underarms). Certain Dri offers three types of antiperspirant, but their highest type, prescription strength antiperspirant, is best suited for addressing cases of hyperhidrosis. This product, Certain Dri Prescription Strength, is an over-the-counter antiperspirant that is made of 12% aluminum chloride and 88% moisturizing and anti-irritating solutions. The antiperspirant is considered a roll-on solution, and Certain Dri’s website recommends that the user apply the product at night to dry skin in order to see the best results. Most people will need to apply the product every other night, although the product may need to be applied nightly or every third night depending on your personal needs. A 1.2 ounce package of Certain Dri Prescription Strength sells for $8.86, and the product will most likely last 5-6 weeks when used every other night.
Like Certain Dri, DuraDry is also designed to treat underarm sweating for those with hyperhidrosis. DuraDry is considered a stick antiperspirant, meaning that the solution is a solid block, like deodorant, rather than a liquid or gel solution in a tube (roll-on). When purchasing DuraDry, It’s highly recommended to purchase both DuraDry Am and DuraDry PM. While using DuraDry PM , the user applies a stronger antiperspirant consisting of 15% aluminum chloride and 85% moisturizing and anti-irritating ingredients in the evening. The next morning, the user applies the weaker antiperspirant and deodorant combination in DuraDry AM. DuraDry AM consists of 20% aluminum zirconium and 80% moisturizing and deodorizing compounds. Although a package of DuraDry is $37.00, the fact that the solution is estimated to last for 200 underarm applications means DuraDry will most likely last at least 4-5 months. DuraDry also has prescription strength antiperspirants available.
SweatBlock is an antiperspirant wipe that allows the user to reduce sweating and treat axillary hyperhidrosis. However, SweatBlock users have reported that the wipes work to reduce sweating on other regions of the body, and possibly could be used for 
ZeroSweat is a hyperhidrosis formula that offers two solutions - one to address palmar and plantar hyperhidrosis (hands and feet), and a second method to treat axillary (underarms) hyperhidrosis. The first product, the antiperspirant for hands and feet, is a lotion that is applied typically 2-3 times per day on an as needed basis. The second product, the antiperspirant for axillary hyperhidrosis, is applied on a daily basis. The underarm product is estimated to last 3 months, whereas the hand lotion will most likely last 4-8 weeks. The price for a bottle of ZeroSweat hand lotion is $9.95, and the stick antiperspirant is $14.95.
Besides the products detailed above, there are many antiperspirant products on the market that can help those with hyperhidrosis. Several brands have both a regular strength and prescription strength antiperspirant product. Some brands may also advertise a prescription strength deodorant. Many antiperspirants can be used on problem areas they weren't originally intended for. This can be helpful for people who have excessive sweating in areas other than the hands, feet, and armpits. There are even options for people who need antiperspirant for sensitive areas like the face and groin. Antiperspirant is also a solution doctors often propose when  It is also important not to apply antiperspirant right after showering because the water will make it harder for antiperspirant to sink into skin. However, antiperspirant does need to be applied to clean skin, so cleaning your skin, removing any other products, and waiting for it to dry before applying your daily antiperspirant is your best bet.
Dealing with Antiperspirant Issues
Antiperspirant is a lifesaver for many people with hyperhidrosis, but it can cause some functional issues. For example, it can stain clothing. Luckily, there are ways to get antiperspirant out of clothes so that it doesn’t destroy your wardrobe. Stains are already an issue for those who deal with armpit sweating, so it is always a good idea to know how to remove armpit stains from clothing as well. Some people also struggle to remove antiperspirant from skin, but it can be removed by showering with warm water and using a baking soda solution on the affected areas. If you feel like antiperspirant is helping you to reduce sweating but you are still having issues with body odor then you may want to check out a deodorant to use on top of your antiperspirant. This can be a regular deodorant or a prescription strength deodorant.
- 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
- Zirwas, M. J., & Moennich, J. (2008). Antiperspirant and Deodorant Allergy Diagnosis and Management. The Journal of Clinical and Aesthetic Dermatology, 1(3), 38-43. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3013594/
- Clutch Inc. (n.d.). Antiperspirant for Sweaty Hands & Feet. Retrieved May 24, 2018, from https://www.carpelotion.com/
- Certain Dri Inc. (n.d.). Certain Dri® is here for you. Retrieved May 24, 2018, from https://www.certaindri.com/
- DuraDry Inc. (n.d.). Stop Armpit Sweat - Prevent Excessive Armpit Sweating | Duradry. Retrieved May 24, 2018, from https://www.duradry.com/
- SweatBlock Inc. (n.d.). Stop Excessive Sweating and stay dry with Sweatblock! Retrieved June 20, 2018, from https://www.sweatblock.com/
- ZeroSweat. (n.d.). Stop Excessive Sweating. Retrieved May 24, 2018, from https://www.zerosweat.com
- Not Just for Underarms. (n.d.). Retrieved June 20, 2018, from https://www.sweathelp.org/hyperhidrosis-treatments/antiperspirants/not-just-for-underarms
Although many individuals are aware of how to manage hyperhidrosis with a doctor and the medical treatments available to reduce the effects of hyperhidrosis, there are several alternative methods that can be very effective in reducing hyperhidrosis. Notably, individuals can take several actions regarding their choices of diet, clothing, and daily habits to reduce their sweat.
Many dietary factors can increase or decrease the effects of hyperhidrosis. For example, spicy foods can have a powerful effect on your body’s thermoregulation system and worsen any hyperhidrosis symptoms you might already be suffering. In an attempt to regulate your body’s temperature as a response to spicy food, your body may send more nerve impulses to your sweat glands and compound the effects of your hyperhidrosis. Additionally, caffeine can act as a sweat-inducing agent. Beverages like coffee, soda, and energy drinks that are high in caffeine introduce stimulants into your body and increase the activity of your body’s functions, including the sweat glands. A third dietary factor that could have a significant effect on your sweat levels is alcohol. Alcohol dilates your blood vessels and warms the skin, triggering your parasympathetic nervous system to cool down your body with sweat. If spicy foods, caffeinated beverages, or alcohol are a large part of your diet, they may be causing some of your excessive sweating. It may be a good idea to consider reducing your consumption of these foods and drinks to alleviate your sweat. 
In addition to dietary decisions, choices regarding clothing can play a significant role in how you manage your sweat.
First, you should always try to wear breathable clothing made of materials that will allow fresh air to flow in and out of your garments. Choose fabrics such as cotton, linen, and chambray, and avoid fabrics like polyester, rayon, and denim.
Second, be sure to stay away from socks and shoes that will trap heat, air, and moisture around your feet - this is important when treating sweaty feet. Try to use sock materials that are best for sweaty feet, although most cotton clothing is considered breathable, summer-weight wool socks do a better job than cotton socks at keeping your feet dry and comfortable. Additionally, select shoes that have mesh pockets or other openings to allow fresh air to circulate around your feet. Finally, be sure to layer your clothing so that removing layers is easy. Getting overheated in your winter clothing can make you sweat buckets, and good layering will help you cool down quickly and avoid sweating through your base layers. 
Establishing Good Daily Habits
One simple habit that can have a serious impact is making sure to apply antiperspirant at night, this can be especially effective as part of your treatment for axillary hyperhidrosis. Establishing a consistent routine of applying antiperspirants at the same times at night can prove to be a powerful means to reduce excessive sweating. If you have trouble removing antiperspirant from your skin and that is bothering you, there are ways to wash yourself more effectively. Since most individuals sweat less at night, applying the antiperspirant when your skin is dry allows more of the solution to reach your pores. Second, be sure to always wear clean, dry socks and alternate which pair of shoes you wear to treat sweaty feet. Since shoes can be quickly ruined if constantly exposed to sweat, wearing fresh socks that contain the sweat and exposing different shoes to your feet for shorter intervals can go a long way in preserving your shoes. Finally, exercising on a consistent basis can help reduce sweat. Specifically, practicing yoga on a consistent basis can help reduce the amount of sweat your body produces. All of these measures can help you to manage your hyperhidrosis at home and make your life more comfortable.,
- Pariser, D. M. (2014). Hyperhidrosis (4th ed., Vol. 32). Amsterdam: Elsevier Pub. Co., 2014. Retrieved
- Kamudoni, P., Mueller, B., Halford, J., Schouveller, A., Stacey, B., & Salek, M. (2017, June 8). The impact of hyperhidrosis on patients' daily life and quality of life: A qualitative investigation. Retrieved May 21, 2018, from https://hqlo.biomedcentral.com/articles/10.1186/s12955-017-0693-x