Excessive sweating (Hyperhidrosis) Dermatologist2025-01-10T22:12:51+00:00

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Excessive sweating, or hyperhidrosis, is a fairly common condition that often affects children and young adults more so than older individuals

ON THIS PAGE, I EXPLAIN THE SYMPTOMS AND CAUSES OF HYPERHIDROSIS – AND HOW TO TREAT IT

Treatment enables people of all ages take control of their skin condition and get their life back

How does excessive sweating impact people on a day-by-day basis?

SOCIAL AWKWARDNESS, DIFFICULTY WITH FINE MOTOR TASKS, AND GENERAL SOCIAL EMBARRASSMENT

Excessive sweating affecting your whole body or one area

You might sweat excessively through your palms, soles, armpits, face or scalp. You may might also have generalised excessive sweating affecting your whole body.

Sweat can sometimes soak through your clothes

You may need to change your clothes more often and have multiple showers a day. You may develop visible sweat patches that can cause you embarrassment.

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An average day with excessive sweating

Excessive sweating of your palms makes it difficult to hold a pen at school or work and you may experience trouble playing sports or musical instruments.

Excessive sweating can sap your social confidence

When you meet new people are you avoiding shaking hands? Does excessive sweating make you feel awkward and limit your social interactions? These feelings can hinder personal relationships and lead to feelings of seclusion.

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Thankfully, many options are available

I will determine the best treatment by the type of hyperhidrosis that you have and whether it is localised or generalised. Some options may be more suitable than others depending on your circumstances.

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I’ll see you and examine your skin before I recommend treatment. In some cases, I can begin treating your condition on the same day.

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More information about excessive sweating (Hyperhidrosis)

FOR THOSE WHO WANT THE DETAILS

Excessive sweating, or hyperhidrosis, is a fairly common condition that often affects children and young adults more so than older individuals.

The condition can occur due to underlying medical problems. More likely than not, we can find no specific cause. We do, however, have reliable treatments for this condition.

Symptoms and lifestyle impacts:

  • Localised excessive sweating affecting your palms, soles, armpits, face or scalp
  • Generalised excessive sweating affecting your whole body
  • Sweat soaking through your clothes necessitating several changes of clothes and multiple showers a day
  • Visible sweat patches that can cause you embarrassment
  • Excessive sweating of palms resulting in social awkwardness and avoiding shaking hands
  • Excessive sweating of your palms resulting in difficulty holding a pen at school or work and trouble playing sports or musical instruments
  • General social embarrassment resulting in avoiding social situations and which can impact on your work events and meetings.

In a large proportion of cases, the medical community won’t know the cause of excessive sweating.

The scientific consensus suggests some causes of localised hyperhidrosis run in families.

Interestingly, it affects many children and young adults. The problem seems to ease with age.

There can be some unusual causes for excessive sweating. It is essential that I rule out medical conditions, including an overactive thyroid gland, medication and other, more unusual triggers.

Anxiety can make hyperhidrosis worse but is not the sole cause.

However, as you feel increasingly anxious about the possibility of excessive sweating, unfortunately your anxiety can perpetuate the situation.

During your consultation, I will work to determine to what extent excessive sweating impacts your life both physically and socially.

Depending on the pattern of excessive sweating and any treatments you previously tried, we can work on a management plan together.

There are many treatment options for excessive sweating. These include:

Aluminium chloride topical preparations

I can use these in localised hyperhidrosis, such as the one affecting the armpits, hands and feet. This treatment can be useful in milder cases, but sometimes the product can cause local irritation, which limits its usefulness.

Iontophoresis

This method utilises a small amount of electric current that passes through the affected areas of skin while we immerse them in water. I mostly use this treatment for hyperhidrosis affecting the hands, feet and armpits (through special pads). The treatment lasts a few minutes and can cause a tingling sensation. You will usually require a course of treatment, and you can repeat it with ‘top-ups’ as needed.

Glycopyrrolate

When present in topical preparations, Glycopyrrolate can be very useful. It can be challenging to obtain Glycopyrrolate in the UK through prescription. It is, however, available in certain topical preparations sold over the counter or online. Glycopyrrolate can be an effective treatment for hyperhidrosis of the scalp and face as well as the hands and feet and axillae. Sometimes, I add Glycopyrrolate to the water in iontophoresis to make iontophoresis more effective.

Oral anticholinergic agents

These include propantheline, oxybutynin and glycopyrrolate. These agents can be really effective in cases of generalised hyperhidrosis, but they carry potential side effects including a dry mouth, constipation and other rarer problems.

Botulinum toxin injections

These injections can reduce sweating in the areas injected for a period of up to six months. Botulinum toxin injections for hyperhidrosis are only licenced for use in the armpits. It’s best to avoid using Botulinum toxin injections in areas such as the hands and feet due to some potential side effects.

Surgical methods

These can be quite risky, and I generally recommend my patients to avoid them.

“What is the best treatment for excessive sweating (hyperhidrosis)?”

I will determine the best treatment by the type of hyperhidrosis that you have and whether it is localised or generalised.

Some options may be more suitable than others depending on your circumstances.

Additionally, we may need to try more than one treatment before we find the best treatment for you. Thankfully many options are available.

“What are the potential side effects of taking oral medication?”

Though tablets carry a risk of potential side effects, the main limiting factor is a dry mouth.

Any other side effects are rare and reversible on discontinuing treatment.

If you tolerate the oral medication well, it can be a very effective solution.

You needn’t take medication all the time. You can reserve it for specific social situations and work presentations if you desire.

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About the author

Dr Penelope Pratsou | Consultant Dermatologist

MBChB, MRCP (UK) (Dermatology)

I’m Dr Penelope Pratsou, a skilled independent Consultant Dermatologist based in Berkshire. I have specialist expertise in the diagnosis and management of all skin cancers, and in performing mole checks. I’m a trained skin surgeon and remove skin cancers, moles, skin tags, cysts and warts.

I also have invaluable experience in dealing with all skin conditions, from the common skin complaints of acne, rosacea, eczema and psoriasis, to the rarer and more complex skin problems, having seen it all through years of NHS work.

After I obtained my Membership to the Royal College of Physicians, I undertook rigorous specialist training in dermatology, before being appointed as a Consultant Dermatologist at the Royal Berkshire Hospital, Reading. There, I helped set up and lead a busy clinic for the diagnosis and treatment of suspected skin cancer. I was also actively involved in supervising and training both dermatology and GP trainees.

Alongside my increasingly busy private practice, I have maintained an NHS practice in Oxford in order to continue to engage with challenging cases and to develop my specialist interest in skin allergy.

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