Excessive sweating—hyperhidrosis—can affect quality of life, social confidence and comfort. It commonly involves the underarms, hands, feet or face and may occur even when not physically active or in warm conditions. Fortunately, a range of effective treatments exists, from simple lifestyle adjustments to clinical interventions. This article outlines common causes, practical self-help measures and clinical options such as prescription antiperspirants, device-based therapies and injections, so readers can make informed choices.
What is hyperhidrosis?
Hyperhidrosis is a medical condition where sweat production is excessive beyond what is physiologically needed for temperature regulation. It can be:
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Primary focal hyperhidrosis: often hereditary, starts in childhood or adolescence, and affects specific areas such as underarms, palms and soles.
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Secondary hyperhidrosis: caused by underlying conditions (medications, hormonal changes, systemic illness)—requires medical assessment.
How sweat production works
Sweat glands are stimulated by the nervous system. In hyperhidrosis, these glands are overactive, producing more sweat than required. Understanding this helps explain why topical measures sometimes work and why treatments that affect nerve signalling can be effective.
First-line approaches: lifestyle and over-the-counter options
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Antiperspirants: Aluminium chloride or aluminium chloride hexahydrate formulations (stronger prescription types) block sweat ducts temporarily and are often effective for mild to moderate axillary (underarm) sweating.
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Clothing choices: Breathable natural fibres, moisture-wicking fabrics and darker or patterned clothing help manage visible sweat.
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Dietary moderation: Spicy foods, caffeine, and alcohol can trigger sweating in some people—try eliminating triggers to see the effect.
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Topical wipes and absorbents: Helpful for hands/feet, but temporary.
Clinical and device options
1. Topical prescription antiperspirants
Stronger formulations available on prescription may significantly reduce underarm sweating. Follow application instructions to minimise irritation.
2. Botulinum toxin injections
Botulinum toxin type A injections reduce sweating by blocking nerve signals to sweat glands. It is a widely used, effective option for underarm hyperhidrosis and can also be used for palms and soles in specialist hands. Effects typically appear within days and can last several months; repeat treatments are often required.
3. Iontophoresis
A non-invasive device passes a mild electrical current through water to the skin surface (useful for hands and feet). Sessions are carried out in a clinic or with home units; regular maintenance is often needed.
4. Oral medications
Anticholinergic oral drugs reduce sweating by blocking the nerve signal systemically. They may be effective but have side effects such as dry mouth, blurred vision and urinary retention in some people; therefore, they are used selectively under clinical supervision.
5. Energy-based or device treatments
Certain technologies (e.g. microwave-based systems, laser-targeted procedures) can reduce sweat gland activity in the underarm area. Availability and suitability depend on clinic offerings and individual assessment.
6. Surgical options (last resort)
Surgical approaches include sweat gland excision from the underarm or thoracic sympathectomy for severe palmar hyperhidrosis. Due to potential risks and side effects, surgery is reserved for severe, refractory cases.
Choosing the right approach
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Mild symptoms: Start with prescription antiperspirants, lifestyle adjustments and topical measures.
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Moderate to severe axillary hyperhidrosis: Botulinum toxin injections and device treatments often offer reliable improvement.
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Palmar/plantar hyperhidrosis: Iontophoresis, botulinum toxin injections (specialist technique) and oral medication are options.
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If secondary causes are suspected, A medical review is essential to rule out underlying conditions.
Benefits and limitations of botulinum injections for hyperhidrosis
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Benefits: Effective, targeted reduction of sweat can significantly improve daily functioning and quality of life.
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Limitations: Effects wear off over months and require repeat treatment; injections in palms/soles can be more uncomfortable and may affect grip temporarily.
Side effects and safety
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Topical: Skin irritation possible—stop if severe.
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Botulinum toxin: Localised pain, temporary muscle weakness (rare in armpits), flu-like symptoms occasionally—discuss individual risk during consultation.
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Oral meds: Systemic side effects may limit use—careful medical review necessary.
Practical tips and self-management
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Keep a diary to identify triggers (foods, stressors, temperature).
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Trial a strong prescription antiperspirant nightly for several weeks before escalating therapy.
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For hand/foot sweating, ask about iontophoresis; home units can be effective with consistent use.
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Seek professional advice early—effective options exist and can restore confidence.
FAQ’s — Hyperhidrosis
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Is hyperhidrosis common?
Yes. Primary focal hyperhidrosis affects a considerable number of people and is more common than often realised. Many never seek help, but effective treatments are available. -
Will botulinum toxin stop sweating forever?
Botulinum toxin reduces sweat by interrupting nerve signals. Effects are temporary (often several months) and require repeat treatments to maintain benefit. -
Are there side effects from prescription antiperspirants?
Some people experience local irritation or itching; if this occurs, stop use and discuss alternatives with a clinician. -
Can lifestyle changes make a big difference?
For mild cases, yes. Clothing choices, avoiding food triggers (spicy, caffeine) and stress-management techniques can reduce episodes of excessive sweating. -
Is iontophoresis painful?
It can cause mild tingling or discomfort at first; most people tolerate it well. It is a non-invasive option often used for hands and feet. -
When should I see a clinician?
If sweating interferes with daily activities, social life or work, arrange an assessment to discuss safe and effective options. -
Can hyperhidrosis be a sign of something more serious?
Secondary hyperhidrosis can be caused by medication, hormonal changes or medical conditions. A clinical review will check for underlying causes where needed. -
Will treatments be covered by the NHS?
Coverage varies and is often assessed case-by-case. Many people access treatments privately; check local NHS guidance or discuss options with a clinician.
If excessive sweating affects daily life, arrange a clinical assessment to discuss tailored treatment options—from prescription antiperspirants and iontophoresis to botulinum toxin injections and device therapies. A clinician can recommend the safest and most effective approach for the affected area and personal circumstances. To book a consultation, click here.