Hyperhidrosis (hi-pur-hi-DROE-sis) is excessive sweating that occurs even when the temperature isn't hot and you're not exercising. In some people who have hyperhidrosis, the sweat literally drips off their hands.

Hyperhidrosis usually affects the palms of the hands, soles of the feet and underarms. Besides disrupting normal daily activities, hyperhidrosis can cause social anxiety or embarrassment.

One of the first options for treatment involves using prescription-strength antiperspirants on the affected areas. In severe cases, your doctor may suggest surgery either to remove the sweat glands or to disconnect the nerves responsible for the overproduction of sweat.

Most people sweat when they exercise or exert themselves, are in a hot environment, or are nervous, anxious or under stress. The excessive sweating experienced with hyperhidrosis far exceeds such normal sweating.

Hyperhidrosis usually affects the hands, feet, underarms and sometimes the face. Rarely, the entire body is affected. The excessive sweat may soak through clothes or drip off your hands. Episodes usually occur at least once a week without an obvious reason.

When to see a doctor

See your doctor if:

  • Sweating disrupts your daily routine
  • You suddenly begin to sweat more than usual
  • You experience night sweats for no apparent reason

Sweating is your body's mechanism to cool itself. Your nervous system automatically triggers your sweat glands when your body temperature rises. Sweating also normally occurs, especially on your palms, when you're nervous.

In hyperhidrosis, the nerves responsible for triggering your sweat glands become overactive and call for more perspiration even when it's not needed. The problem worsens if you're under stress or nervous.

The type of hyperhidrosis that occurs primarily in your palms and soles may have a genetic component, because it sometimes clusters in families. If you have excessive sweating all over your body, it may be caused by an underlying health factor, such as:

  • Certain medications
  • Menopause hot flashes
  • Low blood sugar
  • Overactive thyroid gland
  • Some types of cancer
  • Heart attack
  • Infectious disease

Complications of hyperhidrosis include:

  • Infections. People who sweat profusely are more prone to skin infections. These infections can range from ringworm to warts.
  • Other skin conditions. Certain skin conditions, such as eczema and skin rashes, occur more frequently in people with hyperhidrosis. Excessive sweating may worsen skin inflammation.
  • Social and emotional effects. Having clammy or dripping hands and perspiration-soaked clothes can be embarrassing. Palm sweat can soak into paperwork, affecting occupational and educational pursuits.

You're likely to start by seeing your family doctor. He or she may refer you to a specialist in skin diseases (dermatologist). In some cases, doctors specializing in the treatment of conditions affecting the nervous system (neurologist) may be consulted.

What you can do

Before your appointment, you might want to write a list that answers the following questions:

  • Has anyone in your immediate family ever had similar symptoms?
  • Does your sweating stop when you're asleep?
  • What medications and supplements do you take regularly?

What to expect from your doctor

Your doctor may ask some of the following questions:

  • When did you begin experiencing symptoms?
  • How often do you experience these symptoms?
  • Have your symptoms been continuous or occasional?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?

During your appointment, your doctor will ask about your medical history and conduct a physical exam. If your symptoms are obvious, it may be relatively easy for your doctor to diagnose hyperhidrosis.

Lab tests

Your doctor may order blood or urine tests to determine if the excessive sweating is caused by another medical condition, such as an overactive thyroid (hyperthyroidism) or low blood sugar (hypoglycemia).

Thermoregulatory sweat test

During this test, your skin is coated with a powder that changes color when it gets wet. The test begins in a room heated to a comfortable temperature, and then you enter a heating cabinet that brings your core temperature up to 100.4 F (38 C). Most people who have hyperhidrosis sweat enough to make the powder turn purple before they go into the heating cabinet.

Hyperhidrosis treatment varies, depending on the severity of the problem. In most cases, your doctor will want to try conservative treatments before suggesting more-invasive options such as surgery.

Medications

Drugs used to treat hyperhidrosis may include:
  • Prescription antiperspirant. If over-the-counter antiperspirants don't help, your doctor may prescribe stronger products to apply at bedtime. Prescription-strength antiperspirants can cause skin irritation, so wash the product off your body in the morning. If your skin becomes irritated, hydrocortisone cream might help.
  • Pills that block nerve communication. Some oral medications block the chemicals that permit certain nerves to communicate with each other. This can reduce sweating in some people, but can also cause dry mouth, blurred vision and bladder problems.
  • Botulinum toxin injections. Commonly used to help smooth facial wrinkles, botulinum toxin (Botox, Myobloc, others) can also block the nerves that trigger sweat glands. However, each affected area of your body will need several injections, which are painful and expensive. And the effects may last for only a few months.

Surgical and other procedures

Other types of hyperhidrosis treatments may include:

  • Iontophoresis. In this procedure, a dermatologist uses a device to deliver a low level of electrical current to the hands or feet, and sometimes the armpits, while that part of the body is immersed in water. Treatments are often performed once a day for several weeks, followed by less frequent maintenance therapy.
  • Sweat gland removal. If excessive sweating occurs just in your armpits, removing the sweat glands there may help. This can be accomplished via liposuction through very small incisions.
  • Nerve surgery. In severe cases of hyperhidrosis, your doctor might suggest a procedure that cuts, burns or clamps the spinal nerves that control sweating in your hands. In some cases, this procedure triggers excessive sweating in other areas of your body.

In addition to over-the-counter antiperspirants, the following suggestions may help you reduce sweating and the associated body odor:

  • Bathe daily. Regular bathing helps keep the number of bacteria on your skin in check.
  • Dry your feet thoroughly after you bathe. Microorganisms thrive in the damp spaces between your toes. Use over-the-counter foot powders to help absorb sweat.
  • Choose shoes and socks made of natural materials. Shoes made of natural materials, such as leather, can help prevent sweaty feet by allowing your feet to breathe.
  • Rotate your shoes. Shoes won't completely dry overnight, so try not to wear the same pair two days in a row.
  • Wear the right socks. Cotton and wool socks help keep your feet dry because they absorb moisture. When you're active, moisture-wicking athletic socks are a good choice.
  • Change your socks often. Change socks or hose once or twice a day, drying your feet thoroughly each time. Women may prefer pantyhose with cotton soles.
  • Air your feet. Go barefoot when you can, or at least slip out of your shoes now and then.
  • Choose natural-fiber clothing. Wear natural fabrics, such as cotton, wool and silk, which allow your skin to breathe. When you exercise, you might prefer high-tech fabrics that wick moisture away from your skin.
  • Try relaxation techniques. Consider relaxation techniques such as yoga, meditation or biofeedback. These can help you learn to control the stress that triggers perspiration.

Hyperhidrosis can be distressing. You may have trouble working or enjoying recreational activities because of wet hands or feet or wet stains on clothing. You might feel embarrassed or anxious about your symptoms and become withdrawn or self-consciousness. You may be frustrated or upset by other people's reactions.

Besides talking to your doctor, you may want to talk to a counselor or medical social worker. Or you may find it helpful to talk to other people with hyperhidrosis. Go online to connect with other people living with the condition.

  • Expertise and experience. Mayo Clinic specialists have been successfully treating hyperhidrosis for decades. Each year, more than 2,000 people seek treatment at Mayo Clinic for hyperhidrosis.
  • Team approach. Specialists from dermatology, neurology, neurosurgery and chest (thoracic) surgery work with you to create the best treatment plan for your needs.
  • Specialized tests. A thermoregulatory sweat test is available at Mayo Clinic in Minnesota. In this test, your body is coated with a powder that changes color when it gets wet. Most people who have hyperhidrosis sweat enough to change the powder's color well before their core temperature is raised to 100.4 F (38 C).
  • Surgical options. Mayo Clinic surgeons developed an effective surgical treatment for hyperhidrosis more than 70 years ago. Over the years, Mayo surgeons have been at the forefront of developing surgical techniques to improve results, speed recovery time and reduce side effects of hyperhidrosis surgery.
  • At Mayo Clinic, we assemble a team of specialists who take the time to listen and thoroughly understand your health issues and concerns. We tailor the care you receive to your personal health care needs. You can trust our specialists to collaborate and offer you the best possible outcomes, safety and service.

    Mayo Clinic is a not-for-profit medical institution that reinvests all earnings into improving medical practice, research and education. We're constantly involved in innovation and medical research, finding solutions to improve your care and quality of life. Your doctor or someone on your medical team is likely involved in research related to your condition.

    Our patients tell us that the quality of their interactions, our attention to detail and the efficiency of their visits mean health care — and trusted answers — like they've never experienced.

    Why Choose Mayo Clinic

    What Sets Mayo Clinic Apart

    Several treatment options are available for hyperhidrosis. Your doctor will work with you to find the least invasive treatment that relieves symptoms. Nonsurgical treatments for hyperhidrosis may include:

    • Topical medications. These include over-the-counter and prescription antiperspirants.
    • Iontophoresis. This procedure delivers a low current of electricity to the hands or feet, and sometimes to the armpits, while that part of the body is immersed in water.
    • Oral medications. These may include medicines that block nerve impulses to sweat glands to reduce sweat output.
    • Botulinum toxin injections. Commonly used to help smooth facial wrinkles, botulinum toxin (Botox, Myobloc, others) can also block the nerves that trigger sweat glands.

    Surgery

    Surgery is generally reserved for severe cases of hyperhidrosis, when more-conservative treatments have failed. At Mayo Clinic, surgery is most successful in treating hand and underarm hyperhidrosis. If excessive sweating occurs just in your armpits, removing the sweat glands there may help. At Mayo Clinic, this can be accomplished via liposuction through very small incisions.

    In severe cases of hand hyperhidrosis, your doctor might suggest a procedure that cuts, burns or clamps the nerves that control sweating in your hands. In some cases, this procedure triggers excessive sweating in other areas of your body. Mayo surgeons have developed surgical techniques that greatly reduce the occurrence of this bothersome side effect.

    Many Mayo doctors perform hyperhidrosis nerve surgeries through just one small incision, typically measuring less than 1/2 inch (1 centimeter). This can shorten recovery time and reduce postoperative pain.

    Mayo Clinic works with hundreds of insurance companies and is an in-network provider for millions of people. In most cases, Mayo Clinic doesn't require a physician referral. Some insurers require referrals or may have additional requirements for certain medical care. All appointments are prioritized on the basis of medical need.

    Specialists in dermatology and chest (thoracic) surgery treat hyperhidrosis in adults at Mayo Clinic in Arizona.

    For appointments or more information, call the Central Appointment Office at 800-446-2279 (toll-free) 8 a.m. to 5 p.m. Mountain Standard Time, Monday through Friday or complete an online appointment request form.

    Specialists in dermatology treat hyperhidrosis in adults at Mayo Clinic in Florida. Surgical treatment is a team effort involving specialists in neurosurgery and cardiothoracic surgery.

    For appointments or more information, call the Central Appointment Office at 904-953-0853 8 a.m. to 5 p.m. Eastern time, Monday through Friday or complete an online appointment request form.

    Specialists in dermatology, neurology, neurosurgery and chest (thoracic) surgery treat hyperhidrosis in adults at Mayo Clinic in Minnesota.

    For appointments or more information, call the Central Appointment Office at 507-538-3270 7 a.m. to 6 p.m. Central time, Monday through Friday or complete an online appointment request form.

    See information on patient services at the three Mayo Clinic locations, including transportation options and lodging.

    Mayo Clinic doctors have conducted extensive research aimed at improving the treatment outcomes for people who have hyperhidrosis.

    Publications

    See a list of publications by Mayo doctors on hyperhidrosis on PubMed, a service of the National Library of Medicine.

    Sep. 21, 2012