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Dermatology
Hyperhidrosis is commonly known as excessive sweating. This condition can affect the whole body, or it can be isolated to certain areas.
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Medically Reviewed October 2023, by Dr. Susan Mayou (GMC: 2405092) - founder of the Cadogan Clinic and one of the world's leading dermatologists
Hyperhidrosis is commonly known as excessive sweating. This condition can affect the whole body, or it can be isolated to certain areas.
People who have this condition often find that they sweat excessively in areas where there is a high concentration of sweat glands, such as the hands, feet, armpits and the groin area.
It is normal to sweat if you get hot or while doing exercise or anything else which requires physical exertion. Sweat is your body’s natural way of cooling itself down. But if you find that you are sweating when your body does not need to be cooled down, then you may be suffering from hyperhidrosis.
The condition is typically worse in the summertime when the temperatures are higher. But the condition can affect sufferers all year round.
Excessive sweating is a common problem, affecting around 2 to 3 percent of the population. However only 40 percent of those affected seek hyperhidrosis treatment.
The condition can be embarrassing, but luckily it can be easily controlled with hyperhidrosis treatment. Excessive sweating treatment can take a number of different forms. Treatment options include tablets, injectables such as Botox, targeting the areas with a weak electric current (iontophoresis) or sweat gland surgery. The treatment will depend on the severity of the hyperhidrosis, the area of the body which is affected and the patient’s own individual circumstances.
There are two types of hyperhidrosis. Primary hyperhidrosis causes excessive sweating in specific areas, such as the underarms and face, without any apparent reason. Secondary hyperhidrosis affects a large area of the body, or sometimes the whole body.
Certain medications or existing medical conditions, such as menopause, can cause secondary hyperhidrosis. But usually primary hyperhidrosis occurs for no obvious reason.
If you suddenly start to sweat excessively, you should seek medical advice to rule out any other medical problem.
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There are a number of reasons why people seek hyperhidrosis treatment.
There are a number of things which can cause hyperhidrosis. Common triggers include:
Sudden changes in body temperature
This may be caused by a number of things including a fever, sunburn or a reaction to a vaccination.
Obesity
There is a strong link between obesity and hyperhidrosis. People who are carrying a large amount of excess weight find that it takes more physical exertion to perform day-to-day activities, resulting in more sweating.
Stress and anxiety
When you get stressed or anxious, your body temperature rises and the sweat glands kick in. Hyperhidrosis is sometimes a secondary symptom of social anxiety disorder.
Pregnancy
Fluctuating hormone levels in pregnancy often cause excessive sweating during pregnancy, particularly during the first and third trimester. It is common for women to sweat excessively during the postpartum period too, as this is the body’s way of getting rid of the extra water retained during pregnancy.
Menopause
Menopause is characterised by hot flushes and night sweats, caused by changing hormone levels.
Alcohol
Alcohol consumption, alcohol withdrawal or alcohol intolerance can cause night sweats. This is because alcohol can affect the nervous system and how the body regulates body temperature. For people who have hyperhidrosis, alcohol can make the problem worse.
Substance abuse
Certain drugs, such as cocaine, increases blood flow, therefore increasing the amount of heat transferred to the surface of the skin, resulting in excessive sweating.
Caffeine
Caffeine is a stimulant. If you drink too much, it can exacerbate excessive sweating, for example in a woman going through the menopause.
Medical conditions
Excessive sweating is also associated with several medical conditions:
Medications
There are also a number of medications which can cause hyperhidrosis. These may include:
You will be asked about your medical history, including the list of medications which you currently take, at your initial consultation at the Cadogan Clinic.
Hyperhidrosis can occur anywhere on the body, but it commonly occurs in areas where there is a concentration of sweat glands. Parts of the body which are particularly prone to excessive sweating include:
Armpits
Most people who suffer with hyperhidrosis experience problems with excessive armpit sweating. People who experience excessively sweaty underarms may find they need to change their shirt or top during the day. Some people may even shower a number of times during the day. However underarm hyperhidrosis has nothing to do with hygiene.
Armpit sweating is usually symmetrical, meaning both underarms sweat equally. If you notice that you are only sweating from one side of your body, you should seek further advice as this may signal an additional underlying problem.
Hands
When hands sweat profusely, this is known as palmar hyperhidrosis. This can make everyday tasks such as holding a pen or using a computer keyboard difficult.
Feet
People who suffer from excessive underarm sweat also tend to experience hyperhidrosis on the soles of the feet too. This is known as plantar hyperhidrosis. People who suffer from this form of hyperhidrosis may find their socks are frequently soaked and as a result change them regularly throughout the day. Sweaty feet can also create odour, meaning a person may feel embarrassed to take their shoes off in public, for example in the changing room at the gym or at a shoe shop. This extra sweat makes the feet slippery, sometimes ruling out certain items of footwear, such as sandals or sliders, as it may be difficult to keep these on the feet.
Face and head
Excessive sweating of the face and head is known as craniofacial hyperhidrosis. There are a number of sweat glands in the face, which makes this particular area of the body prone to hyperhidrosis. People who experience this particular form of hyperhidrosis may take a flannel or towel around with them to soak up any excess sweat. Alternatively, they may carry a small fan to help cool them down. Common triggers for craniofacial hyperhidrosis include eating spicy food and caffeine. A person who experiences excessive sweating of the head and face will often find they continue to sweat long after they finish exercising, meaning they will avoid exercising before work or socialising.
Groin
Men and women can both suffer from a problematic sweaty groin. This form of hyperhidrosis can leave embarrassing stains on clothing and can lead to chafing, itching or a pungent odour. A sweaty groin may also lead to an unpleasant yeast or fungal infection which will require treatment.
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There are a number of products which can be prescribed to help tackle hyperhidrosis, including stronger antiperspirants, foot powders and soap substitutes which are more gentle on the skin. However if you want an effective treatment for excessive sweating, then we offer several hyperhidrosis treatments here at the Cadogan Clinic.
Injectables
Injectables, such as Botox, are an excellent way of tackling excessive sweating. A carefully measured dose is injected into the skin of the armpits. This blocks the signals coming from your nervous system to the eccrine glands (sweat glands). By blocking this signal, this prevents the glands from producing so much sweat.
During the treatment, an iodine solution and starch powder are applied to your armpits to help the dermatologist identify the areas where you sweat. Then a very fine needle is used to deliver a series of small injections to the skin. There may be some stinging, but the procedure is not painful. You should expect results within the following two weeks.
Injectables are not a permanent cure for excessive sweating, but can vastly reduce the amount of sweat produced. The effect varies from one patient to another. You will need repeated treatments in order to maintain the results.
Iontophoresis
Another popular hyperhidrosis treatment is iontophoresis. This treatment involves sending a mild electrical current through water to the hands, feet or armpits, which are all parts of the body which are prone to excessive sweating.
The treatment is spread out over several sessions.
Iontophoresis involves placing the hands and feet into plastic containers filled with tap water, or placing water-soaked pads under your arms. The current is then delivered to the affected areas. The power can be increased or decreased, depending on your tolerance. The treatment may feel uncomfortable, but it should not be painful.
Iontophoresis is usually offered to patients where previous treatments have not worked.
Although iontophoresis is not a cure for hyperhidrosis, this non-invasive excessive sweating treatment can effectively manage the condition.
Iontophoresis machines can be purchased for home use, but we strongly recommend sessions with a trained dermatologist to ensure the best results.
Surgery
In extreme cases of hyperhidrosis, your consultant may recommend surgery. Also known as ETS (endoscopic thoracic sympathectomy), this procedure involves interrupting the nerve signals being delivered to the sweat glands.
This keyhole surgery is carried out under a general anesthetic and takes around two hours in total. A miniature camera is inserted into the chest under the armpit and the surgeon will carefully move your lung aside before cutting or clamping the nerves.
Although surgery is a permanent hyperhidrosis treatment, it is an invasive procedure and comes with significant risks. Immediately after the procedure, you may experience pain or discomfort, particularly when breathing. It is also possible that you may experience something called compensatory sweating, where other areas of your body begin to sweat to make up for a lack of sweating in the areas which have been treated.
There are other serious complications which come attached to ETS, including nerve damage, a slowed heart rate, infection in the space around the lung and air collecting in the chest cavity (pneumothorax). There are also the usual risks associated with general anesthesia, including infection, bleeding and deep vein thrombosis (DVT). If you are considering ETS, your consultant will discuss all the potential risks and benefits with you at your initial consultation.
If you are suffering from excessive sweating of the armpits, then sweat gland surgery to remove the sweat glands from your underarms is a quicker and less invasive surgical option. However this will not tackle the problem of excessive sweating of the hands and feet.
At the Cadogan Clinic, our preferred treatment method is to avoid invasive surgery and to treat the affected areas with injectables, as we believe these to be the most effective and safe.
We have invited a selection of the country's very best consultants to join us at the Cadogan Clinic so that you can be sure that whatever the nature of your treatment, you will be seeing one of the top practitioners in the country.
Dr. Meena Arunachalam
Mr Jonathan Britto
Ms Monica Fawzy
Dr Aveen Connolly
Dr. Roberto Corso
Miss. Elizabeth Hawkes
Dr. Karishma Hemmady
Dr. Wisam Alwan
Dr Maham Khan
Dr Soudeh Mashayekhi
Dr. Susan Mayou
Dr. Sophie Momen
Dr. Alexandra Paolino
Dr. Ravi Ramessur
Mr. Hazim Sadideen
Dr. Amélie Seghers
Dr Kristina Semkova
Dr. Nisith Sheth
Mr. Omar Tillo
Mr. William Van Niekerk
You will meet with one of our highly trained dermatologists at the Cadogan Clinic on Sloane Street, Chelsea for an in-person assessment of your skin.
Your consultant will discuss the following with you at this consultation:
3 Easy Steps
Before undergoing any hyperhidrosis treatment at the Cadogan Clinic, our expert dermatologist will need to examine you in order to give you a diagnosis.
A substance which is made up of a mixture of iodine and starch will be applied to the problem areas. This will change colour when the skin gets wet. This allows the dermatologist to pinpoint the areas of sweating and confirm the severity of the condition.
As part of the diagnostic process, your dermatologist will ask you some detailed questions about your excessive sweating, your medical history and the medications which you take. It is important that you are honest to ensure that we are able to decide on the best hyperhidrosis treatment for you here at the Cadogan Clinic. The dermatologist will also be willing to answer any questions you may have about your treatment.
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Get in touchIs hyperhidrosis genetic?
There is no definitive evidence that excessive sweating is genetic. This is a very common disorder, impacting roughly 3% of the population, or over a million individual people.
Is hyperhidrosis dangerous?
Hyperhidrosis is not a dangerous condition in and of itself, and there is actually very little evidence to show a link between excessive sweating and dehydration.
That said, it can cause a serious impact on self-esteem and self-confidence and have a negative effect on an individual's mental health and wellbeing.
How can I prevent excessive sweating?
Aside from seeking treatment as indicated above, the best advice for limiting excess sweat is:
What hyperhidrosis treatments do the Cadogan Clinic offer?
At the Cadogan Clinic our preferred method of treating hyperhidrosis or excessive sweating is via two methods:
How many treatments will I need for my iontophoresis hyperhidrosis?
With Iontophoresis, the protocol is for 7 treatments over 4 weeks and these must be done regularly and before sweating increases to maintain results. A typical treatment programme will usually follow a format such as:
What results can I expect from my excessive sweating treatment?
Hyperhidrosis can be extremely effectively treated.
Following a prescribed Botox ® injection into the sweat glands, you can expect a major reduction in sweating for a period of between 6 and 12 months, after which you may choose to have further treatment.
The treatment can be administered in a variety of areas, such as the underarms, hands, feet and forehead.
Will hyperhidrosis go away on its own?
Hyperhidrosis can occasionally get better with age, but this is rare. A number of people report that their hyperhidrosis symptoms get worse as they get older. Hyperhidrosis can also change as time goes on to affect other areas of the body. Lifestyle changes, medication changes and changes to a person’s health may cause these changes. Hyperhidrosis may also get worse with pregnancy or menopause.
The only sure-fire way to reduce the symptoms of hyperhidrosis is to seek medical treatment from a dermatologist.
Is my hyperhidrosis treatment permanent?
Surgery for hyperhidrosis is permanent. However these also come with the risk of complications and the results are not guaranteed.
We recommend injectables as a treatment for excessive sweating. These are highly effective and come with much fewer risks than surgery. The results are not permanent, but should last anywhere between six and 12 months before the treatment will need to be repeated.
Is non surgical treatment for hyperhidrosis right for me?
If your aim is to reduce the embarrassment and inconvenience caused by overactive sweat glands but doesn't want an invasive surgical operation such as ETS (Endoscopic thoracic sympathectomy) or liposuction, then either Iontophoresis or Botox® are safe and convenient options.
Iontophoresis is suitable if your hands and feet are affected by excessive sweating. It is a painless non-invasive treatment which is quick and easily performed in the outpatient setting. You need a series of treatments to start off with, an example would be 7 sessions in 22 days, after which you go for maintenance treatments once every 3 weeks or as necessary.
This procedure requires no downtime or recovery time and you can comfortably return to work after the treatment.
Botox injections are very effective for axillary hyperhidrosis and the effects usually last for up to 12 months. Thus, you should choose Botox if you want a once-off treatment for excessive sweating that is long lasting. The procedure is comfortable and you just feel little skin pricks with each injection and just like Iontophoresis, you will resume your normal activities immediately after the procedure.
Botox and Iontophoresis treatments are suitable for people who want treatment for excessive sweating with minimal side effects. There are no serious side effects associated with these techniques and this makes Botox and Iontophoresis the best option for people who wish to avoid surgery.
What lifestyle changes can help manage hyperhidrosis?
In some cases, lifestyle changes can help to manage hyperhidrosis. If your excessive sweating is caused by being overweight or obese, than losing weight can help with this. You can also avoid known triggers, such as drinking alcohol, caffeine or eating spicy foods.
If you experience excessive sweating due to stress or anxiety, then you should try to tackle the cause of this, or alternatively learn some relaxation techniques.
Women who are suffering from excessive sweating due to the menopause should speak to their GP about Hormone Replacement Therapy (HRT) as this may help relieve the symptoms associated with menopause.
The Cadogan Clinic is based at 120 Sloane Street in Chelsea, just off Sloane Square and the Kings Road.
We are accessible by all major bus routes that pass through Sloane Square and Sloane Street, as well as Sloane Square tube station.
We are just a 5 minute walk northwards up Sloane Street once you have arrived at Sloane Square.
Local pay parking is available just around the corner from the Clinic on Cadogan Gate, Cadogan Square and Cadogan Gardens. Our local residential parking zone is the Royal Borough of Kensington & Chelsea.
Address: 120 Sloane Street, Chelsea, London, SW1X 9BW
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