What is Hyperhidrosis?

Hyperhidrosis is a condition causing individuals to sweat in excess.

With normal sweating, our lives are usually not significantly impacted. With hyperhidrosis, however, the excessive production of sweat can have severe physical and emotional consequences.

Why is hyperhidrosis bad?

People with excessive hand sweating (palmar hyperhidrosis) may feel embarrassment to shake hands with someone, or experience difficulty holding a pen or pencil. People with excessive sweating of the soles of the feet (plantar hyperhidrosis) may need to change shoes frequently, or slip when on smooth surfaces or in shoes.

People suffering with excessive sweating of the armpits (axillary hyperhidrosis) may fear embarrassment over visibly moist clothing or staining of their clothes. These are but a few of the examples of how this condition can affect our daily lives, both physically and emotionally.

Hyperhidrosis causes

There are several causes of hyperhidrosis. Exercise and emotional stress are the most common causes.

However, hyperhidrosis can also be caused by: 

  • Medications
  • Infections
  • Certain cancers
  • Thermal conditions
  • Neurologic origin (spinal or brain dysfunction)

We know that not only is hyperhidrosis a cause of emotional stress, it also can create additional problems for those who suffer from it socially and occupationally. It can precipitate dry, flaky skin, bacterial and yeast overgrowth as well, possibly contributing to the development of other issues.

How to diagnose hyperhidrosis

Most of the time, laboratory testing is not necessary to diagnose this disorder, however when needed, a starch iodine test can be performed in the office. The affected part of the body often guides us to the appropriate treatment options.

Hyperhidrosis treatments

There are a few different hyperhidrosis treatments offered when a patient is struggling with it.

Topical hyperhidrosis treatments:

Topical treatment for localized hyperhidrosis is usually initiated first. This may include an antiperspirant known as aluminum chloride to minimize sweating. Sometimes a side effect of skin irritation may result.

A new topical treatment has become available in the past year in the form of a medicated disposable wipe called Qbrexza containing a different medication that is well tolerated.

A daily treatment called Tap water iontophoresis is another option. It can be performed at home and is useful for foot, hand, and axillary hyperhidrosis.

Oral hyperhidrosis treatments:

An oral medication, called glycopyrrolate, can diminish hyperhidrosis in some patients. It is helpful for patients suffering from not only localized hyperhidrosis but generalized or regional hyperhidrosis as well. Some patients may experience side effects such as dry mouth and blurred vision, etc. from this medication.

Injectable hyperhidrosis treatments:

A more aggressive treatment option would be the injection of botulinum (Botox) into the affected areas. This helps to suppress the sweating for 4-6 months, although can be quite uncomfortable during the treatment as it requires multiple injections.

This treatment is also often not covered by insurance plans. Local destruction of the sweat glands by a laser is an additional treatment option available, however it is usually limited to the armpit areas and also is not covered by insurance.

Surgical hyperhidrosis treatments:

Other treatment options include surgery. Sweat glands can be removed surgically for axillary hyperhidrosis. A surgical procedure called a sympathectomy can be performed to help control palmar and plantar hyperhidrosis.


We understand how frustrating and distressing this disorder can be. If you sense that you may have this condition, we encourage you to make an appointment for an evaluation so that an appropriate treatment plan can be initiated.