by EBSCO Medical Review Board
(Excessive Sweating)


Hyperhidrosis is excessive sweating. Common places are the palms of the hands, soles of the feet, and/or the armpits.

Sweat Gland
Nuclus factsheet image
Copyright © Nucleus Medical Media, Inc.


Primary hyperhidrosis does not have a cause. It may be triggered by:

  • High emotional states, such as intense sadness, fear, anger, or stress
  • Spicy foods
  • Hot climates
  • Certain medicines

Secondary hyperhidrosis is caused by an underlying health problem, such as:

Risk Factors

Things that may raise the risk of secondary hyperhidrosis are having any of the health problems that cause it.


Problems may be:

  • Excessive sweating of palms of the hands and/or soles of the feet
  • Excessive sweating of the armpits, head, and/or face
  • Increased amount of sweating
  • Change in pattern of sweating
  • Change in the sweat odor
  • Stained, wet clothing

This problem can be embarrassing and affect relationships.


The doctor will ask about your symptoms and health history. A physical exam will be done. This may be enough to make the diagnosis in some people.

Tests may be done to find out what may be causing the problem.


The goal is to manage symptoms.

Topical Treatments

Treatments can be applied to ease sweating. These are:

  • Aluminum chloride hexahydrate
  • Aluminum tetrachloride
  • Formalin compresses
  • Glutaraldehyde compresses
  • Iontophoresis (stimulation with electrical current)


Medicines may be used to treat secondary hyperhidrosis. This is not common due to side effects. They may be:

  • Amitriptyline
  • Clonazepam
  • Beta blockers
  • Calcium channel blockers
  • Gabapentin
  • Oxybutynin
  • Indomethacin

Botulinum A Neurotoxin

Botulinum A neurotoxin injections can ease sweating in certain areas. It is often used on the palms of the hands and armpits. It can last 6 to 8 months.


Some people may choose to have surgery. Choices are:

  • Endoscopic thoracic or lumbar sympathectomy to kill the nerves that stimulate sweating
  • Curettage to remove sweat glands with surgical scraping
  • Liposuction techniques to remove sweat glands


There are no current guidelines to prevent hyperhidrosis.


Family Doctor—American Academy of Family Physicians 

International Hyperhidrosis Society 


Health Canada 



Hyperhidrosis. EBSCO DynaMed website. Available at: Accessed October 23, 2020.

McConaghy JR, Fosselman D. Hyperhidrosis: Management Options. Am Fam Physician. 2018 Jun 1;97(11):729-734.

Revision Information