Normally, sweating helps cool the body to prevent overheating. When sweating is so excessive that it disrupts normal daily life and causes anxiety, it is likely hyperhidrosis.

What is hyperhidrosis?

Hyperhidrosis is a medical condition that causes abnormal excessive sweating unrelated to external heat or exercise. It can affect the palms, feet, underarms, groin and/or head. Most people sweat in only one or two areas, but the sweating is so intense that it may soak through clothing and drip off your hands. People affected with hyperhidrosis may sweat even when they are cold.

Excessive sweating can cause a person to lose confidence, become self-conscious, create performance anxiety, panic, depression, social avoidance, and low self-esteem.

What are the symptoms?

  • Excessive sweating that has lasted at least six months, affects both sides of the body, begins upon waking and each incidence lasts for at least one week
  • Excessive sweating occurs in one or two areas of the body
  • Sweating that interferes with daily life, and work and personal relationships
  • Excessive sweating began before age 25
  • Sweating that does not occur when sleeping
  • There is a family history of hyperhidrosis

Presence of these symptoms suggests you may have primary focal hyperhidrosis. Secondary hyperhidrosis is caused by an underlying medical condition. If you have sweating and weight loss, sweating during sleep or with rapid heartbeat or chest pain, it is time to call a doctor.

What are the causes of hyperhidrosis?

The cause of primary hyperhidrosis is unclear but heredity plays a role. A family history of hyperhidrosis is an important fact to tell Dr. Pantea Hashemi during your consultation.

Secondary hyperhidrosis can be caused by many conditions including:

  • Heart disease
  • Anxiety
  • Diabetes
  • Gout
  • Hyperthyroidism
  • Obesity
  • Pregnancy
  • Shingle
  • Cancers
  • Infectious diseases
  • Adverse effects of medications

How is it diagnosed?

Dr. Hashemi will review your medical history and conduct a physical examination. She will ask specific questions about your circumstances to attempt to understand the cause. Medical tests may be ordered to identify any underlying causes.

What are the treatment options?

Topical prescription strength antiperspirants

Prescription strength Antiperspirants are considered the first line of treatment for excessive sweating of the underarms, hands, and feet. They are the least invasive treatment option for hyperhidrosis and Dr. Hashemi often recommends that they be tried first before other more invasive treatments.

Prescription-medicated cloth

There is a new topical medication that can be used for excess armpit sweating in patients 9 years of age and older. The medication is supplied on a cloth that is wiped under each arm once daily. The medication works on the sweat glands directly to decrease sweating. Dry mouth, skin redness in the treated area, burning and stinging are potential side effects. However, this drug is contraindicated in some patients with specific medical conditions. Dr. Hashemi will assess whether this treatment is appropriate on an individual basis.

Neuromodulators such as Botox and Dysport Injections  

Botox and Dysport are two excellent methods for controlling hyperhidrosis in the underarms. Additionally, studies suggest it may be effective for other areas where excessive sweating is a problem. They work by temporarily blocking the chemical signals from the nerves that tell sweat glands to produce sweat. Results appear in four or five days and last up to six to eight months.  Retreatment is safe, but temporary muscle weakness may be experienced when used to treat the hands.


This is an option for excessive sweating of the hands or feet. It involves the use of a special medical device that delivers a low-voltage electric current into water to turn off the sweat glands. It can be used several times a week.  It may have side effects so discuss this option with Dr. Hashemi.

Hyperhidrosis effects all ethnicities and ages. For many people, hyperhidrosis begins during puberty. It makes no difference whether you live in a cold climate or a warm, you can still experience hyperhidrosis.

Schedule a dermatology consultation

Hyperhidrosis doesn’t need to negatively impact your life.  Dr. Pantea Hashemi looks forward to discussing treatment options with you at her office at the University Skin Institute in Sacramento, CA.