How to Stop Excessive Sweating (Hyperhidrosis)

Excessive sweating (hyperhidrosis) is defined as sweating beyond what is necessary for temperature regulation. Signs include visible sweating that soaks through clothing, sweating that interferes with daily activities like gripping objects, needing to change clothes during the day, or avoiding social situations due to sweating.

Primary hyperhidrosis (excessive sweating without an underlying cause) is not dangerous but significantly impacts quality of life. Secondary hyperhidrosis can be caused by thyroid disorders, diabetes, infections, medications, or menopause. A healthcare provider can help determine whether evaluation for secondary causes is warranted.

Glycopyrrolate (Cuvposa) and oxybutynin are the most commonly prescribed oral medications for hyperhidrosis. Glycopyrrolate is often preferred due to fewer central nervous system side effects. A topical glycopyrronium cloth (Qbrexza) is FDA-approved specifically for underarm sweating.

Clinical-strength over-the-counter antiperspirants contain higher concentrations of aluminum compounds and help many people with mild to moderate sweating. Prescription aluminum chloride 20% (Drysol) is stronger and effective for severe underarm, palm, or foot sweating. Apply at night to dry skin for best results. If OTC products are not working after 4 to 6 weeks, ask a provider about prescription options.

Botulinum toxin (Botox) injections temporarily block the nerves that activate sweat glands, typically reducing underarm sweating by 80 to 90 percent for 4 to 6 months. It is FDA-approved for severe underarm sweating and is often performed by a dermatologist. Botox is a procedural treatment and is not offered by Innocre, but we can evaluate your sweating and refer you to a specialist if appropriate.

If secondary causes are suspected, initial labs typically include thyroid-stimulating hormone (TSH), fasting glucose or A1c, complete blood count, and sometimes follicle-stimulating hormone or estradiol in women near menopause. Night sweats with weight loss or fever may also warrant additional testing. A telehealth provider can order these labs at a nearby lab in MD, WA, or DE.

Night sweats can be benign (room too warm, perimenopause, alcohol, anxiety) or signal a medical condition such as thyroid overactivity, infections, certain cancers, hormone changes, or medication side effects. Persistent drenching night sweats with weight loss, fever, fatigue, or lymph node swelling should be evaluated promptly. Isolated mild night sweats are usually not concerning.

Iontophoresis involves placing hands or feet in shallow water while a mild electrical current passes through. It is effective for palmar and plantar hyperhidrosis, typically requiring 3 to 4 sessions per week initially, then maintenance once or twice weekly. Devices can be purchased for home use. A provider can help you determine if iontophoresis is right for you and offer a prescription for the device when needed.

For people whose sweating is generalized and worsened by being overweight, weight loss often reduces sweating because the body has less mass to thermoregulate. However, primary focal hyperhidrosis (underarms, palms, soles, face) is not strongly tied to body weight and may not improve much with weight loss. Diet, hydration, and avoiding spicy foods and caffeine may also help.

Yes. A telehealth provider can take a focused history, screen for secondary causes, order appropriate labs, and prescribe oral medications like glycopyrrolate or topical treatments like prescription aluminum chloride when appropriate. Innocre serves adults and adolescents 12 and older in MD, WA, and DE. For procedural treatments like Botox, iontophoresis, microwave therapy, or surgery, you will be referred to a dermatologist.