Sweating (Hyperhidrosis)
Why do I sweat so much?
Excessive sweating is called hyperhidrosis. It often affects the armpits but can also happen on the hands, feet, groin, face, or scalp. Sweating is normal when you're hot or exercising—but hyperhidrosis means you sweat too much, especially when you're nervous, anxious, or stressed. It often runs in families.
Sometimes, sweating is a sign of a medical issue, like diabetes, low blood sugar, menopause (hot flashes), thyroid problems, infections, or even a heart attack. If you're sweating along with other symptoms, talk to your doctor.
How do I get my sweating to stop?
The first-line treatment for hyperhidrosis (excessive sweating) is a clinical strength antiperspirant—not just a deodorant. These products are designed for the armpits but also work on hands, feet, and groin.
Use aluminum-based antiperspirants — they block sweat glands to reduce sweating.
Apply twice daily for the first 2–3 weeks.
Most important: Apply to completely dry skin at bedtime, when sweating is lowest.
Once sweating improves, drop to once daily or a few times per week.
Tips:
If your skin gets irritated, use hydrocortisone 1% ointment twice daily.
“Natural” (aluminum-free) products may help with odor but don’t stop sweat.
What if antiperspirants aren’t working?
If strong antiperspirants aren’t enough, there are prescription and procedural options. Here’s a quick overview of my favorites:
1. Glycopyrrolate pills (oral prescription)
Temporarily blocks sweating for 2–6 hours.
Great for high-stress events (presentations, interviews, dates).
Not ideal for long-term use.
Tip: Combine with antiperspirants—pills can stop the sweat long enough for antiperspirants to start working.
2. Iontophoresis (great for hands/feet)
Uses gentle electrical current to reduce sweating.
Done 3× weekly for several weeks, then weekly for maintenance.
In-office cost: ~$50 per 20-minute session per area (hands or feet).
Home devices: $500–$1,000 (RA Fischer or Hidrex brands).
Needs a prescription in the U.S.
Works best on hands and feet; optional pads can help with armpits.
3. Botox injections
Works well for armpits, palms, or feet.
Requires 20–30 injections per area.
Lasts 2–3 months.
May be covered by insurance after trying cheaper treatments.
4. miraDry
Uses heat energy to permanently destroy sweat glands.
Very effective for underarms.
Expensive: $2,000–$3,000.
Not covered by insurance.
More info and support: sweathelp.org
What if my sweating isn’t getting better?
Most people improve by using antiperspirants as described above. But if sweating continues to be a problem, additional treatments may be needed. Prescription pills, iontophoresis, Botox, or miraDry can make a big difference. Look for a board-certified dermatologist in your area. If you are in or near Utah, see one of my excellent colleagues at the University of Utah or me virtually with Honeydew.
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