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Hyperhidrosis is excessive sweating that can occur in specific, local areas of the body such as palms, feet, armpits, or all over (while people are awake). Often, sweat is visible on the palms, fingertips, and soles of feet/toes. It can be mild or severe and can affect a person’s occupation, activities of daily living (such as writing, handling papers, shaking/ holding hands, and gripping objects), and may have social impact. Hyperhidrosis is not related to any underlying disease process, or medications. It is not a contagious condition or the result of poor hygiene.

Coping strategies

  • Wicking clothing and sheets are available made of microfiber materials that pull wetness away from the skin surface and dry quickly.

  • Wearing cotton socks, and changing them throughout the day can ease the feeling of soggy feet.

  • Absorbent shoe liners are available to pull wetness away from the foot surface.

  • Use of writing utensils that are waterproof and smudgeproof (e.g. Fisher Space Pen).

  • Stress reduction and anxiety avoidance- increased awareness of triggers and use of relaxation or biofeedback may reduce episodes or severity of condition.

Hyperhidrosis treatment

  • Over-the-counter and prescription preparations applied directly to the areas that sweat. The active ingredient is Aluminum Chloride and is present in many clinical strength antiperspirants. Application to dry skin is usually recommended twice daily, especially at bedtime. Irritation to treated areas can sometimes occur.

  • Oral medications may be prescribed to decrease sweating. These medications can affect sweat production all over the body and people should take measures to avoid overheating. Side effects can also include dry eyes, rapid heart rate, dry mouth, and bowel or bladder dysfunction. Most people tolerate this quite well. 

  • Tapwater iontophoresis is the use of a small device that delivers a mild electrical current through a water pad or tray that will "zap" the sweat ducts, causing them to close. Units are available with varying costs and effectiveness, and response varies per individual. Dryness and cracking of treated sites sometimes occurs. Despite involving electrical currents, the associated pain with treatments is usually well tolerated and minimal.

  • Botulinum toxin injections may be recommended for severe axillary hyperhidrosis that doesn’t respond to other treatments. Multiple injections are given at the site of sweating. This procedure can be painful and often requires repeat injections at 3-6 month intervals. This is a very expensive treatment, and rarely used in children.