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Excessive Sweating

What is hyperhidrosis?

Hyperhidrosis is a medical condition characterized by excessive sweating. Normally, sweating helps control the body’s temperature, but when sweating occurs too often and in an amount over what is needed, this may result in hyperhidrosis.

Many patients who have hyperhidrosis sweat from one or two areas of the body. Most often, they sweat from their underarms, palms or soles.

Hyperhidrosis can be uncomfortable, embarrassing and interfere with everyday activities. Underarm sweat can be seen through clothing and cause embarrassment. Sweaty palms can create the appearance of nervousness or lack of confidence in work or social situations.

Causes of hyperhidrosis

Our body’s nervous system tells the body when to sweat. Hyperhidrosis is caused by dysregulation of the nervous system, or by abnormal glands that produce sweat. There are many underlying etiologies of hyperhidrosis. The leading causes of excess sweating are:

  • Idiopathic
  • Hereditary
  • Underlying medical condition such as diabetes and gout
  • Side effect of medications
  • Anxiety disorders

Hyperhidrosis effects all ethnicities and ages. For many people, hyperhidrosis begins during puberty. Hyperhidrosis occurs independent of outside temperature or environment.

If you are experiencing excessive sweating, board certified dermatologist Dr. Rachel White will assess for an underlying cause and further, discuss the myriad of treatments available to you such as those listed below.

Treatment options for hyperhidrosis

Topical prescription strength antiperspirants

Antiperspirants are considered first line treatment for excessive sweating of the underarms, hands, and feet. They are the least invasive treatment option for hyperhidrosis and Dr. White often recommends that they be tried first before other more invasive treatments. If topical prescription strength antiperspirants fail, other modalities are recommended, such as, oral medications or injections with Botox or other botulinum toxin products that reduce sweating in these sensitive areas.


Qbrexza is a newer topical medication that can be used for excessive underarm sweat in patients 9 years of age and older. The medication is incorporated into a cloth that is wiped under each arm once daily. Qbrexza, an anticholinergic medication, works on the sweat glands directly to decrease sweating. Although it’s relatively simple to use, Qbrexza should be avoided in certain medical conditions like glaucoma, myasthenia gravis, Sjogren’s syndrome among others. It is also not recommended in pregnancy or lactation.

Botox and other botulinum toxin injections

Botox and other botulinum toxin products are excellent methods for controlling hyperhidrosis. They work by temporarily blocking the chemical signals from the nerves that tell sweat glands to produce sweat. When the glands don’t receive these signals, sweat isn’t produced and your skin stays dry in the targeted areas. Sweat continues normally in untreated regions of the skin. Prior to injections, the skin is numbed to increase your comfort. Typically, one session of Botox is needed to achieve results and sweating gradually returns between 6 and 9 months.

Oral agents

Systemic anticholinergic medications are also considered; however, side effects often outweigh the benefit of these medications.

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