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Ask the Expert: Hyperhidrosis (Excessive Sweating)

Written by Natalie Moulton-Levy, MD on November 16, 2017
ask the expert - hyperhidrosis

How do I know it’s hyperhidrosis and not something more serious?

Hyperhidrosis is defined as excessive sweating. There are two types of hyperhidrosis:

  • Idiopathic (or primary) hyperhidrosis has no known underlying cause.
  • Secondary hyperhidrosis is due to an underlying condition.

If you have new onset hyperhidrosis, it’s a good idea to see a board-certified dermatologist to determine the underlying cause.

Will my hyperhidrosis improve as I get older? Or does it typically stay the same?

Hyperhidrosis most often starts during adolescence and typically stays the same over time.

Do I need to see a doctor about my excessive sweating, or is it something I can handle on my own?

If your sweating doesn’t interfere with your quality of life and you can manage it on your own, there is no need to see a doctor.

However, if you’re frustrated by excessive sweating, you should see a doctor in order to come up with a treatment plan. There are many options available.

What type of doctor should I see for my excessive sweating?

You should see a board-certified dermatologist.

How can I determine what triggers my excessive sweating?

To determine your triggers for excessive sweating, start keeping a journal. Write down the foods or situations that precede episodes of hyperhidrosis. If you can't identify your triggers after keeping a journal, see a board-certified dermatologist.

My hyperhidrosis gets worse whenever I’m nervous or excited. Is there anything I can do to help keep it under control?

If your hyperhidrosis is situational (that is, it occurs when you’re nervous or excited), there are many things you can do to keep it under control.

First, you should make sure that you’re wearing a deodorant with antiperspirant. In my practice, I work with patients on relaxation, meditation, and deep-breathing to prevent sweat from occurring in situations where it's usually anticipated.

Alternatively, there are prescription medications that can help with situational anxiety. Botox can also be helpful. More recently, we’ve discovered some energy-based devices that can produce long-lasting effects, some lifelong.

See a board-certified dermatologist to discuss your options.

Summer makes my symptoms worse. How can I manage my excessive sweating in the heat?

Managing excessive sweating in the heat is difficult. Your best bet is to wear a good antiperspirant and breathable clothing. Many people choose to wear darker colors or sleeveless tops in the summer. Although this won’t decrease the sweating, it helps to camouflage the underarm wetness so that others can’t tell you’re living with hyperhidrosis.

Are there any lifestyle changes I can make to keep excessive sweating from interfering with my daily life?

Try a deodorant and relaxation.

Are there specific antiperspirants that are more effective than others?

Antiperspirants with aluminum salts are most effective. These can be over the counter or prescription. The prescription strength ones yield better results and can only be obtained by seeing a board-certified dermatologist.

Are there any changes I should make in my diet to help with excessive sweating?

There are some dietary changes you can make to help with excessive sweating. Things to reduce or avoid are:

  • caffeine
  • alcohol
  • spicy foods
  • piping hot foods
  • onions
  • garlic

How common is hyperhidrosis? Does it affect certain people more than others?

It’s estimated that 2 to 3 percent of the population has axillary (underarm) or palmoplantar (hands and feet) hyperhidrosis.

There are a number of medical conditions, like obesity, where we see increased rates of hyperhidrosis.


Natalie Moulton-Levy, MD, is a board-certified dermatologist specializing in both cosmetic and medical dermatology. Her research has been published in textbooks and journals, and she has lectured at numerous national dermatology meetings.

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