A lot of sweating or hyperhidrosis: symptoms and causes

Hyperhidrosis indicates too much sweating or sweating. Hyperhidrosis or excessive sweating is a common condition that brings a lot of misery. An estimated 2-3% of people suffer from excessive sweating of the armpits or of the palms and soles of the feet. These problems often reveal themselves around puberty. Left untreated, these problems can persist throughout life. Excessive sweating is surrounded by shame and people who sweat excessively experience the psychological and practical consequences. There are various ways to treat excessive sweating. Sweaty armpits can often be treated effectively with the MiraDry. It is a safe and non-invasive treatment that permanently reduces axillary (armpit) sweating.

Excessive sweating

  • What is hyperhidrosis?
  • Primary and secondary hyperhidrosis
  • Causes of many sweats
  • Symptoms of hyperhidrosis
  • Complications excessive sweating
  • Diagnosis and examination
  • Treatment excessive or perspiring a lot
  • Antiperspirants
  • Electrotherapy
  • Aluminum chloride
  • Botulin injections
  • Anticholinergics
  • MiraDry
  • Endoscopic thoracic sympathectomy (ETS)
  • Surgical operation
  • Prognosis

What is hyperhidrosis?

Hyperhidrosis is a medical condition in which a person sweats excessively or perspires due to an overactivity of the sweat glands. This over-activity can take place anywhere on the skin, or be limited to a specific area. Places where it is common are:
  • palms;
  • armpits;
  • groin; and
  • feet (feet).

People with hyperhidrosis sweat even when the temperature is cool or when they are at rest. Hyperhydrosis occurs when more than 100 g of fluid is produced in one armpit for 5 minutes.
In attacks or continuously
Excessive perspiration can be attack or continuous. Primary hyperhidrosis (see below) affects an estimated 2 to 3% of the population, but fewer than 40% of patients with this condition seek medical advice. The symptoms often arise between the ages of 10 and 20 and can persist for decades. In some people this condition is present from birth. Perspiration can be exacerbated by physical exertion, intense mental concentration, nervousness and tension or a warm temperature. Due to concentration, tension or rest, perspiration can also stop temporarily.

Primary and secondary hyperhidrosis

A distinction is made between primary and secondary hyperhidrosis. If sweating occurs as a result of a medical condition, it is called secondary hyperhidrosis. If there is ideopathic (= no cause to be found) hyperhidrosis, this is called primary hyperhidrosis. This form is usually located in the armpits or in the palms or soles or a combination of palms and soles.

Causes of many sweats

In the case of excessive perspiration, no cause can be found in the majority of cases. It occurs in the family in 30-50% of patients. Therefore, a genetic predisposition is suspected. In all likelihood there is an incentive to perspire in the brain, in the hypothalamus.
Hypophysis / Source: Tefi / Shutterstock.com
Underlying condition
If sweating occurs as a result of a medical condition, so with secondary hyperhidrosis, we can think of the following disorders and diseases, among others:
  • acromegaly (which is a rare disease caused by a lump in the pituitary gland, resulting in an excessive production of growth hormone, among other things);
  • certain psychiatric disorders, such as anxiety disorders;
  • cancer;
  • carcinoid syndrome (this syndrome causes small, slow-growing, malignant tumors in various parts of the body);
  • certain medicines;
  • excessive activity of the thyroid gland;
  • heart disease;
  • lung disease;
  • tuberculosis.

Symptoms of hyperhidrosis

Hyperhidrosis is defined as excessive sweating, so that it disrupts normal activities. Episodes of excessive sweating occur at least once a week and have an effect on social life and daily activities. Symptoms of hyperhidrosis may include:
  • Clammy or wet palms;
  • Clammy or wet soles;
  • Frequent sweating; and
  • Noticeable sweating, for example because your clothing is soaked.

Additional complaints and psychosocial problems
People with hyperhidrosis can experience the following:
  • Irritating and painful skin problems, such as fungal infections or bacterial infections;
  • Worry about getting soaked clothing;
  • Reluctant to make physical contact;
  • Withdrawn, sometimes leading to social isolation and depression;
  • Looking for work where physical contact or human interaction is not a requirement;
  • Spending a good part of the day sweating, such as changing clothes, wiping sweat, placing napkins or pads under the arms, washing, wearing dark clothing, etc .;
  • You worry about your body odor.

Complications excessive sweating

In severe cases, the skin can become soaked by constant sweating and be affected and swell. Hyperhidrosis is often associated with bromidrosis: the spread of an unpleasant smell of sweat. This is due to the bacterial breakdown of sweat and surface cells.
Hyperhidrosis, especially in childhood, can have a negative impact on life and even lead to social isolation and school problems or problems at work.
Blood collection for examination / Source: Istock.com/anna1311

Diagnosis and examination

Case history and physical examination
In the first instance, a doctor will try to rule out any underlying conditions, such as an overactive thyroid gland (hyperthyroidism) or low blood sugar (hypoglycaemia), by blood and urine tests. the doctor will try to find out more about your symptoms during an interview, such as on which parts of the body you sweat a lot, how often you perspire, in what circumstances, whether there are triggering factors and whether you also sweat during sleep. The doctor can also ask you the following questions:
  • How do you deal with episodes of excessive sweating; for example, do you use napkins, antiperspirants, towels, or other aids?
  • Does hyperhidrosis affect your behavior or mental state when you move among people?
  • Has hyperhidrosis or has no effect on your career choice?
  • Have you ever lost a friend due to hyperhidrosis?
  • How often do you change clothes?
  • How often do you wash yourself or take a bath or shower?
  • How often do you think about excessive sweating?

Iodine starch test
The iodine starch test allows the doctor to get an idea of ​​the amount of sweat secretion. The skin is first thoroughly dried and rubbed with an iodine solution. Starch is then sprinkled over the skin, which reacts with iodine in the presence of perspiration. This gives a dark blue or black discoloration.

Treatment excessive or perspiring a lot


Hyperhidrosis is often combated with antiperspirants in the beginning. If this does not harm the dike, one often finds the way to the doctor. This can prescribe agents that can be used locally to reduce the activity of the sweat glands. These products generally have little effect.


With lighter forms of hyperhidrosis, electrotherapy may be a possibility. Hereby the sweat channels are temporarily closed. This treatment option is especially suitable for hands and feet.

Aluminum chloride

If ordinary deodorants do not help sufficiently, aluminum salts in a strength of 15-20% and alum powder can be used. Apply this solution of aluminum chloride on dry and clean skin in the evening. Washed off again in the morning. Apply to the skin every evening at the beginning and after 5 days every other day or a few times a week (a maintenance dose). This treatment can cause skin irritation.

Botulin injections

Botulin injections can also offer a solution. With this treatment the sweat secretion is made with the help of botulinum toxin
blocked. This treatment must be repeated regularly. As far as is known, there are no known risks or side effects. 100 U of type A botulinum toxin (10 injections of 0.1 ml per treatment) is the first choice of treatment for hyperhidrosis axillaris (sweatpumps).


Anticholinergics are medicines that are taken via tablet form and that suppress the activity of the sweat glands via the nerves.


The MiraDry is a device that destroys the sweat glands by heat via the microwave principle. The device delivers precisely controlled electromagnetic energy to the armpits. The sweat glands are eliminated with high precision and a lasting result.

Endoscopic thoracic sympathectomy (ETS)

A thoracic sympathectomy is an operation in which the sympathetic nerve in the chest is run through. ETS is a possibility for therapy-resistant invalidating hyperhidrosis. However, this operation must be carefully considered and any causes must be excluded. Teenagers with hyperhidrosis can also be treated with ETS.

Surgical operation

As a last resort, one can proceed to the surgical removal of the most active sweat glands. The disadvantage is that new sweat glands often develop after the operation, so that the effect is not long-lasting.


Hyperhidrosis is a persistent condition that usually lasts for a few years and sometimes even for life. When all sweat glands are involved all over the body, improvement will usually occur if the underlying cause is addressed. The treatment of sweatpicks is considerably improved by the MiraDry. Treating sweaty hands and sweaty feet is still no easy feat.
  1. V.M.R. Heydendael. Low and high doses of botulinum toxin type A are equally effective with hyperhidrosis axillaris. Ned Tijdschr Medic. 2006; 150: 516

Video: Hyperhidrosis - Mayo Clinic (February 2020).

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