Hyperhidrosis

What's happening beneath the skin?

Hyperhidrosis is a condition characterised by excessive sweating beyond what the body requires for temperature regulation. It most commonly affects the underarms, palms, soles, and face, and can significantly affect confidence and daily life. It is more treatable than many people realise.

In hyperhidrosis, the sympathetic nervous system's signalling to eccrine sweat glands is dysregulated. Glands are stimulated beyond any thermal or physical demand.

Primary hyperhidrosis, the most common form, has no identifiable underlying cause. It involves overactivity in neural pathways controlling eccrine gland function, with a strong genetic component, and affects specific focal areas. Secondary hyperhidrosis is driven by an underlying medical condition or medication and tends to produce more generalised sweating.

What Causes It?

Primary hyperhidrosis: genetic predisposition (runs in families). Triggers include heat, exercise, stress, and certain foods, though sweating often occurs without them.

Secondary hyperhidrosis: underlying conditions such as thyroid dysfunction, diabetes, or menopause, or side effects of certain medications.

What You Can Do

At home:

Clinical-strength or prescription antiperspirants with aluminium chloride applied to dry skin at night. Breathable, natural fabrics. Avoiding personal triggers including spicy foods and caffeine.

Professional treatments:

miraDry (microwave energy permanently destroys eccrine and apocrine sweat glands; lasting reduction, glands do not regenerate); Neuromodulator injections (botulinum toxin blocks nerve signals to sweat glands, lasts 4–6 months, used for underarms, palms, soles, and face).