Do You Sweat All The Time?

Do you sweat a lot? Like, a lot? We’re not talking about sweat dripping off your face during spin class or trickling down your back on a humid day. More like, totally drenched underarms when you’re just sitting still, or palms that always are wet to the touch. 

If so, you’re not alone. You may have a condition called hyperhidrosis, or excessive sweating, which affects up to three percent of the U.S. population. And awareness is on the rise. "There’s no longer that attitude of 'Don’t worry about it—it won’t kill you,' from doctors," says Dee Anna Glaser, MD, president of the International Hyperhidrosis Society. "Now, we understand the impact on quality of life."

There are more treatments available now than ever, so we’ve done the research to bring you the pros and cons of each. If excessive sweating is taking a toll on your day–to–day (not to mention your dry cleaning bills), check out these ways to put a stop to all the sweating.

Antiperspirant Before moving to stronger treatments, your doc will likely suggest you try super strong antiperspirants. Make sure you’re using the products correctly, whether it’s an over-the-counter clinical strength formula or a prescription strength option, for maximum effect. "These preparations work best when applied at night," says Glaser. Surprisingly, it doesn’t wash off, even if you shower in the morning. "It has to do with the aluminum-based compounds (the active ingredient) getting down into the sweat duct and blocking the sweat from coming up." Some scientists have suggested that these compounds may be a risk factor for the development of breast cancer, but according to The American Cancer Society, no clear link has been made between antiperspirants that contain aluminum and breast cancer. 

Botox The frown-line-freezing injectable is FDA-approved to treat excessive underarm sweat. (And doctors often use it off-label to treat sweating in the hands, feet, and face.) It works by blocking secretion of the chemical that turns your sweat glands on, interrupting the signal that starts the sweating. "Botox works well and has an outstanding safety record," says Glaser. But it's not a permanent fix. "One treatment will generally last seven months, so I tell patients to plan on coming in twice a year." And though it really doesn’t hurt much in the underarms (we swear), the pain level goes way up if you have it done on your hands and feet, which contain far more nerve endings. Side effects are generally pretty minimal, though bruising and discomfort at the site of the injections are possible. As for cost, it varies by city and doctor, but you can expect to pay between $1,200 and $2,000; in many cases, the procedure is covered by insurance.

Iontophoresis Iontophoresis uses water to run a mild electrical current through the skin’s surface (don’t worry—you won’t get electrocuted). Experts aren’t quite sure how the procedure works, but it’s thought that the combination of minerals in the water and the electricity thickens skin's outermost layer, keeping sweat from reaching the surface. It requires a lot of treatments (roughly 10 20- to 40-minute sessions to stop the sweating initially, plus weekly maintenance treatments), so most patients opt to buy their own iontophoresis devices to use at home. Models can cost upwards of $900. Pricey, yes, but the process is effective (a success rate of over 80% for treating hands and feet, according to the American Academy of Dermatology), and there are no scary side effects.

Medication If you’ve already tried antiperspirants, Botox, and iontophoresis but haven’t gotten any relief, your doctor may suggest medication. The most common kind used to treat hyperhidrosis (called anticholingerics) block the chemical messenger that triggers the sweating response from reaching the sweat glands. They work all over the body, which can make them very effective, but they can come with side effects like dry mouth, blurred vision, and heart palpitations. And if you’re an athlete or highly active person, take note: You may have trouble keeping cool while on the medication, putting you at risk of overheating. But your doc can help tailor the meds to your specific sweating needs. "With a low, monitored dosage, we can reduce the excessive sweat without eliminating the ability to sweat altogether," says Glaser.

miraDry This procedure uses electromagnetic energy to destroy the sweat glands in your armpit. If you're wondering "Won’t I overheat if I don’t have sweat glands there?" fear not: "We have sweat glands all over our body, so getting rid of a few glands in one specific area really doesn’t impact our ability to regulate body temperature," explains Glaser. MiraDry requires two treatments done roughly three months apart— and that’s it. But it’s not currently covered under any insurance plans, and it can cost up to $3,500. 

Endoscopic Thoracic Sympathectomy Known as ETS, this surgery is considered a last resort. Thoracic surgeons discrupt nerve signals from the spinal column to the sweat glands by cutting or destroying the nerve. And while Glaser says the surgery itself is safe, the known side effect is serious. It’s called compensatory hyperhidrosis, and it means that once the sweating stops in the area targeted by ETS (usually the palms), patients will start sweating excessively in a new area. Up to 80% of ETS patients experience it, and it cannot be fixed. "When I talk to a patient, I really urge them to try all the other options first," says Glaser. "It’s not that I don’t ever recommend it, but it should be reserved for those who’ve tried and failed the other therapies." 

Learn more about excessive sweating at the International Hyperhidrosis Society’s website (sweathelp.org).