Excessive sweating: causes of hyperhidrosis, how to know?

Hyperhidrosis refers to the excessive production of sweat and affects between 1 and 3% of the population (men and women). 'It's really heavy sweating, not just sweaty hands,' says influencer Zoé Tondut.

[Updated September 20, 2022 at 5:25 p.m.] Hyperhidrosis means the excessive sweat production and affects between 1 and 3% of the population (men and women). ' It's really big transpiration , not just sweaty palms. When I shake hands with people, I'm too embarrassed because I know they're gonna touch a sweaty hand and they'll think it's dirty, a little gross' testified the influencer Zoé Tondut ( ' Just Zoe ' on Instagram ) in a video for Brut in September 2022. Among his tips: 'I wear clothes that absorb for example jeans, a cotton T-shirt, to be able to wipe my hands.'

See this post on Instagram

A post shared by Zoe Tondut (@justezoe)

What is hyperhidrosis?

Hyperhidrosis is defined by an excessive secretion of sweats exceeding physiological needs. It can be generalized to the whole body, regional or localized. She may be primary or secondary to a disease (endocrine, metabolic, neurological, etc.), a drug or a toxin. She usually begins during childhood or adolescence and concerns especially the armpits, palms of the hands, soles of the feet, and the region of the skull and face .

Why do we sweat mostly on our feet, hands and armpits?

Most of sweat glands is located at the soles of the feet, palms, groin and armpits , hence the fact that we sweat more in these places. These glands are ten times more present in the feet and hands than in the back. Each sweat gland, located under the skin, is attached to a pore. It has the shape of a rather long hollow tube, composed of cells. There are 2 types of sweat glands, the eccrine glands and apocrine glands .

The eccrine glands cover most parts of the body. They are numerous on the level of the head, the palms of the hands and the soles of the feet. They are functional from birth.

Apocrine glands are not distributed all over the body. They are attached to the hair. They are found in the regions genital and axillary . They are only active from puberty . About a liter of sweat is produced per day by the sweat glands. This production can reach or even exceed 10 liters per day during excessive sweating occurring during hyperhidrosis.

What are the causes of hyperhidrosis?

Hyperhidrosis results from overactive sweat glands. Their activity is controlled by the sympathetic nervous system. Hyperhidrosis can be primary or secondary to a endocrine problem (diabetes or hyperthyroidism ), hormonal imbalance, in the grip of some medications or nerve damage.

How do you know if you have hyperhidrosis?

'No patient sweats excessively, unrelated to outside temperature . It's disabling' explains Dr. Laurence Netter, dermatologist . L'hyperhidrosis often begins in childhood or adolescence , She is bilateral and symmetrical (both armpits are affected for example or both feet and in the same way). She disappears at night while sleeping and is on the other hand increased in case of stress, heat, sports activities or when eating certain foods. There are often other cases of hyperhidrosis in the family.

What are the consequences of hyperhidrosis?

Sweating hands handicap daily those who have to shake hands for example. He also sometimes prevents you from correctly practicing certain trades or hobbies as the piano for example. Armpit sweating causes bad smells as well as halos on clothes . Sweaty feet cause bad odors but also bacterial infections or fungal infections . The appearance of a eczema in the feet is favored by excessive perspiration. It is called dyshidrosis .

'Psychology, homeopathy, essential oils have no effect'

Why does stress make you sweat more?

Stress is a common cause of excessive sweating. During an episode of stress, the increase in the blood level of certain hormones such as adrenaline leads to over-excitation of the sweat glands, which is the cause of this excessive production.

Sweating and menopause

Excessive sweating, occurring mainly at night, is one of the so-called 'climacteric' signs of menopause , with hot flashes. Women speak of 'night sweats' and say they are 'in water'.

When to consult?

When perspiration becomes bothersome, it is already excessive and requires a consultation. The attending physician can then direct to an endocrinologist and or a dermatologist if applicable. 'Most of the time we don't do further tests. The primary or secondary diagnosis is an interrogation diagnosis. Is the sweating increased at night? Is it bilateral, localized? Are you taking medication?' comments Dr. Netter.

What are the treatments for hyperhidrosis?

Treatments for hyperhidrosis are local (solutions applied to the sweating area), medication, l' iontophoresis , the botox and the surgery in extreme cases. ' Psychology, homeopathy, essential oils have no effect. You must consult a doctor specializing in perspiration who will propose a treatment depending on the location and the importance of the discomfort. immediately warns Dr. Netter.


The use of an effective antiperspirant without risk to health, i.e. without parabens, alcohol or MIT, helps stabilize the flow of perspiration in the context of moderate hyperhidrosis. They mainly contain aluminum salts. They are used to reduce the amount of sweat. 'No serious study has shown a risk of cancer to date but they are skin irritants , says Dr. Netter. The should not be applied to freshly shaved armpits .'


'They are active on the smell but do not regulate the flow of sweat' reminds the dermatologist. Some products have a double action: they are both antiperspirant and deodorant.

Botox injections: especially for the armpits

L'injection of botox or botulinum toxin is very beneficial in people with heavy sweating because it causes a blocking the release of acetylcholine, mediator of the nervous system, at the injection site, thus preventing the sweat glands from secreting sweat . She is particularly used in the case of hyperhidrosis of the armpits (but can also sometimes be for the hands, feet and scalp). The effectiveness of the treatment lasts approximately 4 to 6 months : it is therefore necessary to repeat injections at regular intervals. Botox is done on the hands and feet when hyperhidrosis is poorly controlled by iontophoresis. 'It is not devoid of side effects and the injections are very painful (decreased strength in the hands)' says Dr. Netter. Moreover, after a while it is possible that antibodies neutralize botulinum toxin and block its action on perspiration.

Iontophoresis: for hands or feet

This is a device that delivers a current that decreases the diameter of the pore. This treatment could result in insensitivity of the sweat glands to the mediators causing sweat secretion. Iontophoresis is recommended in cases of moderate hyperhidrosis of the hands or feet. 'It is necessary to do 10 to 15 sessions over 15 days followed by maintenance once or twice a week. The effectiveness is 60 to 80% improvement if the sessions (of 20 minutes) are done regularly' says Dr. Laurence Netter.

Surgery: only for extreme cases!

'It is at high risk of compensatory hyperhidrosis at a distance (in 50% of cases). It should no longer be reserved for cases of extreme palmoplantar hyperhidrosis' insists the dermatologist.

Essential oils

Certain essential oils such as Clary sage, Palmarosa or Cistus are sometimes recommended against excessive perspiration. For Dr. Netter: 'They can possibly limit odors but have no effect in hyperhidrosis.'

Le Miradry (ondes)

This is a technique that has been used for 7 years (160,000 treatments performed) which reduces perspiration in the armpits by approximately 80% in a single session. This small intervention is done under local anesthesia in the office of the equipped dermatologist. 'Miradry uses microwaves to permanently eliminate the sweat glands by heating. It is safe because only 2% of the glands are located in the armpits. A prior consultation is essential. This treatment should be considered in axillary hyperhidrosis unresponsive to antiperspirants' says Dr. Laurence Netter.

Source journaldesfemmes.fr