Frequently Asked Hyperhidrosis Questions

How do I know I suffer from hyperhidrosis?Hyperhidrosis Treatment Help - Question and Answers
Hyperhidrosis is defined as sweating beyond your bodies needs. It is a subjective feeling but if a person has dripping sweat from the hands, armpits or feet he or she is suffering from hyperhidrosis. A regular case of hyperhidrosis is usually not associated with any other illnesses which is contrary to some circulating ideas that hyperhidrosis is associated with nervousness, anxiety, thyroid problems, etc.

An exact diagnosis should be made between the patient and treating physicians after all other possibilities are excluded.

Where should I start with regard to treatment?
Obviously a discussion between the patient and a physician (Family Doctor / Dermatologist) should be the first step. This should be followed with conservative measures and understanding of the different options. The surgical approach should be attempted only after conservative efforts are tried.

What age is suitable for surgical treatment?
Generally speaking 14 is the youngest age where surgical treatment will be considered. It is about the age where social and functional problems are beginning to be experienced.

What is the recovery period for each surgery?
Typically the endoscopic thoracic sympathectomy (ETS) is performed on an outpatient basis. The operation itself usually takes about 1 hour and after chest x-rays are taken the patients can be on their way home or to their hotel. The recovery is quick and very well tolerated by the patients.

Does obesity play a role in hyperhidrosis?
Hyperhidrosis is the result of a genetic trait. It can affect overweight patients as well as patients with normal weight. To go into more specifics obese people do have a bigger body surface area which contains more sweat glands. Those people tend to sweat more in general terms. On the other hand patients who are obese pose a difficult technical problem to the surgeon performing the surgery (ETS - Hands or ELS - Feet). The nerves are surrounded by excessive amounts of fatty tissue which makes isolation and identification of the nerve more difficult. In order to get a better idea about your unique situation please discuss with the surgeon.

The endoscopic lumbar sympathectomy (ELS) initially required a one night stay at the hospital but currently can be done on an outpatient basis. The pain in this particular operation is described as less than the one experienced by patients during ETS.

A return to normal daily life can be accomplished in both procedures in a matter of days not weeks.

With regard to sub-dermal laser ablation the return to normal life is pretty much quick and without too many restrictions or soft tissue trauma. This is accomplished because of the precise and non traumatic action of the laser energy.

Can the ETS (hands) and ELS (feet) surgeries be done at the same time?
The simple answer is no. It is unknown about the magnitude of the physiological impact that both surgeries can affect the body if done at the same time. Attempts were done to do one side ETS and one side ELS but the experience gained was not a favorable one. As for now a patient can have ETS done first and a few months later ELS can follow. Both procedures have high success rates and are typically done on an outpatient basis.

Are sympathectomy and sympathotomy different?
No, these are two medical definitions which basically speak to the same thing. In sympathectomy the function of the sympathetic chain segment responsible for the overproduction of sweat is being eliminated with excision of that segment. In sympathotomy that function is being eliminated by the application of clamps.

Does alcohol, marijuana or recreational drugs have an effect on hyperhidrosis?
It is a known fact that many patients state that usage of alcohol, marijuana and other recreational substances reduce their palmar hyperhidrosis (sweaty palms). These are true statements that basically describe the relaxing effect of those items on the patients. By doing so their sympathetic level activity goes down and as a secondary effect their hyperhidrosis is reduced. This effect is a temporary one and in order to get a long-term solution it will force the patients to use those items on a regular basis which will make normal life activity somewhat more difficult. At the same time some patients are making statements that they were treated by mental health professionals with different relaxing medications in order to try to reduce their excessive hand sweating. Here we are facing the same situation where long-term usage will have negative effects on the patients. Increased dosages for the patients will make the conduction of normal life activities somewhat difficult.

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sweaty armpits and bad odor

the only area i sweat the most is armpits what can i do for this problem i do not like to be in public becuase it gets to the point that people make comments about it

re: sweaty armpits and bad odor

Excessive sweating from the armpit is one of the presenting forms of hyperhidrosis. Usually sweaty armpits are coming together with excessive hand sweating and excessive foot sweating. Isolated axillary hyperhidrosis is somewhat of a problematic issue for the surgeons. As in any other medical problem the initial treatment that should be tried are the strong antiperspirants (non medicated and medicated ones). The medicated antiperspirants can be obtained with a prescription and most contain aluminum chloride salts which are supposed to block the pores of the sweat glands. If they are effective they can help and the side effects of irritation can be bothersome. The question of aluminum toxicity was not yet solved and if a patient plans to use it long term they should consult his or her physician about it.

We are much less successful in treating the bad odor that comes together with excessive armpit sweating. If conservative treatments are failing the option of axillary suction curretage still exists. With this surgical procedure (axillary suction curretage) is applied to the inner layer of the armpit skin and thus destroying as many sweat glands as possible. It does not give 100% cure but one can expect about 85% reduction of their sweat in the armpit area. Again the odor problem is not as successfully treated even with this method.

Sweaty hands + armpits + legs

I have a pair of sweaty hands. Since I am small, I feel embarrassed to hold peoples hand. But recently, my leg and armpits started sweating. What is the best treatment for my combination sweaty armpit, hands and legs?

Re: Sweaty hands + armpits + legs

Not knowing your age, which could help me with answering your question. Basically you have a typical case of palmar, axillary, and plantar hyperhidrosis. As a rule palmar hyperhidrosis is the first one to be manifested and slightly later in life (late teens) the axillary and the plantar hyperhidrosis will come to a full clinical manifestation. As we often tell patients the first steps will be to try some conservative approaches such as drysol, Iontophoresis machines and prescription medications (pills). In a negligible amount of cases, if at all, those conservative measures do not help with severe cases of hyperhidrosis. Having said that they should be tried. If those attempts fail then the possibility of thoracic sympathectomy and or lumbar sympathectomy (for the feet) are viable options.

severe excess sweating on face and head

Hi! Im a 31 year old that has always suffered from severe excess sweating on my face and head. Im pretty much at the desperation phase. Ive tried numerous medications as well as botox, nothing helps. Ive lost a ton of weight (thinking that was the cause), but the more I work out, the more I sweat even when just sitting. Ive been on anti-anxiety medications in hopes that was the cause and it was not. Botox subsided the sweating on certain areas of my face, but since I have to pay out of pocket for it (being on my face, its classified as cosmetic), i cannot afford to treat all areas of my face or the back of my head that gets really bad either.
I was out with friends playing pool and was drenched in sweat to the point where strangers were asking if I was ok. This is beyond embarrassing. My dermatologist doesnt seem all that concerned, even when I beg for other treatments. Any advice?

Advice from a (near) recovered Wrist Sweater

Hi. My left wrist has sweated profusely since middle school. When in college, I began to do Yoga and Tai Chi and Meditate. I realized that the sweating was attributed to base level anxiety/nerviousness which I did not think I had prior to starting the yoga. If I do yoga and other methods of decreasing the sympathetic nervous system (deep breathing, etc), the wrist never sweats. Right now, I do a short, 10 minute yoga video every night, which is something anyone who has a basic sedentary life would benefit from anyways.

I am now in my mid 30's, and wrist sweats only happens when I get off my yoga schedule for several days in a row, or if I am hanging around stressed family too much near the holidays (i.e. this week). Take responsibility for what you can, there is a lot out there that we can fix without surgery medicine etc. Mostly it is just knowing what to try...Good Luck!

Re: Advice from a (near) recovered Wrist Sweater

Thanks for your comment. I will be the first one to say that any conservative method that helps with any ailment is better than surgery. Yoga especially with all its other added benefits obviously is a great solution. I do not know if it helps everyone in terms of hyperhidrosis but trying is a good option.

Re: severe excess sweating on the face and head

Unfortunately the problem with excessive facial sweating is a very disabling one to those who are affected. In the past sympathectomy was offered as a surgical solution for this problem but over time I found out that those patients will develop excessive compensatory sweating more than wished for. As a result I stopped performing sympathectomy for excessive facial sweating. At present I am using oral medications as a treatment modality. Obviously I cannot write a prescription to you without meeting you. If you would like please call our office at (310) 557-3037.

Also see:

wrist pain

When my sweating is about to start, I feel slight pain in the nerves of my wrist. As soon as the pain releases the temperature of my palm rises significantly and burst into sweat. Is my case somewhat different?
I am a 24 year old male from India.

re: wrist pain

What you describe is not at all a typical case of essential hyperhidrosis which is caused by overactive sympathectic nerves. The sympathetic system does not have a sensory or motoric function. What you feel could be related to other reasons. Hopefully this answers your question.

wrist sweating

My son is 15 years old and he excessively sweats on one of his wrists. He is not overweight and there is not anything that seems to increase or decrease the rate of sweating. He has tried to ice his wrist, used wraps on his wrist, used antiperspirant, etc...all with no success. It has become very bothersome and I'm seeking some options (hopefully non-surgical). Are there topical creams to treat a specific area on the body for this? Help!

Did you ever have luck getting help

My left wrist does the same only during cool months winter fall I can have it drop off my wrist drench my shirt or my pillow whil sleeping any help would be appreciated if you could email me info thanks

re: Did you ever have luck getting help

As mentioned in my previous answer to this issue isolated wrist sweating is a very unique and unusual presentation of focal hyperhidrosis. Unfortunately this is not a condition where surgical treatment is advised. Short of the local alternative methods that are available such as lotions, pills, etc I would not advise surgical intervention as a valid option.

re: wrist sweating

Your son represents a very unique and unusual condition. The main presentation of palmar hyperhidrosis is as the name applies severe excessive sweating in the palms not only in the wrists. The fact that it is only on one side also posses a difficulty in giving you a definite answer about what to do with it. In order to further evaluate your sons condition you are more than welcome to give me a call at 310 557 3037.

severe sweating my whole body

I'm 72 years old, I thought when I was younger I was going though the change of life (hot flashes). Now! I will breaks out my whole body and the sweat runs like I just got out of the shower. It's very embarrassing, when sweats running down your face. I don't know what to do? or who I should go see. Would massage help or acupuncture?


it is called hyperhidrosis speak to your doctor and ask for a referral to see a doctor name is dr. Rafael reisfeld good luck.

re: severe sweating on whole body

As is mentioned on our website and others constant body sweating as it appears in your age group is a subject that affects a certain population in your age group. It does not represent the typical focal (local) hyperhidrosis which is the subject of this website and others like this one. sweaty-palms .com. This type of total body sweating is the result of aging and some constitutional reasons that we don't have good explanations for. Whereas focal hyperhidrosis affects palms, feet and sometimes armpits is basically genetically determined. If a patient like you never had a form of focal hyperhidrosis earlier in life (20's 30's) then your problem lies basically in an aging process that again no explanation or treatment are readily available. A search for hormonal changes or lack of certain hormones might give an explanation but so far studies have not shown any good correlation between total body sweating and hormonal changes. With regard to your specific question about massage or acupuncture there is no evidence of those modalities that can help or hurt but you are more than welcome to try those.

I'm a 23 yr old female I have excessive sweating

I'm a 23 yr old female I have had hyperhidrosis since birth. My entire body is affected. Hands feet face armpits back legs private areas etc. I have been to a dermatologist I've had Botox the water treatments and used Drysol nothing has seemed to work. Having this really has effected my everyday life and the things I will participate in. Is there a surgery that can stop it all ?

Re I'm a 23 yr old female I have excessive sweating

Thanks for the questions. Hyperhidrosis is an ailment that affects patients quite badly on a daily basis and most of those cases cannot be helped with the use of local treatments as you mentioned. For focal hyperhidrosis of the hands, armpits and feet there are two operations, endoscopic thoracic sympathectomy for the hands and armpit and lumbar sympathectomy for the feet. The success rate for groin sweating is somewhat limited with those two operations but experience has shown that the ETS procedure followed by the ELS procedure (few months later) can give some relief or reduction of groin / private area sweating. Since I do not know too many details about yourself, you are welcome to call us or contact us for more details - (310) 557-3037.

Severe palmar and planter hyperhydrosis

Ever since I was born I have had extremely sweaty hands and feet, My family told me it would go away when I got older but 14 years later and I am still suffering from both sweaty hands and feet. After I started puberty it has become much worse my hands sweat so bad I can not grip a pencil to write in class, I have been made fun of my entire life. I have no one in my family who has hyperhidrosis so I have no one to comfort me or who knows what I am going through. I am not a very social or confident person, I want to socialize but I cant, and I wish I could be more confident but when I cant wave hello, shake your hand, or even touch anyone anywhere at all that's kind of hard to do. I cant even wear flip flops summer is not very enjoyable because of it. Every-time I shake someones hand they say something about my hands being sweaty. I recently moved and im am so nervous to start at a new school. I have tried a aluminum chloride product called hypercare and it didn't help so then I tried Drysol and it hasn't helped.I have also been drinking sage tea daily and I have not noticed a difference. My hands effect me everyday and every second of my life. What are the most e effective treatment options for a someone of my age? Thanks!

Re: Severe palmar and planter hyperhydrosis

Thank you very much for your question. What you are describing is a very typical case of focal hyperhidrosis affecting the hands, armpits and the feet. You are not alone in dealing with this condition. If I understand correctly your hands are wet to the level of dripping which is the most extreme case. You are more than welcome to try other conservative measures such as oral medications (robinol, ditropan) or use the Iontophoresis machine. I do not believe that those modalities will help you but at least you can try it. If you try those it is important you keep records for future references. The only long standing solution today is the surgical procedure known as ETS or ELS. Information is available about both of these procedures on our website. You can always call our office directly at (310) 557-3037 to speak to Dr. Reisfeld directly.


Hi... Im a 27 yo female... I experienced hyperhydrosis in my palms, feet esp to my armpit since Im 10 yo... But i noticed that i sweat more than usual and its smells bad which started when i was 17 yo... I used different antiperspirant and deodorant... I even consulted a dermatologist and gave me an antiperspirant but no relief.... I used also Driclor an aluminum hydroxide, tried home remidies but its continues to embarassed me....what will be my next step?.. Botox?.. How long it will last and estimated amount for botox?..if ever botox is effective to me, will I do it for life?

Re: Embarassment

From your description it sounds like you are a typical patient with isolated hyperhidrosis which affects the hands, armpits and feet. Are your hands wet to the level of dripping? Whatever conservative, non surgical methods you have used so far, are likely not to have great success rates with cessation of the sweating. Botox injections are another possibility of conservative treatment mainly for the armpit sweating. It is going to have a limited effect maybe three months and it has to be repeated on a constant basis. There is also the issue of cost. Botox is not recommended for plantar and palmar hyperhidrosis. Please feel free to contact us anytime for more specific information.

Dr. Reisfeld

Please Help - Buttocks Sweating

I'm 18 I just started having excessive buttocks sweating less than a year ago, I go outside and walk for even 10 minutes on a day of 60 degree weather and my boxers become soaked. This problem has changed my life drastically. Is there any solutions to this problem besides surgery?Please a answer would be very helpful

Re: Please Help - Buttocks Sweating

Buttocks sweating is a unique form of very localized excessive sweating in a particular location. To connect this particular clinical presentation with the classification of hyperhidrosis is not an exact science. Buttocks excessive sweating can be caused by obesity or be caused by some genetic pre-disposition. Unfortunately short of conservative measures (see our left navigation) there is no known surgical intervention that can eliminate excessive sweating in this area. Even though in a small number of cases, where patients had severe excessive compensatory sweating in their buttocks region, lumbar sympathectomy was show to help reduce the sweating. This is only an observation on a small number of cases and much more information is needed before a recommendation can be made.

Please Help

I am almost 13 yrs old boy - my hands sweat when I play video games, take exam, play music, play tennis :( I am really sad I know I have to wait till I am 14 for ETC surgery, so can I do Botox? does it hurt? please help. Kids in my school talk behind my back about it. what can I do to get rid of my sweaty hands?

re: Please Help

Thank you for your question. Your situation is a very common one to anybody who suffers from severe excessive hand sweating / hyperhidrosis. I know it’s embarrassing but it should not cause you any limitations in life. I know it’s very difficult to social and do certain functions such as using a computer and using video games. Fortunately you do have options but you should first explore all options such as conservative measures before you make any decisions with regard to surgery. I also suggest to you that you and your parents call our office together so I can discuss your particular situation. You can also refer them to this website or to Botox is not a recommended approach because of the limited success as well as the price and pain associated with this procedure

Need Help

I am a 26 year old female suffering from SEVERE sweating of the armpits and hand. I have been dealing with this problem as far back as of my teenage years and since it has just got worse. For example my wardrobe is made of all Black attire, and I always have to keep a paper towel and cloth with me due to excessive sweating. This sweating is so embarrassing at times, as of today I went to my daughters elementary gathering and while there I was inside an very well air conditioned room and sweat was dripping from my underarms badly. HELP Please.

re: Need Help

You represent a typical case of severe palmar and axillary hyperhidrosis. Your feet are likely to also sweat more than your body needs. As I always tell patients they should first try conservative treatments/measures before surgery is considered. You should discuss those issues with the surgeon you intend to use. You can get in touch with me directly via 310 557 3037.

doctors and cost

hi Im 26 and I've had sweaty hands feet and armpits since i can remember. its very embarrassing and had always been hard for me to be friends with anyone meeting people or having a relationship without feeling embarrassed. i had even joined the military before and found out on hard floors its not easy doing pushups due to the fact my hands sweat and won't stay in place.i was wandering where i can find a doctor in my area that performs these surgeries i live in northwest Indiana also the price range of these surgeries without insurance.

re: doctors and cost

The cost of the operation depends on the type of unique operation being performed (hands, feet, armpits), if the patient has insurance, and the type of insurance. Dr. Reisfeld performs the hyperhidrosis procedures for people from all over the world. Please feel free to contact our office to discuss your unique situation.

Do you have a direct email

Do you have a direct email adress so I can contact you too. I live in Guatemala and I really need a solution for this problem. Here you don't have to many options to treat Hyperhidrosis because the specialist will only use the conservative methods and don't have experience with surgical treatments.


Hello you can reach us directly by calling (310) 557-3037 or going to our contact page. Sorry we missed this.


hey guys i too have excessive hand, feet, and armpit sweating. it is such a pain as i do hula, tae kwon do, and volleyball. this year im at a new school and i want to make a good first impression on all of my new friends and teachers. In order to make a good impression, i need confidence, which I lack greatly from my sweaty hands/feet/armpit problem.

Needs help...

I am a 25 year old female and I've been suffering from hyperhidrosis for over 10 years. I'm not overweight, nor do I suffer from depression or any anxiety/mood disorder. I've searched many, many online resources for severe hyperhidrosis and none seem to match the problems I'm having. I literally sweat from everywhere, excessively. My head, face and neck (these three areas are where it's most severe, although all other areas are severely excessive as well) back, chest, arms (armpits, forearms all sides), palms, thighs, legs, feet... anywhere I have skin I will sweat. Not just damp sweat, but dripping sweat and it won't stop until I'm in a cold, dry environment. If I step outside and the temperature is above like 75 degrees F... I'm dripping sweat... If I run for even 30 seconds (even outside in the winter) I'm dripping sweat (from everywhere, I'm not exaggerating... everywhere). I can't even wear winter coats or sweaters that are too heavy in the winter because I'll sweat then as well, no matter how cold it is outside. I sweat when using a hairdryer to dry my hair in the mornings... I also have moderate acne on my face, back (upper and lower), chest and sometimes on my hips. I've been to a doctor a few times for acne and they said that the sweating would likely diminish after puberty. I've had my hormones checked more than once and everything was normal.

I now live in Japan with my husband (I'm American) and due to Japan's humid weather (all year round, regardless of temperature) the sweating has finally become unbearable. In the US I could run to the bathroom at work every hour to use a spray powder (like antiperspirant/deodorant) all over my body and dry the sweat with a towel... but in Japan I do not have the ability to do this. The sweating has gotten so severe that I cannot even go outside to take out the garbage (2 min trip at most) without having to change clothes once I get back inside. I almost never leave the house in the day time and now am having my husband run errands due to my embarrassment at the sweating. I'm not sure what treatment options are available to me in Japan, but I make regular trips back home to the US so treatment there could even be possible. If you could advise me as to what you might think is the best treatment for my hyperhidrosis I'd truly appreciate it.


Re: Needs help...

The case you have described is not a typical case of focal hyperhidrosis (sweating in specific locations – palmar, axillary, plantar). There is no known or recommended surgical operation that eliminates sweating for the entire body. In order to eliminate other reasons for this total body sweating consider conducting some generalized investigations with regard to your endocrine system, etc. Again for this presentation of generalized hyperhidrosis the operations are not recommended.


I have been living with hyperhidrosis since I was 13. Now 26 it has actually got increasingly worse. I suffer from excessive hand, feet and armpit sweat which has impacted my live in the most negative of ways. I have tried just about everything with no luck of resolve. Surgery, although a scary thought seems the most likely solution at this point. Is it recommended to have surgery in regards to all 3 locations? If so what would the side effects be? I'm afraid if I resolve this issue in the places where it happens now it will migrate to another location.

Re: Suffering

For patients who suffer from focal hyperhidrosis which all three areas you mention and with no success with conservative measures then surgery is a good option. Endoscopic Thoracic Sympathectomy can help a lot with hands and armpit sweating and Lumbar Sympathectomy will help with excessive feet sweating. Those two operations cannot be done at the same time though. Compensatory sweating which is a side effect of these operations is well tolerated by the majority of the patients even though a small percentage can suffer from excessive compensatory sweating which at times can be bothersome to the patients.

sweaty hand and feet bad

I have suffered with hyperhidrosis since i can imagine, i work in health care now at 26 and its so difficult to put gloves on with sweaty hands. I also suffer with bad sweaty feet, I keep reading about surgery but am to scared to undergo this because of all the stories i hear about compensatory sweating. I have tried everything in the book nothing has worked for me, i have even had an appointment to have the surgery done by a vascular surgeon but i put it of because i am terrified. I just need to know someone who has had it and what the results were like for them.

I just want to live a normal happy life and not have to worry about shaking peoples hands, and even to having th chance to wear flip flops or sandles.

Do you think i should go through with the surgery?

Re: sweaty hand and feet bad

From your description of a severe case of palmar and plantar hyperhidrosis if it bothers you enough and causes social and functional problems you may consider the surgery especially after trying conservative / non-surgical methods. It is important for you to discuss the surgical procedure with the doctor who performs the surgery raising all the questions you have stated. Compensatory sweating does affect all patients but the majority of the patients experience mild to moderate cases of compensatory sweating which is preferable to their original excessive sweating. Again we emphasize the need to discuss all questions with the surgeon who is to perform the operation. Dr. Reisfeld will be happy to talk with you for any additional questions you have.