Sweating is a physiological mechanism essential to the body's temperature regulation. It allows heat to be released and maintains a stable internal temperature. However, in some people, this process becomes excessive, uncontrollable and sometimes disabling. It is then referred to ashyperhidrosis, a condition that can affect up to 3 % of the population.
Hyperhidrosis can be localised (underarms, hands, feet, face) or generalised. Daily life then becomes a succession of adjustments, avoidance strategies and, sometimes, silent suffering.
Managing this condition requires both a good understanding of the medical options and the adoption of simple everyday habits.
Adjusting hygiene and body care
One of the first measures to consider is skin hygiene, which should be thorough but gentle.
- Shower daily, or even twice daily, using mild, fragrance-free soaps to avoid irritation.
- Shave areas such as the underarms regularly to limit the bacterial growth responsible for odour.
- Dry thoroughly after washing, particularly between the toes or under the arms, to limit residual moisture.
The choice of products used is also important :
- Choose alcohol-free deodorants, preferably enriched with soothing ingredients.
- For localised sweating, use antiperspirants containing aluminium chloride (available on prescription or over the counter), although these can cause skin irritation if used incorrectly.
Adapting your wardrobe
The choice of clothing plays a crucial role in everyday comfort. Some synthetic materials worsen sweating or increase the sensation of dampness. It is therefore advisable to favour breathable fabrics, such as cotton or linen ; loose-fitting clothing that allows air to circulate ; layers, to adjust quickly to the surrounding temperature ; dark colours, which conceal any sweat patches.
For the feet, wearing natural-fibre socks, alternating shoes and, where appropriate, using absorbent powders helps limit moisture on the soles.
Behavioural techniques : learning to manage triggers
Although hyperhidrosis is not always linked to stress, some forms are aggravated by it, particularly on the face or hands. Stress management then becomes an essential part of day-to-day care.
The following techniques may be useful :
- Controlled breathing, heart coherence exercises. guided relaxation,
- Mindfulness exercises, to restore a calmer relationship with your body.
- Cognitive behavioural therapy (CBT), where sweating causes social anxiety or avoidance of social interaction.
These approaches do not treat excessive sweating, but they often help reduce its emotional and social impact and prevent the self-perpetuating effect of the “stress of sweating”.
Medical treatments : targeted care
When hygiene measures and practical adjustments are no longer sufficient, it is essential to consult a doctor to establish an accurate diagnosis and consider an appropriate treatment strategy.
Possible treatments include :
- Botulinum toxin injections : the sole indication is primary axillary hyperhidrosis. Botulinum toxin temporarily blocks nerve stimulation of the sweat glands, producing a dramatic reduction in sweating, generally for 6 to 9 months. It is a straightforward, well-tolerated treatment that can be repeated.
- Iontophoresis : used mainly for the hands and feet, this method involves passing a weak electrical current through water, temporarily blocking sweat gland activity. It requires regular sessions and can be demanding.
- Anticholinergic medicines : these may be prescribed for generalised forms. Their effectiveness varies and is often limited by side effects (dry mouth, drowsiness, constipation). They are rarely prescribed as first-line treatment for localised forms.
- Surgical treatments : thoracic sympathectomy, reserved for extreme, treatment-resistant cases, involves cutting certain nerves. It is rarely used because it is invasive and carries a risk of severe compensatory sweating.
Tips for managing challenging situations
Certain situations — work meetings, social events, public transport — cause specific anxiety in people with hyperhidrosis.
Here are some simple but useful solutions :
- Carry a change of clothing in a discreet bag.
- Keep absorbent wipes in your pocket to dry your hands.
- Use absorbent underarm pads that fit beneath clothing.
- Keep a folding fan or small mist spray to hand (for facial hyperhidrosis).
- Avoid stimulating drinks (coffee, alcohol), which can worsen sweating in certain situations.
These measures help you prepare for uncomfortable episodes and prevent anxiety from taking over.
Misconceptions about excessive sweating
Hyperhidrosis remains poorly understood by the general public. It is often played down or even dismissed, including by some people who experience it. This lack of understanding leads to hasty judgements, delayed diagnosis and sometimes a degree of patient isolation. Clarifying the most common misconceptions is essential to managing this condition better day to day.
- “You just need to wash more often”. This is one of the most common misconceptions. Yet hyperhidrosis is not linked to poor hygiene, but to overactive sweat glands, independently of bodily cleanliness. Many patients wash several times a day, change their clothing regularly and use antiseptic or absorbent products without resolving the problem. Worse still, excessive hygiene (repeated exfoliation, harsh soaps, frequent shaving) can weaken the skin and worsen irritation. What the patient needs is not hygiene advice, but an appropriate medical solution.
- “It is psychological, it is stress”. Stress can indeed worsen existing sweating, particularly on the face or hands. But it is not the cause. Many patients sweat at rest, at night or without any particular anxiety-provoking situation. Primary hyperhidrosis is a functional neurological condition that has nothing to do with psychological vulnerability. Reducing sweating to a simple emotional reaction denies the physiological reality of the condition and wrongly makes patients feel responsible.
- “You just need to avoid certain foods” : although some foods may occasionally influence sweating, their role in chronic hyperhidrosis remains minor.
- “There is no real solution”. This is incorrect. Effective treatments are now available, particularly botulinum toxin injections for primary axillary hyperhidrosis, or iontophoresis, anticholinergics and even surgical treatments in certain extreme cases. What matters is receiving appropriate guidance, being well informed and receiving care from a doctor.
The influence of diet and lifestyle on sweating
Although hyperhidrosis is primarily a condition of neurological or functional origin, certain dietary and behavioural factors can temporarily worsen sweating episodes. Understanding them better helps you adopt a more supportive lifestyle.
- Foods with a thermogenic or vasodilating effect : some foods stimulate heat receptors or promote vasodilation, which can increase sweating. Examples include spicy foods (chilli, pepper, curry) ; coffee (through its stimulating effect on the nervous system) ; black tea or caffeinated drinks ; alcohol, which acts as a peripheral vasodilator. With hyperhidrosis, limiting their consumption may be helpful, especially before an event.
- Food intolerances and histamine : some patients with hyperhidrosis notice increased sweating after meals rich in histamine (fermented cheeses, cured meats, red wine). Although these cases remain rare, a targeted dietary assessment may help identify individual sensitivities.
- Insufficient hydration : the less hydrated you are, the more sweating may intensify, as the body seeks to eliminate toxins by every means. Drinking 1,5 to 2 litres of water a day is recommended, including for people who sweat heavily. Adequate hydration also helps dilute sweat, thereby reducing body odour.
- Sedentary habits and physical fitness : regular physical activity helps regulate the autonomic nervous system and strengthen resistance to stress. Although exercise-related sweating may seem uncomfortable, it differs from pathological hyperhidrosis. Conversely, an overly sedentary lifestyle sustains nervous system hyperreactivity, particularly during stress or when facing social pressures.
