Hyperhidrosis – Specialist Treatment for Excessive Sweating in London

What is hyperhidrosis?

Hyperhidrosis is a condition characterised by sweating that exceeds what the body requires for temperature regulation. It may be focal—affecting specific areas such as the armpits, palms, soles, or face—or generalised, affecting larger body regions. The condition can significantly impair quality of life.

Causes and how it develops

There are two types of hyperhidrosis:

• Primary hyperhidrosis – the most common form, caused by overactivity of sweat glands without an underlying disease. It usually starts in childhood or adolescence and affects both sides of the body symmetrically.
• Secondary hyperhidrosis – due to another medical condition (e.g., diabetes, thyroid disease, infections, neurological disorders) or triggered by medications. Sweating may be generalised and often begins later in life.

Hyperhidrosis Symptoms and patterns

Typical signs include constant or episodic excessive sweating that soaks through clothing, dripping sweat from palms or soles, foot odour, or makeup smudging from facial sweat. It often worsens with stress or heat but can also occur spontaneously.

Hyperhidrosis Diagnosis and tests

Diagnosis is clinical, based on patient history and physical examination. Dermatologists may assess severity using scales such as the Hyperhidrosis Disease Severity Scale (HDSS). Secondary causes are ruled out with targeted blood tests if suspected (e.g., thyroid function, glucose).

Hyperhidrosis Treatment options and management

Topical treatments

Aluminium chloride antiperspirants are first-line for underarm sweating. Newer topical agents may also be considered.

Oral medication

Oral anticholinergics reduce sweat gland activity but may cause dry mouth, blurred vision, or urinary side-effects; prescribed only under medical supervision.

Procedures

Botulinum toxin injections block nerve signals to sweat glands and provide months of relief. Iontophoresis uses mild electrical current for palm/sole sweating. Microwave thermolysis destroys sweat glands in underarms for longer-term results. In very severe cases, surgery (sympathectomy) may be considered.

Lifestyle and supportive care

Tips include breathable clothing, absorbent powders, shoe rotation, and stress management. Support groups and counselling may help with the psychological impact.

When urgent review is needed

Seek medical attention if sweating develops suddenly, is accompanied by weight loss, palpitations, fever, night sweats, or other systemic symptoms, as these may indicate underlying disease.

Why choose Skinhorizon for hyperhidrosis?

• Consultant dermatologist-led diagnosis and treatment selection.
• Access to advanced therapies including botulinum toxin injections and iontophoresis.
• Personalised care under CQC standards with clear monitoring and follow-up.

Your first visit — what to expect

1. History: Onset, severity, triggers, family history, medical conditions, and medicines.
2. Examination: Distribution of sweating and any skin complications.
3. Discussion: Education about hyperhidrosis types and treatment options.
4. Treatment plan: Stepwise approach starting with topical/oral treatments, with procedural options as needed.
5. Follow-up: Regular reviews to monitor treatment effectiveness and adjust therapy.

Reviewed by: Dr Mohammad Ghazavi, Consultant Dermatologist
Skinhorizon Clinic, 4 Clarendon Terrace, Maida Vale, London W9 1BZ
Last reviewed: 21 August 2025