Sufferers know the struggle well: a dripping forehead before an important event, damp armpits the second the morning commute starts, or wet palms right before a major business meeting handshake.
Sweating is a regular part of life, but not all sweaters are created equal. In particular settings, some people sweat much more than they should and definitely more than they want to. While many people can stay relatively dry, even in hot and stressful situations, others may have genetic conditions or underlying causes that cause them to sweat excessively.
Fortune spoke with Dr. Maral Skelsey, clinical professor of dermatology at Georgetown University Medical Center and director of the Dermatologic Surgery Center of Washington, who says there is a “Goldilocks of sweating,” or a normal range in which most people fall. She also breaks down what questions to ask yourself if you suspect you might be on the far end of the sweating spectrum—and what you can do to alleviate the worst symptoms.
“It's really an under-recognized problem,” she tells Fortune.
What is excessive sweating?
Sweating, our bodily secretion of water and salt, helps regulate our body temperature, especially when someone is physically active or experiencing hot temperatures. Feeling stressed, which increases our heart rate and blood pressure, can also trigger our glands to produce sweat, which is why we tend to sweat before a competition or presentation.
However, some people are prone to sweat more than others and in settings that don’t require the body to cool down. Hyperhidrosis is the pathological condition of excessive sweating, which is defined as sweating more than necessary to regulate your body temperature, according to the Cleveland Clinic.
“These are people who sweat so much they have to change their clothes multiple times a day,” Skelsey says. “A child might not be able to hold handlebars on a bicycle or hold crayons without everything getting smeared.”
Common symptoms of hyperhidrosis include frequently feeling beads of sweat on your skin, having damp clothes, and sometimes, excessive body odor. Primary hyperhidrosis can be genetic and often affects a particular part of the body, usually the armpits, feet, face, back, and hands. Secondary hyperhidrosis typically presents after age 25—often at night and affecting the whole body—and is caused by an underlying condition, such as Parkinson's, menopause, thyroid problems, and diabetes, according to the Mayo Clinic.
How do you know if you’re sweating too much?
Skelsey says you can ask yourself a few key questions to determine if you’re sweating too much and figure out the best course of action to address it.
First, where are you sweating? If the palms of your hands and soles of your feet are sweating to the extent that you’re slipping, you’re probably sweating too much, Skelsey says.
“Is sweating impairing your daily activity? Are you thinking about not going to a social event or not dating because you don't want someone to hold your hand?” Skelsey says. If you answer yes, those are signs that something is off.
And finally, are you sweating in an environment that doesn’t align with needing to cool down? “New York's hot in the summer. Subways are crowded. There's a lot of people in a subway car. It's a pretty physiologic response,” she says. But pay careful attention to the environment you’re in and if the sweat matches the circumstances. “If you're in a restaurant where it's 68 degrees and you're the only person sweating, there is a disconnect within the environment,” she says.
What can you do if you’re sweating too much?
It’s important to see a board-certified dermatologist who can help manage excessive sweating or treat the condition causing it. Whether you’re diagnosed with hyperhidrosis or not, there are ways to address a level of sweating that makes you uncomfortable.
“There's ways to help reduce your physiologic sweating so that it's not affecting your professional or social life,” Swelsey says.
Simple things to do include carrying around a personal fan, wearing lighter clothes, and applying deodorant daily. You can also wear a prescribed, clinical-strength antiperspirant at night on dry skin along with a deodorant during the day, Skelsey says. The antiperspirant doesn’t only have to go on your armpits. It can be applied to other highly sweaty areas like your back, for example.
Dermatologists may also recommend anticholinergic agents, a set of medications that block a neurotransmitter responsible for sweating, and glycopyrronium wipes, a topical treatment for underarm sweating. The FDA has also approved Botox to treat excessive sweating, and in the most extreme cases, there are surgical interventions like sweat gland removal.
However, Skelsey warns medications that decrease sweating have side effects like dry eyes and mouth, and that a medical provider must ensure the benefits outweigh the costs.
The bottom line? While sweating is normal, excessive sweating may have deeper underlying causes. But there are ways to manage the condition to make sure that you can still live your best life.
