Dr Arthur Richardson - Hepato-Biliary, Upper Gastro-Intestinal and General Surgeon Associate Professor,University of Sydney
Dr Arthur Richardson

Patient Info


Hyperhidrosis is a condition of excessive and uncontrollable sweating. It is due to overactive sweat glands. The most common areas affected are armpits (axillary hyperhidrosis), hands (palmar hyperhidrosis) and feet (plantar hyperhidrosis). Excessive sweating without an underlying medical condition is called primary hyperhidrosis whereas excessive sweating due to a medical condition is referred to as secondary hyperhidrosis.

Hyperhidrosis may significantly affect the social and psychological wellbeing of an individual. It may cause physical discomfort, social embarrassment and affect occupational and daily activities.


  • Blood tests
  • Urine tests
  • Patients may require assessment by a neurologist.


Several treatment options are available for treatment of hyperhidrosis.

  • Dietary changes
  1. Weight loss may be appropriate
  2. Avoidance of caffeine
  • Antiperspirants –may help but may cause skin rashes with prolonged use.
  • Some oral medications - including non-steroidal anti-inflammatory drugs (NSAIDS); calcium channel-blockers and anti-cholinergics may help.
  • Iontophoresis – involves use of a small electric current to block the sweat glands. Treatments need to be repeated.
  • Botox injections – may impair the nerves that control the sweat glands so that sweating is decreased. A treatment may last for 4-12 months.
  • Surgery – may be a last resort in patients with severe refractory symptoms.
  1. Excision of axillary sweat glands may be helpful.
  2. Endoscopic thoracoscopic sympathectomy (ETS) – is a procedure where some of the nerves that supply the sweat glands are cut in the chest. This procedure is done under general anaesthesia via two or three small incisions in the axilla and may require an overnight stay in the hospital.

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