Underarms
Axillary hyperhidrosis can cause persistent visible sweating, frequent clothing changes and difficulty wearing certain fabrics or colours.
Clinical Consultation · South Kensington
Excessive Sweating (Hyperhidrosis) Consultation
Excessive sweating can affect confidence, clothing, work, social situations and everyday comfort.
At Santi London, we assess the pattern and possible causes of excessive sweating before discussing management options and, where appropriate, prescription treatment following clinical assessment.
Understanding the condition
What is hyperhidrosis?
Hyperhidrosis means sweating that is excessive for the body's normal temperature-regulation needs.
Sweating itself is normal and essential. The issue in hyperhidrosis is that perspiration can become disproportionate to heat, activity or the situation you are in.
Some people notice persistent underarm sweating, while others are more affected by the palms, feet, scalp or face.
Hyperhidrosis is more than “sweating a lot”.
The diagnosis depends on the pattern, frequency, duration and
impact on daily life.
Primary vs secondary hyperhidrosis
Primary focal hyperhidrosis
Primary hyperhidrosis often affects specific areas such as the underarms, palms, soles or face.
It is commonly symmetrical and may begin earlier in life without another medical condition clearly causing it.
Secondary hyperhidrosis
Secondary excessive sweating can occur as a result of another medical condition, medication or physiological change.
It may be more generalised, may begin later in life or may be associated with other symptoms.
Why assessment matters:
sudden or unexplained changes in sweating should not automatically
be treated as primary hyperhidrosis.
Where can hyperhidrosis occur?
Hands
Palmar sweating can affect handshakes, paperwork, keyboards, phones, tools and other everyday activities.
Feet
Plantar hyperhidrosis may cause damp footwear, discomfort and practical difficulty during work, exercise or daily life.
Face & scalp
Some people experience excessive sweating over the forehead, scalp or other facial areas.
Multiple areas
More than one body area can be affected, and the severity may differ between sites.
Generalised sweating
Sweating affecting much of the body deserves particular attention to possible medical, hormonal or medication-related causes.
Severity
How do you know if sweating is excessive?
There is no single volume of sweat that defines the problem for every person.
The practical question is whether sweating is frequent, disproportionate and interfering with normal life.
Clothing
Do you need to change clothes repeatedly, avoid certain colours or carry spare clothing?
Work & daily tasks
Does sweating interfere with handwriting, computer use, handling objects or professional interactions?
Social confidence
Do you avoid handshakes, physical contact, events or particular situations because of sweating?
What can make sweating worse?
Triggers vary from person to person and are not necessarily the cause of hyperhidrosis itself.
Heat
Warm environments can increase normal sweating and may make an existing problem more noticeable.
Stress or anxiety
Emotional situations can increase sweating, particularly in areas such as the palms and underarms.
Exercise
Exercise naturally increases perspiration, although people with hyperhidrosis may feel the response is disproportionate.
Caffeine
Some people notice increased sweating after caffeine, although individual responses vary.
Spicy foods
Food-related facial sweating can occur in some people and may be more noticeable where facial sweating is already a concern.
Medication
A range of medicines can influence sweating, which is why a medication history forms part of assessment.
Medical assessment first
When should you see your GP before booking treatment?
Some patterns of sweating deserve medical investigation before elective treatment for hyperhidrosis.
Please seek medical advice if sweating is:
- New or suddenly much worse without a clear reason
- Predominantly occurring at night
- Generalised across much of the body
- Associated with unexplained weight loss
- Associated with fever or persistent illness
- Associated with chest pain, palpitations or tremor
- Beginning after a new medication or dose change
If symptoms are severe, acute or accompanied by chest pain, collapse or significant breathlessness, seek urgent medical care.
What happens during a hyperhidrosis consultation?
Step 01
History
We discuss when the sweating started, areas affected, severity, family history, medication and whether there are symptoms suggesting a secondary cause.
Step 02
Impact & pattern
We look at how often sweating occurs, whether it is symmetrical, what triggers it and how much it interferes with daily life.
Step 03
Management plan
The clinician can explain appropriate non-prescription options, whether further medical assessment is appropriate and, where relevant, discuss prescription treatment privately following assessment.
How can hyperhidrosis be managed?
Treatment depends on the area affected, severity, previous treatments, medical history and personal preference.
Clinical-strength antiperspirants
Aluminium-based antiperspirants are often an early treatment option, especially for underarm sweating.
They may cause irritation in some people, so frequency and application technique matter.
Iontophoresis
Iontophoresis is commonly considered for excessive sweating of the hands and feet.
Treatment involves passing a mild electrical current through water while the hands or feet are immersed.
Prescription treatments
Prescription-only options may be appropriate for some patients after clinical assessment.
Their suitability, benefits, limitations and risks are discussed privately with the prescribing clinician rather than promoted as a default treatment on this page.
Specialist referral
Severe, unusual or difficult-to-manage hyperhidrosis may require further specialist assessment or discussion of additional medical or surgical options.
Management by treatment area
| Area | Common first-line considerations | Other options |
|---|---|---|
| Underarms | Clinical-strength antiperspirants | Prescription treatment following assessment |
| Hands | Antiperspirants · iontophoresis | Prescription or specialist options where appropriate |
| Feet | Antiperspirants · iontophoresis | Further medical options depending on severity |
| Face / scalp | Careful assessment of pattern and cause | Individualised medical management |
Useful before consultation
Keep a simple sweat diary
If sweating varies from day to day, a short record can help identify useful patterns before your consultation.
Record when it happens
- Time of day
- Areas affected
- What you were doing
- Temperature or environment
- Stress or emotional triggers
Record the impact
- Clothing changes
- Difficulty with work or equipment
- Social situations affected
- Products or treatments used
- How effective those measures were
What happens after treatment?
Aftercare depends on the treatment selected. Your clinician will give specific instructions based on the area treated and the procedure used.
Temporary tenderness
Some procedures can cause short-term tenderness, redness or minor bruising at treatment sites.
Results are not immediate in every case
The timing and degree of improvement depend on the treatment chosen and individual response.
Maintenance may be needed
Hyperhidrosis management may require repeat or ongoing treatment depending on the method used.
Hyperhidrosis FAQs
What is hyperhidrosis?
Hyperhidrosis is sweating that is excessive relative to normal temperature-regulation needs. It can affect specific areas or sometimes be more generalised.
What is the difference between primary and secondary hyperhidrosis?
Primary focal hyperhidrosis usually affects particular areas and is not explained by another medical condition. Secondary hyperhidrosis is associated with another condition, medication or physiological factor.
Can anxiety cause hyperhidrosis?
Stress and anxiety can increase sweating and may make existing hyperhidrosis more noticeable, but they are not necessarily the underlying cause.
Can hyperhidrosis start suddenly?
Yes, but new or sudden-onset excessive sweating deserves medical assessment, particularly if it is generalised, occurs at night or is associated with other symptoms.
Can you treat underarm sweating?
Yes. Underarm hyperhidrosis is one of the most commonly assessed patterns of excessive sweating. Appropriate treatment depends on severity, previous treatment and clinical assessment.
What about sweaty hands and feet?
Palmar and plantar hyperhidrosis can be particularly disruptive. Options may include antiperspirants, iontophoresis and other medical treatments depending on severity and suitability.
Does hyperhidrosis always need treatment?
No. Treatment depends on how much the sweating affects daily life and whether there is an underlying cause that needs to be addressed first.
Are prescription treatments available?
Prescription-only treatments may be appropriate for some people following clinical assessment. Their suitability and risks are discussed privately with the prescribing clinician.
Will treatment permanently stop sweating?
Not necessarily. The duration and degree of improvement depend on the treatment used and individual response. Some approaches require maintenance.
When should excessive sweating be medically investigated?
Seek medical advice for sudden onset, night sweats, generalised sweating or sweating associated with symptoms such as unexplained weight loss, fever, palpitations, tremor or a new medication.
Related clinical resources
Santi London · South Kensington
Excessive sweating affecting everyday life?
A consultation can help establish whether the pattern is consistent with primary hyperhidrosis, whether further medical assessment may be appropriate, and which management options are worth considering.
Santi London · 33 Thurloe Street · South Kensington · London SW7 2LQ
This page provides general information about hyperhidrosis and does not advertise prescription-only medicines. Prescription treatment, where clinically appropriate, is discussed following individual assessment with a suitably qualified prescriber.