Do I have hyperhidrosis?
Focal / Primary - mostly hands, feet & underarms
Your hands and feet are basically never dry - always damp and clammy (if you've already noticed this, you almost surely have it)
Certain fabrics or materials set off your sweating the moment you touch them
The slightest nervous moment makes you sweat profusely
You crumpled your school papers into wet pulp - the easiest tell
You can't walk barefoot on smooth floors without nearly slipping
Your hands swell up when they sweat
Your sweat's salt corrodes and ruins your things
Facial - mostly the face & scalp, often with flushing
Your face and scalp drench instantly at the lightest heat or effort
Your face flushes red and beads with sweat in front of other people
Generalized - everything above, plus it's all over the body
You sweat clean through your clothes
Your groin is often swampy
You're soaked even when it's cold out
You leave a body-shaped watermark on the mattress overnight
You have sweat trigger zones - a blanket brushing your neck, something touching your ankles, and the flood gates open
Sitting a while leaves a mark on the seat behind you
i If your matches stay within one of the first two groups, that's your type. Once the sweating is also all over your body, it's most likely generalized hyperhidrosis.
Start here
01

Get tested first

Check your thyroid and vitamin D before anything else - sweating can be a symptom of an underlying issue worth ruling out.

02

Read the database

The r/Hyperhidrosis pinned HHDB holds detailed, community-sourced treatment information beyond this summary.

Topical

Aluminum chloride antiperspirant

Clinical-strength roll-on (Drysol, Driclor) - underarms, hands & feet

Start cheap
EffectivenessHit or miss
CostVery low
InvasivenessMinimal
UpkeepNightly at first
Pros
  • +Cheapest, most accessible thing to try - OTC or prescription
  • +Worth ruling out first before creams, devices or pills
  • +No appointments or devices - buy it and apply at home
Cons
  • Often doesn't work for moderate-to-severe cases (didn't work for me)
  • Stinging, itching and irritation - worse on hands and feet
  • Best for underarms; far less reliable on palms and soles
  • Applied to dry skin at night, then washed off - fiddly routine

Antihydral cream

Topical paste - hands, feet & underarms (not face or groin)

Top pick
EffectivenessVery high
CostModerate
InvasivenessMinimal
UpkeepLow · ~2×/wk
Pros
  • +Easy to apply; one tube lasts a long time
  • +Only needs applying about twice a week
  • +Works almost everywhere except face & groin
Cons
  • Can get expensive over the long run
  • Causes over-drying - moisturize religiously or skin cracks
  • Can leave a yellow tint - exfoliate it off
  • Itchiness and pain in hot water / showers
  • May not fully stop fingertip sweat

Qbrexza wipes

Glycopyrronium wipe - a topical anticholinergic, mainly underarms

Targeted
EffectivenessModerate–high
CostHigh
InvasivenessLow (topical)
UpkeepDaily wipe
Pros
  • +Anticholinergic effect applied right where you need it
  • +Far less whole-body effect than the oral pills
  • +Single-use wipes - simple, no device
Cons
  • Mostly underarms - not made for hands or feet
  • Can still cause dry mouth, dry eyes or blurred vision
  • Wash hands after use - accidental eye contact stings badly
  • Prescription, pricey, and hard to find outside some countries
Device-based

Iontophoresis

Electric water bath - hands, feet & underarms

Most accessible
EffectivenessHigh · 80–90%
CostLow · one-time
InvasivenessMinimal
UpkeepDemanding
Pros
  • +One-time purchase, then ~zero ongoing cost
  • +Curbs 80–90% of sweat in hands, feet & armpits
  • +Can be DIY'd at home
  • +More water in the bath can stop fingertip sweat
Cons
  • First effects only appear after ~4 weeks
  • Big commitment: 4+ sessions/wk at first, then 2–4
  • 20 min immobile per area (hands / feet / armpits)
  • Cuts or wounds make it too painful - cover them with petroleum jelly or a small piece of electrical tape, or lift the area out of the water
  • Mineral/carbonated water boosts it but adds cost
  • Can cause irritation or electric burns on weak skin spots
Systemic medication

Anticholinergics

Glycopyrrolate / Oxybutynin - oral pill, whole-body sweating

Effective, systemic
EffectivenessHigh
CostVaries
InvasivenessSystemic side-effects
UpkeepDaily, timed
Pros
  • +Can almost completely stop sweating for the day
  • +Dose-adjustable - covers the whole body, not one area
Cons
  • Wears off through the day - one dose can fade by evening, so sweating returns at night unless you re-dose
  • Hard to find - often not stocked by pharmacies across entire regions (e.g. the Middle East)
  • Cost varies a lot - depends on your insurance coverage and what the prescription goes for locally
  • Must be taken on an empty stomach (2–3 hrs before eating)
  • Severe dry eye / dry mouth (varies by person)
  • Unproven concerns linking long-term use to dementia (esp. blood-brain-barrier-crossing ones like oxybutynin)
  • Tolerance can build, pushing the dose higher over time

Beta-blockers & clonidine

Propranolol / clonidine - oral pills for nervous & situational sweating

Trigger-based
EffectivenessSituational only
CostLow
InvasivenessSystemic side-effects
UpkeepAs needed / daily
Pros
  • +Propranolol blunts the nervous, performance & anxiety-driven kind of sweating
  • +Taken about an hour before a known trigger (a meeting, a date) - not instant, so plan ahead
  • +Clonidine is sometimes used for more generalized sweating
Cons
  • Only really helps trigger-based sweating - not constant baseline sweat
  • Lower blood pressure, slower heart rate, fatigue or dizziness
  • May do nothing for the sweat itself - for many people the real benefit is the anxiety, not the wetness
  • Not suitable for asthma and some heart conditions - needs a doctor
In-office procedures

Botox

Injections - underarms, hands & face

Targeted
EffectivenessHigh
CostHigh
InvasivenessModerate
UpkeepEvery ~6 mo
Pros
  • +Very effective for armpits - by far the most available and reliable area to treat
  • +Available for hands and face too, but trickier: the sites sit close to muscles you don't want affected, so results are more mixed
Cons
  • Painful
  • Expensive
  • Must be reapplied every ~6 months
  • Can lose effectiveness after a few years of repeat treatment
  • Can cause temporary loss of sensation / grip in hands

miraDry

Microwave energy - underarms only

Armpits only
EffectivenessHigh (armpits)
CostHigh
InvasivenessModerate
UpkeepPossible redo
Pros
  • +Supposedly stops armpit sweating completely
Cons
  • Painful, with large bruises for a few weeks
  • Some report sweating returned within 2 years
  • Expensive and hard to book (limited availability)
i Laser sweat ablation is a newer underarm alternative that works similarly - but since miraDry itself is barely offered in most clinics, expect this to be even harder to find.
Surgery - last resort

Local underarm surgery

Sweat-gland curettage, excision or liposuction - underarms only

If you must cut

If surgery is genuinely on the table, this is the option to weigh - local, armpits-only, and without the body-wide compensatory sweating that makes ETS so regretted.

EffectivenessGood (armpits)
CostHigh
InvasivenessSurgical, but local
UpkeepOne-time
Pros
  • +Targets only the armpit sweat glands - no spinal nerve involved
  • +Compensatory sweating risk is far lower than ETS - but not zero: block sweat anywhere and the body can reroute it
  • +Often lasting once it takes - a single procedure
Cons
  • Underarms only - does nothing for hands, feet or face
  • Still surgery: scarring, bruising and a real recovery period
  • Results vary by surgeon and technique; sweating can partly return

ETS - Endoscopic thoracic sympathectomy

Spinal nerve surgery - hands, face & feet

⚠ Avoid

Frequently regretted. It is widely discouraged in the community - the trade-off is severe and cannot be undone.

! This is not a cosmetic decision. A significant number of people who went through ETS report deep, lasting regret and depression - many describe becoming suicidal afterward. If it's on your mind, please talk to people who've actually had it before going anywhere near an operating room.
EffectivenessNet negative
CostHigh
InvasivenessExtreme · irreversible
Upkeep-
Pros
No meaningful upside the community agrees on.
Cons
  • Invasive, irreversible surgery that cuts a spinal nerve to stop sweating in hands, face & feet
  • In return, compensatory sweating surges almost everywhere else on the body
  • The body loses its ability to regulate heat - risk of hyperthermia
  • Emotional dampening is widely reported - a flattened, muted affect alongside the loss of the body's fight-or-flight response

Nerve reconstruction surgery to reverse ETS is emerging, but reported success rates are unverified - it is not a dependable undo. Treat ETS as permanent.

Everyday workarounds

These don't stop the sweat - they manage how it shows. Pair them with any treatment above.

Upper body

Sweat-proof undershirts

e.g. ThompsonTee, OfficeUndershirt

  • +Stops sweat seeping through - wear anything over it
  • +Reusable for years; blocks odor too
  • Can feel bloated/wet once the pads soak up sweat
  • Wash after every use & air-dry; it's a tee, so no sleeveless or deep necks
Upper body

Sweat-absorbing pads

Stick-in underarm pads & vests

  • +Wear under anything; easy to apply and swap mid-day
  • +Underarm sweat vests are an option for women
  • Don't work as well as a full shirt
  • Mostly single-use; reusable ones review poorly
Lower body

Sweat-proof underwear

e.g. Ejis

  • +Same concept as the undershirt, for the lower half
  • Reportedly feels like a diaper once soaked - uncomfortable
Feet

The right socks

Ankle-length, natural fibres

  • +Ankle-length Dickies (or similar) socks wick and breathe
  • +Any natural fibre - cotton, bamboo, merino - beats synthetics
  • +Cheap, easy to swap during the day
Drying

Powders & insoles

Cornstarch / Gold Bond, charcoal insoles

  • +Foot/body powder keeps skin dry and cuts friction and rubbing
  • +Add an antifungal powder if the damp brings on athlete's foot
  • +Charcoal or cedar insoles soak up sweat and odor - swap and dry them
  • Powder cakes up once it's fully soaked; reapply through the day
  • Rotate shoes so each pair dries out fully between wears
Odor

Odor control

It's the bacteria, not the sweat

  • +Odor is bacteria feeding on sweat - antibacterial soap or a benzoyl-peroxide wash on feet and pits cuts it at the source
  • +A black-tea or diluted-vinegar foot soak knocks odor down (tannins)
  • +Silver- or copper-infused socks slow odor between washes
  • Deodorant only masks smell - it doesn't reduce sweat, so pair it with a real solution