Medical Dermatology

Hyperhidrosis (Excessive Sweating) Treatment Singapore

Dr. Liew Hui Min

accredited consultant dermatologist

Hyperhidrosis is a condition characterised by abnormally increased sweating that occurs without the typical triggers of heat or physical exertion, and is best assessed by a dermatologist. This condition can affect specific areas of the body, commonly the palms, soles, underarms, and face, or present as generalised excessive sweating. Individuals with hyperhidrosis may notice effects on their daily activities, as unpredictable sweating can disrupt routine tasks.

Hyperhidrosis (Excessive Sweating) Treatment Singapore

Symptoms Causes Diagnosis Treatment Prevention FAQ

Symptoms of Hyperhidrosis

Hyperhidrosis presents with several distinct symptoms that can affect daily functioning and comfort levels.

Visible sweating

Noticeable moisture appears on specific body areas without heat or exercise. The sweating may drip or soak through clothing.
Clammy or wet palms

The palms become consistently moist, making it difficult to handle paper, metal objects, or electronic devices. Handshakes may become awkward due to consistently wet hands.
Frequent clothing changes

Regular changing of clothes becomes necessary throughout the day due to sweat-soaked garments. Multiple clothing changes may be required, particularly for underarm hyperhidrosis sufferers.
Skin problems

Softening and breaking down of skin occurs in areas of persistent moisture (maceration). This may lead to secondary skin infections such as fungal infection, particularly in skin folds.
Social withdrawal

Avoidance of social situations develops due to embarrassment about sweating or body odour. This can lead to reduced participation in work activities, recreation, and interpersonal relationships.

Causes and Risk Factors

Hyperhidrosis develops through several mechanisms that affect the normal regulation of sweat production in the body.

Primary hyperhidrosis

The condition occurs without an identifiable medical cause and often begins in childhood or adolescence. This form appears to have genetic components, as many affected individuals report family members with similar symptoms.

Secondary hyperhidrosis

Excessive sweating develops as a result of an underlying health condition or medication side effect. This type typically begins in adulthood and may affect the entire body rather than specific areas.

Neurological factors

Overactivity of the sympathetic nervous system stimulates sweat glands excessively. The nerves that trigger sweat production activate without appropriate environmental or physical triggers.

Medications

Certain medicines cause increased sweating as a side effect, particularly some antidepressants, hormone treatments, and pain medications. Discontinuation of the medication may resolve the sweating in these cases.

Medical conditions

Various health issues, including fever, infections, diabetes, thyroid problems, and certain cancers, can trigger excessive sweating. Treating the underlying condition often helps reduce the hyperhidrosis symptoms.

Diagnostic Methods

Clinical assessment: A detailed medical history and physical examination identify the pattern, frequency, and severity of excessive sweating. The assessment includes questions about the age of onset, aggravating factors, and family history.

Starch-iodine test: This procedure involves applying iodine solution to the affected area, followed by starch powder. The areas with excessive sweating turn dark blue-black, helping visualise the exact distribution of hyperactive sweat glands.

Treatment Options

There are several management options for hyperhidrosis, which are typically applied in a stepwise manner.

Prescription antiperspirants

Clinical-strength products containing aluminium chloride hexahydrate block sweat ducts when applied to dry skin overnight. These formulations work by forming plugs in the sweat duct openings, temporarily reducing sweat output from affected glands.
Iontophoresis

This procedure uses a mild electrical current passed through water to temporarily block sweat glands in the hands and feet. Regular sessions, typically twice times per week initially, then maintenance treatments, help manage symptoms by creating a temporary ion blockage in sweat glands.
Oral medications

Anticholinergic drugs like glycopyrrolate or oxybutynin reduce sweating by blocking the chemical messenger that stimulates sweat glands. These medications affect the entire body and may cause side effects such as dry mouth, blurred vision, or urinary retention.
Botulinum toxin injections

Small amounts of this purified protein can be injected into affected areas to block the nerves that trigger sweating. The effect typically lasts 4-6 months, requiring repeat treatments, and works by preventing the release of acetylcholine, the chemical that activates sweat glands.

Prevention and Management

Several practical approaches can help manage hyperhidrosis symptoms. Wearing loose, breathable clothing made from natural fibres keeps skin drier, while avoiding triggers like spicy foods, alcohol, and caffeine may reduce episodes. Applying antiperspirants to dry skin at night works better than deodorants. Carrying absorbent materials and practising stress management techniques can help handle unexpected sweating. Regular bathing and changing damp clothing promptly prevent skin problems and odour.

Frequently Asked Questions

Can hyperhidrosis be cured?

Primary hyperhidrosis has no definitive cure but can be effectively managed with various treatments. Secondary hyperhidrosis may resolve if the underlying medical condition causing it is treated successfully.

Does hyperhidrosis cause body odour?

Hyperhidrosis itself does not directly cause body odour, as sweat is initially odourless. The odour develops when bacteria on the skin break down sweat components, which happens more readily with excessive moisture present.

How does climate affect hyperhidrosis?

Hot, humid environments often worsen hyperhidrosis symptoms by increasing the body’s natural sweating response. Many people notice improvement in dry, cool climates or during winter months.

Dr Liew Hui Min

Dually Accredited Dermatologist In Singapore and the UK

Dr. Liew Hui Min is an accredited consultant dermatologist from the Ministry of Health and the General Medical Council UK.

Her clinical interest includes:

Paediatric Dermatology,
Women’s Dermatology,
General Adult Dermatology.

Having trained in major London Hospitals, Dr Liew returned to Singapore in 2014 as a Consultant at KK Women’s and Children’s Hospital (KKH) where she specialised in paediatric, women, obstetric and vulva dermatology. Currently, Dr Liew practices at The Skin Drs. clinic located at Gleneagles Hospital.

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