Why Do I Sweat Excessively? Scientific Causes of Axillary Hyperhidrosis

Why Do I Sweat Excessively Under My Arms? The Real Causes of Axillary Hyperhidrosis

Have you wondered why you sweat much more than others, even in normal situations? Axillary hyperhidrosis affects 3-5% of the population and has specific causes that go beyond heat or exercise.

Understanding these causes is the first step to finding the appropriate solution.

What Is Axillary Hyperhidrosis Really?

Axillary hyperhidrosis is a medical condition characterized by excessive sweating in the armpits, beyond what’s necessary for body thermoregulation.

Main Characteristics:

• Profuse sweating: Can soak clothes several times a day
• Independent of heat: Occurs even in cool environments
• Unrelated to exercise: Appears at rest or light activities
• Emotional impact: Causes social anxiety and low self-esteem

Difference from Normal Sweating:

The average person produces 500-700ml of sweat daily. Those with hyperhidrosis may produce up to 4 liters daily.

Primary Hyperhidrosis: The Most Common Cause

Primary hyperhidrosis is the most frequent form, without identifiable underlying medical cause.

Characteristics:

• Early onset: Generally begins in adolescence or youth
• Hereditary: 30-50% of cases have genetic component
• Symmetrical: Affects both armpits equally
• Episodic: May improve temporarily without treatment

Physiological Mechanism:

Excess activity in the sympathetic nervous system, which controls sweat glands. It’s like the body’s “thermostat” is miscalibrated.

Genetic Factors: Is It Hereditary?

Genetics plays an important role in axillary hyperhidrosis.

Genetic Evidence:

• Family studies: 40% of patients have first-degree relative affected
• Autosomal dominant inheritance: Identified transmission pattern
• Involved genes: Variants in genes regulating sympathetic activity

Not Inevitable:

Having genetic predisposition doesn’t mean you’ll develop hyperhidrosis. Environmental and hormonal factors may activate the condition.

Hormonal Changes: An Underestimated Factor

Hormonal fluctuations can trigger or worsen axillary hyperhidrosis.

Involved Hormones:

Puberty: Increase in androgens stimulates sweat glands Menopause: Estrogen changes affect thermoregulation Pregnancy: Progesterone and estrogen alter sweat response Hypothyroidism: Thyroid hormones influence sweat metabolism

Special Case: Menstrual Hyperhidrosis

Some women experience increased axillary sweating during menstrual cycle due to hormonal changes.

Stress and Anxiety: The Vicious Cycle

Psychological stress is both cause and consequence of hyperhidrosis.

How They Relate:

1. Stress activates sweating: Sympathetic nervous system responds with excessive sweat
2. Sweating generates anxiety: Concern about odors or stains
3. Anxiety increases sweating: Cycle feeds back on itself

Quantified Impact:

Patients with hyperhidrosis have 2-3 times higher risk of developing anxiety disorders.

Medical Conditions: Secondary Hyperhidrosis

Secondary hyperhidrosis appears as a symptom of another underlying medical condition.

Common Medical Causes:

Endocrinological:

• Hyperthyroidism
• Diabetes mellitus
• Cushing’s syndrome
• Pheochromocytoma

Infectious:

• Tuberculosis
• Chronic infections
• Fever from any cause

Neurological:

• Spinal cord injuries
• Parkinson’s disease
• Cerebrovascular accident

Others:

• Obesity
• Lymphoma
• Medications (antidepressants, etc.)

Important:

If hyperhidrosis appears suddenly in adulthood, requires complete medical evaluation to rule out secondary causes.

Environmental Factors and Lifestyle

Although not direct causes, certain habits can worsen hyperhidrosis.

Aggravating Factors:

Diet:

• Spicy or seasoned foods
• Caffeine and alcohol
• Foods rich in tyramine

Environment:

• High temperatures
• High humidity
• Non-breathable synthetic clothing

Habits:

• Smoking (increases adrenaline)
• Lack of sleep
• Sedentary lifestyle

Recommendations:

• Wear breathable cotton clothing
• Avoid very hot environments
• Maintain adequate hydration
• Practice relaxation techniques

How Is Axillary Hyperhidrosis Diagnosed?

Diagnosis combines clinical evaluation and specific tests.

Initial Evaluation:

• Clinical history: When it started, triggering factors, impact on quality of life
• Physical exam: Assessment of severity and distribution
• Severity scale: Classification from mild to severe

Diagnostic Tests:

Iodine-Starch Test:

• Application of iodine solution
• Cornstarch powder reveals sweating areas
• Characteristic pattern in hyperhidrosis

Quantitative Sweat Test:

• Precise measurement of sweat amount
• Difference from normal sweating

Hormonal Evaluation:

• TSH, T4, cortisol, catecholamines
• Rules out endocrinological causes

Psychological and Social Impact of Hyperhidrosis

Beyond the physical, axillary hyperhidrosis deeply affects quality of life.

Emotional Consequences:

• Social anxiety: Fear of public situations
• Depression: Feelings of shame and inferiority
• Isolation: Avoidance of social/sports activities
• Low self-esteem: Impact on personal and professional relationships

Professional Impact:

• Limited clothing choices
• Avoidance of presentations or meetings
• Constant odor concern

Alarming Statistics:

• 75% of patients report significant impact on daily life
• 50% avoid social activities due to hyperhidrosis
• 25% have changed jobs or rejected promotions

Treatments Available for Axillary Hyperhidrosis

Knowing the causes allows choosing the most appropriate treatment.

Topical Treatments:

• Aluminum chloride antiperspirants: First line, effective in mild cases
• Glycopyrrolate creams: Alternative topical option

Medical Treatments:

• Iontophoresis: Electric current reduces glandular activity
• Botulinum toxin: Injections that block sweat nerves
• Oral medications: Anticholinergics like glycopyrrolate

Advanced Treatments:

• Morpheus8: Radiofrequency that permanently destroys glands
• Surgery: Thoracic sympathectomy (last resort)

Recommendation:

Morpheus8 offers the best effectiveness-permanence ratio for moderate-severe cases.

Prevention and Daily Management

Although not always preventable, it can be managed.

Preventive Measures:

• Identify and avoid triggers
• Maintain strict hygiene routine
• Use quality antiperspirants
• Practice stress control techniques

Daily Care:

• Frequent showers with antibacterial soaps
• Change undergarments several times a day
• Use specific deodorants
• Avoid synthetic fabrics

Psychological Support:

• Cognitive-behavioral therapy
• Support groups
• Relaxation techniques

When to Consult a Specialist?

Not all excessive sweating is hyperhidrosis requiring treatment.

Warning Signs:

• Sweating that interferes with daily activities
• Negative impact on quality of life
• Failure of topical treatments
• Sudden onset in adulthood

Benefits of Consulting:

• Precise diagnosis of the cause
• Personalized treatment
• Adequate medical follow-up
• Significant improvement in quality of life

Conclusion: Hyperhidrosis Is Treatable

Understanding the causes of your axillary hyperhidrosis is the first step toward the solution.

Remember:

• It’s a medical condition, not a personal flaw
• Effective and safe treatments exist
• Morpheus8 offers permanent results
• You don’t have to live with this discomfort

Do you suffer from axillary hyperhidrosis? Our specialists can evaluate your case and recommend the most suitable treatment for you.

📞 +57 300 260 1698 💬 WhatsApp available

About the author: Dr. Oscar Barón, aesthetic dermatology specialist. International certification in hyperhidrosis treatments. More than 200 cases successfully treated with Morpheus8.