Excessive Sweating in Men: Derms Explain the Causes and Prevention

There’s one in every group selfie—the guy who stands with his arms crossed, fingers tucked in and thumbs extended upward to cover up all evidence of a dark armpit area. Maybe you’re that guy, and if so, you’re among the 4.8% of men in the United States who experiences excessive sweating for no particular reason—a condition known as hyperhidrosis. Thankfully there are a variety of treatment options nowadays.

Excessive sweating in men is certainly not a new topic, but it's one that has gained more awareness nowadays as more men have been willing to open up about it. From a distance, it may not seem like a big deal: sweaty pits, a damp brow, a moist upper lip—stuff we all experience from time to time, especially on hot days or after physical activity. Some of us even spring for a quality shvitz by hopping into a sauna or steam room. But for those afflicted with a condition that causes them to sweat prolifically, it can be a nightmare. A recent study revealed that it can have a profoundly negative effect on mental health, self-esteem, and social activity.

We took a deep dive into the causes, treatment, and prevention of excessive sweating in men and consulted with two experts who gave us their valuable insight: board-certified plastic surgeon Smita Ramanadham, MD, and board-certified physician Azza Halim, MD. We’ll also take a look at night sweats, another condition that more and more men report having experienced and what to do to combat it. 

What Are the Causes of Excessive Sweating in Men? 

The culprit behind excessive sweating comes down to hyperhidrosis, defined as “excessive sweating that is more than physiologically required” and caused by the overstimulation of sweat glands by nerves. This type of sweating can interfere with your daily life, soaking your clothing and wreaking havoc on both your wardrobe and social life. While research has yet to prove that men experience it more than women, Ramanadham points out that “generally, men may sweat more because, while they have similar concentrations of sweat glands, they tend to produce more sweat and those glands tend to be more active. Additionally, sweating occurs with increased internal heat, which can be related to more muscle mass in men vs. women, on average.”

However, when it comes to getting an accurate diagnosis, Ramanadham explains that there are two types we need to look at. Primary hyperhidrosis has no actual cause, as it’s not triggered by heat or exercise but could be exacerbated by anxiety or stress. It also tends to be hereditary. Secondary hyperhidrosis, on the other hand, is caused by a medical condition, the most common of which include:

• Acromegaly: Increased production of growth hormone by the pituitary gland, which can cause enlarged features including height and facial features, but can also be associated with increased sweating and body odor. 
• Diabetes: Increased sweating can occur with low blood sugars or hypoglycemia. In these cases, Ramanadham stresses the importance of treating low blood sugar.
• Infection/Fever: You know the drill. You’re freezing one second and overheated the next, drenched in sweat, but it’s important to find out the underlying cause.
• Hyperthyroidism: An overactive thyroid can put your body into overdrive, causing increased metabolism with weight loss, a fast heart rate, sweating, even anxiety and tremors. 
• Cancer: Leukemia or lymphoma may cause sweating, primarily night sweats. 

What Causes Night Sweats in Men?

Waking up in the middle of the night feeling as though you’d fallen asleep in a wet ditch is never fun, and something we’re hearing about more frequently nowadays. Ultimately, when it comes to night sweats, hyperhidrosis can be blamed as well. However, the underlying causes can vary somewhat from those that cause excessive sweating in men in the daytime. Ramanadham mentioned a few common ones, including stress and anxiety, gastric reflux (GERD), certain medications that can trigger hyperhidrosis symptoms, as well as other underlying medical conditions. 

Booze consumption is another cause of night sweats, whether from overindulgence, intolerance, or withdrawal. Alcohol can speed up the heart rate, causing the blood vessels in the skin to dilate which, in turn, can make the skin feel warm and flushed and lead to sweating. Heavy drinkers can experience night sweats a few hours or days after their last drink as their body experiences the symptoms of withdrawal. And those afflicted with alcohol intolerance—which essentially means your body lacks a sufficient amount of the enzyme required to break down alcohol—are prone to two telltale symptoms: facial flushing and excessive sweating, especially at night.

How Can I Treat Excessive Sweating? 

Both doctors say the first thing you should do is see a doctor to find out what’s really going on. “A proper diagnosis is necessary to differentiate if it's normal or abnormal, as some people just sometimes sweat more than others,” explains Halim. “Seeking a consultation with a medical professional is key in order to make the proper diagnosis and rule out any more serious disorders such as cancer, carcinoid, pheochromocytoma, lymphoma, alcoholism, or heart failure, to name a few.”

When it comes to treating excessive sweating in men, you’ve got a few options that run the gamut in terms of both price and practicality.

• Over-the-Counter Antiperspirants: If your hyperhidrosis symptoms are mild to moderate, a super-strength antiperspirant may be enough to get you through the day. Luckily, there are plenty on the market nowadays, like Dove Men+Care Clinical Protection.
• Prescription Treatment: Halim recommends Qbrexza wipes, a prescription-only medicated wipe that contains an ingredient called glycopyrronium, which is thought to reduce sweating by blocking acetylcholine receptors. While Qbrexza can be costly, it’s often covered by insurance. 
• Botox®: Injecting Botox® directly into sweat glands (most commonly the armpits) blocks the nerve signal, thus preventing the glands from producing sweat. While Ramanadham touts Botox® injections as one of the best ways to treat excessive sweating, it also tends to be costly and lasts three to four months on average. 
• miraDry: This non-surgical treatment delivers electromagnetic energy to the underarm area to basically eliminate sweat glands permanently. With no sweat glands to produce sweat, your problem is basically zapped away in one or two treatments. While each treatment can cost upward of $2,000, it may be an investment that, in the long run, ends up being cheaper than years of products or regular Botox® treatments.
• Oral Medications: In extreme cases, you may be prescribed an oral anticholinergic to reduce sweating. However, because a high dose is usually required in order for it to be effective, going this route may end up with more side effects (constipation, blurry vision, dry mouth, to name a few) than you’re willing to bear.

Can Excessive Sweating Be Prevented?

While all of the above have been proven to treat the symptoms of excessive sweating in men, whether temporarily or permanently, there are a few steps you can take to eliminate sweat triggers from your life and impact your overall situation, such as avoiding excessive hot temperatures, staying away from spicy foods, and cutting down on alcohol and caffeine, which can impact heart rate. If stress and anxiety tend to bring on the sweat showers, think about practicing yoga or sticking to a meditation routine to get them under control. 

If night sweats are your main concern, follow all of the above but also try sheets made from moisture-wicking material, such as Wicked Sheets, which help draw moisture away from the body so you don’t wake up damp. 

In conclusion, as much as excessive sweating in men can put a strain on your image, perhaps more important, it can also be a sign of something more serious. So before you stock up on industrial-strength antiperspirant or book your Botox® appointment, schedule some face time with your doctor to get to the root of the problem. The more you know about your sweating situation, the less you’ll sweat the details.