Sweating is a natural process that helps cool the body. However, excessive sweating of the face and head could indicate a condition known as hyperhidrosis.
The term “hyperhidrosis” means excessive (hyper) sweating (hidrosis). It can occur on its own, or as a result of another condition or medication. When excessive sweating affects the head and face, it is known as craniofacial hyperhidrosis.
Read on to learn more about hyperhidrosis, what causes excessive sweating of the head and face, and how to stop it.
Sweating is the body’s way of cooling down. It can help to prevent overheating during hot weather, when exercising, or when a person has a fever. However, sweating can also occur unnecessarily. When this happens frequently, it is known as hyperhidrosis.
- Primary focal hyperhidrosis: This is the most common type of hyperhidrosis. It causes a person to sweat more in one or several specific areas of the body, such as the face or hands. The term “primary” means that this does not occur due to another medical condition or medication.
- Secondary hyperhidrosis: In this type, a medication condition or medication is responsible for the symptoms. This could also include dietary supplements.
Hyperhidrosis of the head and face could be primary or secondary.
Experts believe that hyperhidrosis may occur due to a problem with the sympathetic nervous system. This is the part of the nervous system that is responsible for controlling many bodily functions, including heart rate, breathing, and sweating.
Usually, the nervous system sends signals along nerves in the body to tell sweat glands when to produce sweat, and when to stop. This may be in response to stimuli such as heat or certain emotions, such as anxiety.
But in hyperhidrosis, this signaling does not work as it should. The reasons for this differ depending on whether it is primary or secondary.
Primary focal hyperhidrosis
Many people with primary focal hyperhidrosis also have a family member who sweats more in specific areas. This suggests there could be a genetic link, but scientists are still learning about this.
Secondary hyperhidrosis has many potential causes. They include:
- hormonal shifts during puberty, menopause, or after pregnancy
- overactive thyroid gland (hyperthyroidism)
- low blood sugar (hyperglycemia)
- certain medications such as certain antidepressants, propranolol, pilocarpine, and bethanechol
- Parkinson’s disease
- drug or alcohol use
- withdrawal from drugs or alcohol
- head trauma or brain tumors
- blood cell or bone marrow disorders, such as Hodgkin’s lymphoma
- diseases that impact the sympathetic nerves
- certain rare inherited conditions
Sometimes, treating the underlying cause will reduce or stop secondary hyperhidrosis.
Hyperhidrosis often affects parts of the body that sweat the most, such as the underarms or feet. However, the face and head can also sweat a lot in hot weather. For example, some people develop a sweaty forehead, temples, or upper lip under those conditions.
As a result, hyperhidrosis can affect the head and face too. If a person has primary focal hyperhidrosis, the symptoms may only affect this area. In contrast, secondary hyperhidrosis may affect the whole body.
In primary focal hyperhidrosis, there is not always a clear reason why sweating affects one body part and not another. It may be that only some nerves are overactive.
People with craniofacial hyperhidrosis tend to experience sweating on the face, head, or scalp that:
- is visible, soaks into clothing, or drips from the face
- cannot be explained by heat or stress
- interferes with daily activities, such as reading or working
- smells different to usual sweat
If the cause is primary, symptoms will occur at least once per week and may:
- begin during childhood or adolescence
- only affect the head, or just the head and one or two other body parts
- occur when a person wakes up, but not while they are asleep
- cause the skin to wrinkle, become soft, or peel
- lead to skin infections
If hyperhidrosis is secondary, the symptoms could begin at any time, and may affect many areas of the body. A person may also sweat at night.
In either case, hyperhidrosis can have a significant impact on quality of life and mental health. Some people may avoid contact with others due to embarrassment, particularly those with facial sweating, as this is more difficult to disguise than other types of hyperhidrosis.
To diagnose hyperhidrosis, a doctor will ask someone about their symptoms and examine the affected areas. They may also perform a sweat test, which involves covering areas of the skin with a powder that turns purple when wet.
To identify the cause of excessive sweating, they may also recommend:
- blood tests
- urine tests
- medical imaging tests, such as an MRI scan
A doctor will also review the medications and supplements someone is taking to determine whether they could be contributing.
If a medical professional cannot find an underlying cause, they may diagnose primary hyperhidrosis. If they do find a cause, it is secondary hyperhidrosis.
A range of factors may trigger symptoms of hyperhidrosis. These factors are typically those that would increase body temperature or the risk of sweating.
Common triggers include:
- warm weather
- spicy foods
- wearing tight, thick, or restrictive clothing
- monosodium glutamate (MSG)
Depending on the severity, people with excessive sweating may benefit from self-care strategies, medical treatments, or in extreme cases, surgery.
Self-care and management
There are a few strategies that may help reduce the symptoms of hyperhidrosis or make them more manageable. It may help to:
- Regulate body temperature: Where possible, avoid hot weather and wear loose, lightweight clothing in natural fabrics, such as cotton or linen. These help keep the body cool. People can also carry mini fans to cool the face.
- Avoid triggers: If a person knows certain things trigger their sweating, they may be able to avoid them entirely, or choose to avoid them at certain times. For example, a person might avoid spicy food before a meeting if they know this may cause symptoms.
- Absorb excess sweat: People can use tissues, blotting paper, or soft face cloths to dab sweat away during the day. If sweat mainly comes from the scalp, it may help to use sweatbands to prevent moisture from dripping onto the face.
- Reduce the appearance: People may be able to reduce the appearance of sweat by wearing the hair up, wearing light colors around the neck, or using absorbent face powders.
- Reduce stress: Worrying about sweating, or experiencing stress more generally, may lead to more sweat. People may benefit from relaxation techniques or mental health support if they are struggling with this.
The first-line treatment for craniofacial hyperhidrosis is a medicated face wipe that contains glycopyrrolate. This medication stops the sweat glands from becoming activated, reducing sweating.
Other options include:
- antiperspirants, though these may not be suitable for the face
- Botox injections
- oral medications that prevent the sweat glands from working
Doctors tend to prescribe oral medications in cases where the symptoms are severe.
Another hyperhidrosis treatment is iontophoresis, which involves passing a weak electrical current through water or a moistened pad to temporarily stop the sweat glands from working. Usually doctors recommend this for the hands or feet rather than the face, though.
In cases when symptoms do not respond to any other treatment, doctors may suggest medical procedures or surgery.
Endoscopic thoracic sympathectomy
This surgical treatment for hyperhidrosis involves cutting or clipping the nerves responsible for triggering sweating in the affected area with very small incisions. This stops the nerves from being able to sending signals.
However, because the body is unable to sweat in one location, the procedure may cause compensatory sweating in other areas.
Removal or destruction of sweat glands
Some treatments involve destroying sweat glands themselves. Doctors can do this in various ways, but many techniques, such as surgically cutting out sweat glands, have high complication rates.
A newer approach involves using microwave energy to create heat in the skin, destroying sweat glands without making incisions. Early trials of this treatment have been promising, but none have focused specifically on face and head sweating.
It is typical for the face and head to sweat when a person feels hot. However, if sweating occurs for no apparent reason, this could be hyperhidrosis, or excessive sweating.
Hyperhidrosis of the face and head can be uncomfortable and challenging. If there is an underlying cause, addressing this may reduce the symptoms. If there is no treatable cause, people may benefit from medical treatments to improve quality of life.
People should contact a doctor about excessive or unexplained sweating, especially if it develops fairly suddenly or after starting a medication.
People should also contact a doctor about sweating that causes excessive embarrassment, reduces self-esteem, or interferes with daily activities.