exhausted and sweaty woman holding her head with closed eyes

Excessive Sweating on Face

Sweating is a natural healthy process that helps cool the body and prevent overheating. However, some people may encounter excessive sweating on the face and head, which could be a sign of an underlying condition.

Hyperhidrosis is one such condition in which sweating can be excessive. Craniofacial hyperhidrosis occurs when hyperhidrosis impacts the face or head.

What is hyperhidrosis?

Hyperhidrosis means too much or excessive sweating. It occurs when someone sweats when they do not need to. The purpose of sweat is to cool down the body but in hyperhidrosis, sweating occurs even when there is no need to cool down the body.

Hyperhidrosis is of two types: one is primary focal hyperhidrosis and the other is secondary hyperhidrosis.

Primary focal hyperhidrosis is a very common type of hyperhidrosis. It occurs when excessive sweating is not related to another medical condition. When the cause of hyperhidrosis is a medication or a medical condition, it is called secondary hyperhidrosis.

Why the head and face?

When hyperhidrosis affects the head, scalp, and face, it is called craniofacial hyperhidrosis. It may also affect the:

palms of the hands
soles of the feet
chest
groin
armpits

There is no accurate definition of excessive sweating.

Hyperhidrosis can impact anyone of any age, but people with primary hyperhidrosis tend to have the symptoms as children or after reaching puberty.

Primary hyperhidrosis is likely to cause excessive sweating that affects both sides of the body equally. It also tends to affect one or two regions while the rest of the body stays completely cool. But symptoms of primary hyperhidrosis may improve with age.

People with secondary hyperhidrosis tend to experience symptoms throughout the entire body, and symptoms can occur at any age. Symptoms can develop suddenly. Secondary hyperhidrosis may also cause uncontrolled night sweats.

Causes (Reasons for excessive sweating)

Sweating is usually controlled by brain signals which are sent along sympathetic nerves to sweat glands in the skin. Sympathetic nerves are part of the autonomic nervous system that controls many body functions, including sweating.

When someone’s body temperature increases, the brain sends signals to initiate sweating to help release the internal heat and cool down the body. Sweating may also occur in response to the emotions such as embarrassment or anxiety.

The cause of primary hyperhidrosis remains unknown.

Hyperhidrosis seems to affect the eccrine sweat glands, or water-producing sweat glands, rather than the apocrine, oil-producing glands. It may occur when the brain sends signals to cool down the body when it is not necessary.

Genetic factors may also play a role in primary hyperhidrosis. About 33% of people with hyperhidrosis have a family history with the same condition.

In some cases, there is no apparent cause for secondary hyperhidrosis. But, secondary hyperhidrosis may occur due to:

Infections
Diabetes
menopause or after pregnancy
overactive thyroid gland
low blood sugar
Obesity
Gout
Tumours
fluoxetine and other similar antidepressant medications
propranolol, pilocarpine, and bethanechol
Parkinson’s disease
drug or alcohol use
injury, such as head trauma
Frostbite
blood cell or bone marrow disorders
certain rare inherited conditions

Diagnosis

To diagnose hyperhidrosis, a doctor will ask about their symptoms and will examine the affected areas. They may also run a sweat test, which involves covering affected areas of the skin with a powder that turns out purple when wet.

A doctor may then run a series of blood and urine tests to check for any other causes of excessive sweating. They may also review the medications someone is taking to know whether they may be causing excessive sweating.

If no other cause is determined, a doctor is probably to diagnose primary hyperhidrosis. If a doctor finds a cause, the diagnosis will be a secondary hyperhidrosis.

How to stop the sweating?

There are a few ways that may help reduce symptoms of hyperhidrosis. Common tips include:

avoiding warm weather or places
wearing loose or lightweight clothes
wearing lighter colours, rather than darker clothing
using an antiperspirant rather than deodorant
wearing clothes made out of natural fibres instead of synthetic fibres
wearing sweatbands
treating anxiety using stress-reducing techniques or cognitive behavioural therapy (CBT)
using unscented facial powder
staying hydrated
keeping hairs away from the face and neck

Surgery

In rare cases when symptoms do not respond to any other treatment, surgery may be required. Potential surgical procedures include:

Endoscopic thoracic sympathectomy

This is the commonly used surgical treatment for hyperhidrosis. It involves cutting or clipping the nerves responsible for triggering sweating in the affected area through very small incisions. It may cause gustatory sweating, sweating in the neck and face after eating, or excessive sweating elsewhere.

Removal or destruction of sweat glands

In this, sweat glands surrounding the affected area are physically cut or scraped away. Electromagnetic radiation may also be used to ruin the sweat glands. It is mainly done when armpits are involved.

Take Away

Sweating of the face and head is normal. However, excessive sweating (hyperhidrosis) of these areas can be sometimes very uncomfortable and challenging.

People should contact a doctor about excessive sweating, especially if it develops fairly suddenly or after starting to take medication.

People should also contact a doctor regarding night sweats or sweating that causes excessive embarrassment, reduced self-esteem, social withdrawal, or interference with any of their daily activities.