cold sweats

It sounds like an oxymoron, but breaking out in a case of the cold sweats is a real problem for many people. While normal sweating is part of the body’s normal cooling response, breaking out in a cold sweat is usually due to sudden fear or stress, which kicks in your body’s “fight-or-flight” stress response. While cold sweats by themselves aren’t usually a health risk, they can be a sign of more serious health issues.

Top 8 Causes of Cold Sweats

  • 1. General Anxiety
  • 2. Hypoglycemia
  • 3. Heart Attack
  • 4. Hormonal Changes
  • 5. Pain or Shock
  • 6. Infection
  • 7. Alcohol or Drug Withdrawal
  • 8. Medication Effects

People in the middle of a cold sweat often have clammy skin and report feeling cold; they may also seem unusually pale. Cold sweats can break out on your palms, armpits and even the soles of your feet.

What Causes Cold Sweats?

The medical term for sudden, excessive sweating is diaphoresis. This kind of sweat isn’t caused by heat or exertion. It’s set apart from regular sweating by what the person is doing when the sweating cranks up.

Under normal conditions, your body produces sweat in order to cool down your body temperature – typically in response to environmental factors like the temperature on a hot summer day or when exercising. But with cold sweats, your sweat glands are being abnormally activated by something other than heat or activity, such as your built-in stress response.

While the specific details are all over the map, most cold sweats can be traced back to our ancient fight or flight response, which readied our ancestors’ bodies to either battle it out with an enemy or get the heck out. The fight or flight response still makes us break out in cold sweats today, but it’s more likely to be triggered by a traffic jam or a big presentation rather than marauding invaders or wooly mammoths. When you’re in fight or flight mode, your heart rate speeds up, you start breathing more shallowly, your mouth goes dry and your sweat glands open up — and then start the sweat pouring. Since you’re usually not fighting for your life when this happens, it can be a little embarrassing.

Top 8 Causes of Cold Sweats

Depending on your unique physiology and stress response, cold sweats could be triggered by a variety of different things, but the following list represents some of the most common causes.

1. General Anxiety

A panic attack, generalized social anxiety, or other types of anxiety are some of the worst offenders for triggering a cold, clammy sweat. If this is something that happens to you, or you experience levels of anxiety that truly feel overwhelming, make sure to talk with your doctor about treatment options for the root cause of your cold sweats.

Cold sweats related to anxiety are often a result of the stress that your anxiety is putting on your body, which often keeps oxygen from getting to your brain and other vital organs. This kind of anxiety disorder can cause long-term health hazards and be extremely limiting to your quality of life, so it’s something you definitely want to talk with your doctor about.

2. Hypoglycemia

When someone’s blood sugar levels drop to well below normal, that can trigger a cold sweat. This is another serious health condition, especially for people with diabetes. When the blood sugar drops dramatically, your brain processes this change as a dangerous drop in oxygen and triggers the same response: cold sweats. Most of the time, drinking fruit juice or eating something with a small amount of natural sugar can help get the blood sugar back up to a healthier level.

3. Heart Attack

Sometimes people having a heart attack break out into a cold sweat – they also typically experience chest pain, intense pressure in the chest or upper body, shortness of breath, and have waxy, clammy skin. If you find yourself — or anyone else — with sudden chest discomfort, get medical attention immediately.

4. Hormonal Changes

Hormone levels can fluctuate, especially for people in menopause or perimenopause – this can sometimes lead to hot flashes, cold sweats, and even night sweats. The same happens during pregnancy and during puberty, for both boys and girls. In addition, thyroid disorders can lead to hormonal imbalances that can send your sweat glands for a loop. Along with sudden, uncontrollable hot flashes and cold sweats are one of the telltale signs of menopause.

5. Pain or Shock

When we suffer intense pain due to an accident or severe injury — or even a migraine — cold sweats are pretty common. If the profuse sweating comes with low blood pressure and a high heart rate, you might be dealing with a case of shock – and you should seek medical care immediately. When you’re suffering from shock, you’re getting dangerously low blood flow to your vital organs, including the brain.

If you’re offering first aid to someone who might be showing symptoms of shock, recognizing the cold sweat is an important clue, and you should get emergency medical help immediately. In the meantime, having the person lie flat on his back while elevating the feet can help. Ultimately, treating the injury itself and managing the symptoms associated with shock can bring the cold sweats under control.

6. Infection

Sometimes, if your body is fighting off an infection – especially something severe like tuberculosis or HIV – sweaty and cold, clammy skin can be a sign of your body’s response to that infection. An infection typically kicks your immune system into high alert, leading to a cold sweat. Any infection that spurs a fever can cause hot flushes and sweats, but tuberculosis is the infection most often associated with sweating at night. In addition, sepsis, the most severe type of infection, can often lead to shock, which usually brings with it a case of the cold sweats.

7. Alcohol or Drug Withdrawal

For anyone going through the process of stopping alcohol or drug use, there are often unpleasant side effects. One common side effect is breaking into a sudden cold sweat – and these symptoms can set in quickly, as fast as four to 12 hours after the last dose of drugs or alcohol, according to some estimates. The body’s response to a lack of neurochemicals is to trigger symptoms that sound a lot like a bad case of the flu-like excessive perspiring, confusion, insomnia, nausea, body aches, heart palpitations, and more.

8. Medication Effects

A wide collection of medications, including hormone replacement therapy, antidepressants, powerful pain relievers, and steroids can sometimes cause people to break out in a cold sweat. Some you might be familiar with include albuterol, hydrocodone, insulin, and even naproxen sodium. If you suspect that your cold sweats are connected to a medication you’re taking, you should reach out to your doctor for a blood test to see if you can get your dosage or the medication itself adjusted.

Cold Sweats vs. Night Sweats: What’s the Difference?

The term night sweats refers specifically to a condition also known as sleep hyperhidrosis. It can leave your jammies drenched and your sheets in a puddle, but it’s unrelated to the core temperature of your body heating up while you sleep. Sometimes night sweats can be a sign of a serious medical condition, so if sweat is plaguing your dreams, you should definitely reach out to your doctor to discuss.

For example, sometimes obstructive sleep apnea (a narrowing of the throat walls, which restricts breathing during sleep) can cause cold sweats at night. In fact, those who suffer from sleep apnea are three times more likely than the general population to have cold sweats while sleeping. Sometimes night sweats also come along with GERD – gastroesophageal reflux disease. In addition, some cancers, especially lymphoma and leukemia, trigger nightly cold sweats as an early sign of the disease.

Night sweats typically result in a layer of sweat over your entire body, while cold sweats are usually more localized – like on your palms, underarms, and feet.

Treatment Options

As it turns out, there’s no specific treatment for cold sweats. When it comes to relieving a cold sweat, your best bet is to try to address its root cause. If you break out in a cold sweat because of anxiety, for example, you may find relief with options like meditation and yoga that help reduce your stress. Your overall goal is to make sure you’re getting plenty of oxygen to your brain, which meditation and yoga both support by forcing you to focus on your breathing. Cognitive behavior therapy can also be extremely helpful in addressing the areas of your life that trigger the fight or flight reaction.

In addition, getting regular, daily exercise and maintaining a healthy weight can help with how your body processes stress. In other words, the perspiration itself isn’t necessarily the problem – it may be an indicator of a deeper issue. Also, make sure to drink plenty of water.

While you’re working out your causes for cold sweats, you can do simple things to help with sudden cold sweats. Keep your skin clean and dry, shower regularly, and maybe even adjust your diet. Some foods and beverages, like caffeine, for example, can make people sweat more, so minimizing or removing them from your diet completely may help. You may want to avoid alcohol, nicotine, caffeine and/or spicy foods if you notice excessive perspiration after eating or drinking them. It might not be fun to cut those from your diet, but it’s at least worth a shot if it can keep you from turning into a clammy puddle. You may need to talk to your doctor about adjusting medication or correcting hormone imbalances if you believe those are contributing to your frequent cold sweats.

It’s also a good idea to invest in an antiperspirant you can count on to help control your cold sweats and any odor they might bring with them. You can apply an antiperspirant at night before you go to sleep so that it has a chance to work all night.

Treating Your Cold Sweats

The cold sweats can be annoying, and also a little scary if you think they’re signaling a broader health issue. Don’t be afraid to talk with your doctor if you find yourself breaking out into constant cold sweats without an obvious trigger.

Nearly everyone experiences cold sweats at some point in their lives, and there are several causes of cold sweats that are not emergency-related – like hormonal changes or day-to-day anxiety. If you have a serious, ongoing issue with cold sweats, talk to your doctor to make sure there isn’t a deeper issue going on that needs to be treated.

Glycopyrrolate and oxybutynin belong to a class of medications known as anticholinergic drugs, which are often used to treat excessive sweating, or hyperhidrosis. In a general sense, anticholinergic medications block the neurotransmitter acetylcholine within the peripheral and central nervous systems. Essentially, this means that they impede the ability of the sympathetic nerves to communicate with the body’s sweat glands and prevent them from producing sweat.

Pros and Cons of Glycopyrrolate and Oxybutynin

Before starting a course of either medication, you should carefully consider the pros and cons of each. While these medications can be effective, be aware that there are also many negative side effects. Oral medications are typically prescribed when other treatments have failed to show significant positive results. Though no oral medications are currently FDA-approved specifically for the treatment of hyperhidrosis, several have a long history of off-label use for that specific purpose.

Pros of Glycopyrrolate and Oxybutynin

  • Available in a convenient pill form.
  • Oxybutynin is also available as a topical gel and as a transdermal patch.
  • Ability to scale dosage – this allows you to experiment to find the right dose that’s effective for stopping excessive sweating while leading to the fewest side effects.
  • Oxybutynin is relatively inexpensive medications, accessible for a wide variety of people.
  • Effective in preventing plantar (foot), palmar (hand) and axillary (armpit) hyperhidrosis. In fact, one study reports that 70 percent of patients saw decreased sweating symptoms related to axillary and palmar hyperhidrosis, while 90 percent reported improvement in plantar hyperhidrosis symptoms.

Cons of Glycopyrrolate and Oxybutynin

  • Drowsiness
  • Blurred vision
  • Fast, weak pulse or increased heart rate
  • Irregular heartbeat
  • Fever
  • Increased blood pressure
  • Fast, shallow breathing
  • Dry mouth
  • Loss of taste
  • Headache
  • Confusion
  • Fainting
  • Difficulty falling or staying asleep
  • Nausea
  • Vomiting
  • Dry eye
  • Nasal congestion
  • Decreased mental alertness
  • Bloating
  • Constipation
  • Dizziness
  • Eye pain
  • Anxiety
  • Irritability
  • Flushing or redness in the face and skin
  • Constipation or urinary retention
  • Hallucinations

Oral medications are usually most effective when used as adjunctive therapy with other treatment options, like topical medicines and antiperspirants, in order to decrease hyperhidrosis symptoms. People who usually find the most success with oral hyperhidrosis medications are those who experience excessive sweating all over the body.

Before prescribing an oral medication, your physician may encourage you to try other remedies, such as Botox injections, local permanent treatment options, or topical creams. Oral medications, however, can be especially helpful when the cause of excessive sweating is identified, but cannot be eliminated or remedied – for example, if an existing medication regimen causes excessive sweating but cannot be changed or abandoned without causing bigger issues.

What You Need to Know About Each Medication

While not specifically developed to treat hyperhidrosis, anticholinergic drugs like glycopyrrolate and oxybutynin are often prescribed for this purpose. This class of drug binds with acetylcholine, thus preventing it from being used throughout the body. Receptors are located throughout the autonomic nervous system and expand through the whole body – resulting in a system-wide, rather than localized, effect.

Here’s the kicker: These medications also block receptors completely unrelated to the sweat glands and perspiration, which can lead to unintended and unwanted side effects. Let’s take a closer look at what you need to know about each of these oral medications.

Glycopyrrolate

Glycopyrrolate is the most commonly prescribed anticholinergic for excessive sweating. It’s primarily prescribed to treat ulcers and gastric secretions in adults and drooling in children, since it decreases stomach acid and saliva production. In addition, it reduces the body’s ability to sweat. Glycopyrrolate in oral form is the most commonly prescribed anticholinergic drug for hyperhidrosis treatment – mainly because it causes fewer central nervous system side effects. People typically take glycopyrrolate as tablets or a liquid, by mouth, either two or three times per day on an empty stomach – usually one hour before or two hours after a meal. Appropriate dosage is based on your specific medical condition, documented response to treatment and body weight.

Before beginning a glycopyrrolate dose, your doctor will ask if you have ever had any of the following: glaucoma, difficulty urinating, enlargement of the prostate, ulcerative colitis, high blood pressure, overactive thyroid, coronary artery disease, disorders of the nervous system, or kidney or liver disease. In addition, you should notify your physician if you are pregnant, think you might become pregnant, or are currently breastfeeding.

To reduce the incidence of possible glycopyrrolate side effects, your physician may recommend that you begin taking it at a relatively low dosage and gradually increase as your body acclimates to the new medication. You should not increase the dosage or frequency of glycopyrrolate without consulting your doctor – doing so won’t improve your hyperhidrosis, but it will increase your chances of suffering adverse events and side effects.

The glycopyrrolate drug class has shown a high rate of effectiveness when studied – for example, one clinical trial has reported that up to 90 percent of patients taking glycopyrrolate saw a reduction in hyperhidrosis symptoms. Unfortunately, up to one third had to abandon therapy because of adverse side effects, which have been reported by up to 80 percent of participants taking these oral medications as part of clinical studies.

Glycopyrrolate can negatively interact with a wide variety of other medications, so make sure to tell your doctor about any prescription, over-the-counter or holistic medications you are currently taking before starting a round of glycopyrrolate. Depending on the potential combinations, your physician may choose to either change your dosage or monitor you carefully for side effects.

Glycopyrrolate dose helps reduce sweating by systematically reducing all body secretions, which can result in some annoying and uncomfortable side effects. For many people, glycopyrrolate side effects show up as minor irritations that can be mitigated through measures like drinking more water (which may increase urinary frequency), eating mints, or using eye drops. However, these side effects persist over time or grow worse, you should contact your doctor immediately.

While rare, the following side effects of glycopyrrolate can also occur and are especially dangerous. You should consult your doctor immediately if you experience any of the following:

  • Urination problems: difficulty urinating or inability to urinate
  • Hives
  • Rash
  • Diarrhea
  • Difficulty breathing or swallowing

Anticholinergics are systemic medications, which means they cannot target any one particular area on the body in which sweating is most profuse; instead, they decrease sweating over the entire surface of the body, no matter whether that’s needed. If you’re not careful, this overall reduction in the body’s ability to cool itself through sweating can put you at risk of overheating. In essence, the sweating mechanism is turned off, which dramatically decreases the body’s ability to regulate its temperature.

Athletes and those who work outdoors should be especially careful when they take anticholinergics – and for these reasons, these types of patients may be considered ineligible for use of oral medication for the treatment of excessive sweating. The same is true for people who have a natural tendency to overheat. Taking these medications can dramatically hinder the body’s ability to cool itself down, leading to a dangerous situation.

In addition, the high cost of glycopyrrolate for sweating is a limiting factor for some people.

Oxybutynin

Oxybutynin chloride is often prescribed with elderly patients to treat urinary incontinence, overactive bladder or frequent urination. It is the second most commonly used anticholinergic drug to treat hyperhidrosis. Ideally, the lowest possible dose of oxybutynin should be used in order to minimize the risk of adverse side effects.

Oxybutynin tablets are often prescribed – both immediate and extended-release – as well as oxybutynin gel, oxybutynin syrup, or even an oxybutynin transdermal patch. No matter its form, oxybutynin is recommended to take with water on an empty stomach, though some physicians insist that patients with incontinence take the medication with food or milk in order to decrease the chances of an upset stomach. If your oxybutynin is prescribed as a time-release oral medication, be sure to follow the directions carefully. Swallow the tablet whole – do not crush, break or chew it, as doing so will adjust the time-release formulation. Drink lots of water or any other liquid of your choice. Also, be sure to take your oxybutynin tablet at the same time each day.

Oxybutynin dosage will vary from patient to patient, but usually hovers around 5 or 10 mg taken two or three times per day for adults and children over 12. The dosage rarely exceeds 30 mg per day. It is very important to use oxybutynin medication only as directed – no more, no less. Refrain from operating motor vehicles or other large machinery until you have an idea of how your body tolerates the oxybutynin drug.

One important consideration is that oxybutynin effects can cause a serious allergic reaction known as angioedema, which is life-threatening and requires immediate medical care. If you experience any of the following adverse reactions after taking oxybutynin, call your doctor or emergency medical care immediately: chest tightness or trouble breathing, body rash, itching, intense swelling of the face (including lips, throat, tongue, eyelids), hands, legs, feet or genitals.

Oxybutynin has been known to cause a negative reaction when combined with the following drugs and compounds: potassium, glycopyrrolate, donepezil, bupropion, tiotropium, secretin human, glycopyrronium tosylate, rivastigmine, ketoconazole, and galantamine. Tell your physician if you are taking any of these medications. Your doctor may choose to either change your dose of oxybutynin, watch you carefully for side effects of oxybutynin, or modify other medications you take while you are taking oxybutynin.

Certain pre-existing medical conditions can affect your body’s acclimation to oxybutynin, especially with elderly patients. Any of the following conditions have the potential to react negatively with oxybutynin: dementia, overactive thyroid, enlarged prostate, heart disease, hypertension, intestinal or stomach problems, Parkinson’s disease, toxemia of pregnancy, urinary bladder blockage, or glaucoma. Make sure to tell your doctor if you are currently suffering from any of these conditions.

Patients are more likely to see anticholinergic side effects right after beginning a course of oxybutynin or after an increase in dosage. Any of these symptoms should be reported to a physician as soon as possible – your doctor can help you determine whether your side effects are severe enough to need medical attention or if they will likely go away as your body acclimates to the new medication.

In addition, oxybutynin and alcohol are a dangerous combination; oxybutynin exacerbates the effects of alcohol and other CNS depressants like antihistamines, tranquilizers, sedatives, muscle relaxers, and some prescription pain medications.

New Topical Applications Available

One of the biggest drawbacks to any oral medication for the treatment of hyperhidrosis is its systemic nature – it can’t be localized, and it often creates side effects that affect the entire body. However, new treatment options featuring glycopyrrolate and oxybutynin are now being developed and marketed that are topical in nature, which allow patients to concentrate treatment within a particular, localized problem area.

While topical creams containing glycopyrrolate and oxybutynin are now available, their efficacy is still under review. Some early indications show that the creams may have trouble penetrating the outer skin barrier. In addition to topical creams, a new product called Qbrexza features glycopyrronium tosylate within a medicated wipe that can be used to topically treat hyperhidrosis. It is typically used once per day to prevent excessive sweating.

In addition, there is some indication that topical treatments like Qbrexza can be used in conjunction with iontophoresis treatments, which use low-level electrical currents to push medications – usually anticholinergics – through the skin of a particular body area submerged in water. These treatments have shown best results when treating excessive sweating of the hands and feet.

Future Studies and Uses

While no cure is yet available, treatments for hyperhidrosis continue to improve. Excessive sweating affects 3 to 5 percent of the world’s population, and medical experts are still trying to understand the causes of hyperhidrosis. Many current treatments, including the use of anticholinergics, can be invasive and ineffective. However, as this condition is further studied, researchers will be able to develop targeted and more effective treatments.

There is a great deal of promising research on the horizon for those who suffer from hyperhidrosis. Emerging treatments and technologies have great potential to make a profound difference in quality of life. For example, topical medications have great promise in treating hyperhidrosis without many of the negative anticholinergic effects experienced when taken orally. The theory is that being able to apply a topical anticholinergic to a local area will stop or dramatically reduce sweating in that area without the drawbacks associated with an oral dose, which affects the entire body.

Many studies and intended future use of both glycopyrrolate and oxybutynin are on the horizon. One of the most encouraging is the planned use of glycopyrrolate in a topical cream that would be used to directly target the eccrine glands – it would likely include a 1 percent or 2 percent glycopyrrolate suspension. Oxybutynin also is currently being studied in connection with topical applications that would be more effective than current options. In preliminary studies, glycopyrrolate has shown promising results in the higher 2 percent suspension with very few side effects. Other studies have specifically explored a 2 percent glycopyrrolate pad, finding that some participants reported sweat reduction of up to roughly 62 percent. While existing studies have been small, a series of larger, double-blind studies could help further understanding of topical products’ potential to improve quality of life for people with excessive sweating.

In addition, while Qbrexza currently is indicated only for underarm use, additional research could have implications for additional hyperhidrosis treatment throughout the body.

Other Research and Product Possibilities

Along with various topical formulations, researchers are currently working to develop next-generation, non-injection Botox treatments for addressing plantar (foot), axillary (underarm) and palmar (hand) hyperhidrosis. In addition, the FDA-approved MiraDry is a medical device indicated for the treatment of underarm hyperhidrosis. This treatment involves heating the skin to the point that sweat glands are destroyed. Several other devices also are under development that employ various methods for heating the skin to destroy sweat glands.

Another new technology is fractional microneedle radiofrequency treatment, which sends energy into the reticular dermis – the lowest layer of the skin – without harming the epidermis, or the skin’s outer layer. FMR has been widely used to treat wrinkles and acne scars, and early studies show that it has potential to address hyperhidrosis as well. Early results indicate that many people undergoing treatment show significant improvement as soon as two months.

Lasers may also offer some benefit in the future for hyperhidrosis sufferers. Specifically, the 1064-nm Nd-YAG laser has potential, particularly when tested against underarm hyperhidrosis. In some studies, as many as 70 percent of participants showed improvement in self-reported assessments, while physicians’ assessments revealed upwards of 80 percent of participants showing improvement. With further study and refinement, this kind of therapy could be especially effective.

Additionally, ultrasound, which focuses ultrasonic energy within a localized area, is a new focus of interest and further study. In particular, the VASER ultrasound has been shown to improve symptoms for up to six months, but no data for longer time periods is currently available. Early results are encouraging, though more research and study are needed to determine exactly how effective various ultrasound methods may be in treating hyperhidrosis symptoms.

Treating Hyperhidrosis

Today, no cure for hyperhidrosis exists, but further research, medical knowledge, and understanding may expand to the point where a cure is within reach. Above all, scientists must understand the physiology of hyperhidrosis and how various drugs impact that physiology. Doing so can help lead to better therapies that are more effective with fewer side effects. Because hyperhidrosis is at least partly hereditary, understanding its underlying genetic sequence may also reveal additional clues for how best to prevent, treat, or cure the condition. Thankfully, as hyperhidrosis continues to garner awareness and attention, more researchers and medical professionals can get behind exploring new ways to improve quality of life for those with the condition.

If you sweat excessively and haven’t been able to find a treatment that works, the next logical step is to visit with your doctor. At this point, the physician may prescribe oral anticholinergic medicines to decrease the overall amount of sweat produced by your body. Glycopyrrolate and oxybutynin are the two most commonly used anticholinergic agents to treat hyperhidrosis.

Overall, medicines like glycopyrrolate and oxybutynin can be effective components of a comprehensive treatment plan for people with hyperhidrosis, though be prepared for negative side effects. If you’ve been prescribed one of these drugs, the information in this post can help you better understand how each medication works and what to expect in terms of potential side effects. And, as always, make sure you are working closely with your physician to manage your hyperhidrosis symptoms. Your doctor can help you further understand the full pros and cons of using systemic anticholinergic drugs for your specific situation.

You wake up in the middle of the night drenched from head to toe in sweat. Your pajamas are soaked, and your sheets feel like they just came out of the washing machine. Has this ever happened to you? If so, then you’ve had night sweats. There are a number of reasons why you might be suffering from excessive sweating at night.

Top 16 Causes of Night Sweating

  • 1. Perimenopause and Menopause
  • 2. Diabetic or Nocturnal Hypoglycemia
  • 3. Hormone Disorders
  • 4. Hyperhidrosis
  • 5. Infections
  • 6. Cancer
  • 7. Antidepressants
  • 8. Medication
  • 9. Neurologic Disorders
  • 10. Hyperthyroidism
  • 11. Caffeine
  • 12. Tuberculosis
  • 13. Obstructive Sleep Apnea
  • 14. Anxiety Disorder
  • 15. Obesity
  • 16. Low Testosterone (Low-T) Levels in Men

Night Sweats : Common Causes

What causes night sweats?

It’s probably not what you think. They’re not brought on because you wore too many layers to bed or piled on too many blankets. They’re not because you have the thermostat turned up too high or slept too close to that romantic fire in the fireplace. Yes, these things can make you sweat during sleep and soak your sheets, but they’re not considered true night sweats.

True night sweats are repeated episodes of excessive sweating that make you feel like a mop in need of wringing out. They’re due to an underlying medical condition or disease. When the conditions that cause the nighttime profuse sweating are treated or overcome, the night sweats and hot flashes stop. Let’s examine the most common causes of night sweats in men and women.

1. Perimenopause and Menopause

The time in life when women begin to transition into middle age is called perimenopause (means “around menopause”) or menopause transition. This is when a woman’s ovaries begin producing less estrogen. It normally happens to women over 40 but can occur earlier. Perimenopause lasts up until menopause, when a woman’s ovaries stop releasing eggs and they stop having menstrual cycles. Night sweats and hot flashes are among the most common symptoms. Other symptoms include nausea, weight gain, and tenderness of the breasts. Once a woman moves from perimenopause to full-blown menopause, the symptoms can increase in number and severity. The average age for the onset of menopause in the United States is 51.

Night sweats are a common occurrence in menopausal women. This happens because of hormonal changes affecting estrogen and progesterone levels. These hormones affect the body’s temperature control system. When they’re out-of-whack, like during menopause, get ready for the night sweats.

Certain lifestyle practices may help reduce night sweats due to menopause. Avoid these hot flash and night sweating triggers:

  • Smoking– including secondhand smoke
  • Tight or restrictive clothing
  • Too many blankets or sheets on your bed
  • Drinking alcoholic or caffeinated drinks
  • Eating spicy foods
  • Overly warm environments
  • Too much stress

When sleeping, you can try these remedies reduce menopause night sweats:

  • Lower the room’s temperature
  • Turn on a fan
  • Remove blankets or sheets
  • Wear light sleep apparel
  • Try cooling gels, sprays or essential oils
  • Have a few sips of cool water
  • Relax
  • Try plant-based supplements that claim to relieve or reduce night sweats

The only sure-fire cure is to grow a little older and move out of the menopausal stage of life. Not very comforting, but in this case, time is a highly effective cure.

2. Diabetic or Nocturnal Hypoglycemia

Hypoglycemia, or low blood sugar, is a common condition among people with diabetes (both type 1 and type 2). It happens when the level of sugar in the blood drops too low to maintain normal body functioning. This is thought to be 70 milligrams or lower per deciliter.

Nocturnal hypoglycemia is when blood sugar levels fall to dangerous levels during sleep. Most common in diabetes sufferers, it can happen when too little food is eaten after the nighttime dose of insulin or if too much insulin is taken before sleeping.

The symptoms of hypoglycemia while sleeping are:

  • Night sweats
  • Restless sleep
  • Fatigue
  • Mood swings
  • Nightmares or vivid dreams
  • Morning headache
  • Convulsions

While less common, hypoglycemia can also happen in people who don’t have diabetes. Non-diabetic hypoglycemia can occur if your body is unable to stabilize blood sugar levels or if your body produces a little too much insulin after a meal. Night sweating is also a symptom of non-diabetic hypoglycemia.

The treatments for hypoglycemia depend upon the cause. The initial approach for any type of hypoglycemia is eating a fast-acting carbohydrate, sugary food or fruit juice. Foods containing fat or protein are not good choices because they affect the way the body absorbs sugar.

Diabetics regulate glucose levels through doses of insulin and frequent checking of glucose levels. If you’re not diabetic, there may be another underlying cause for your hypoglycemia. Visit with your primary care physician for help in diagnosing another illness that may be responsible for causing hypoglycemic night sweats.

3. Hormone Disorders

Hormonal disorders or imbalances occur whenever there is an overabundance or deficiency of a hormone in the bloodstream. Because of the power of hormones and the essential roles they play in the proper functioning of our bodies, even a small imbalance can cause unpleasant or even dangerous symptoms. A common symptom is night sweats.

Hormones are chemical compounds produced by glands in our endocrine systems. They move throughout the body via the blood to deliver messages and instructions to our organs. They regulate many of the body’s vital functions. These include insulin, steroids, growth hormones, adrenaline, and many more.

Everybody will experience hormonal imbalances. Men and women will have them when going through puberty or growth spurts. Women go through menopause. Men experience testosterone level changes. The causes of hormonal imbalances range from medical disorders to obesity and dietary issues. Allergies and physical injury can also cause hormonal problems.

Effective treatments are dependent upon the cause. Make an appointment with your primary care physician to get started on diagnosing the cause and best treatment for your hormonal imbalance. Your doctor can offer a hormone therapy tailored to your situation.

4. Hyperhidrosis

Night sweats are often caused by hyperhidrosis, a condition characterized by excessive and uncontrollable sweating for no apparent reason. It’s a disorder that affects about 15 million people in the United States. Its cause is not well understood but is thought to be hereditary. While there is no cure, there are a number of effective treatments.

In this instance, when excessive sweating happens in the night, it’s not because you’ve stacked on too many blankets or you’re wearing the latest in thermal underwear. It’s not even because you’re having a bad drug side effect or even an imbalance of hormones. It’s because your sweat glands are being triggered into hyperactivity by your nervous system.

Sufferers of hyperhidrosis not only experience night sweats, but also profuse sweating during the day. Their lives are profoundly affected by excessive sweating in every situation and setting, even while completely rested and relaxed in sleep.

There are dozens of treatments for hyperhidrosis. Some are simple, easy, and inexpensive while others can be invasive, expensive, and painful. One of the best and most frequently used is a prescription strength antiperspirant like SweatBlock. These contain an aluminum chloride ingredient that effectively blocks sweat glands from secreting sweat by forming a gel-like plug. A single application can last up to 7 days. SweatBlock products are proven safe, effective, and life-altering.

5. Infections

Infections are a well-known cause of night sweats. The most common infection linked to night sweats is tuberculosis. HIV infections are also frequently accompanied by night sweats. Other infections associated with night sweats are endocarditis (inflammation of the heart valves), osteomyelitis (inflammation of the bones) and abscesses. Night sweats caused by an infection are alleviated by treating the underlying infection.

6. Cancer

Cancer is one of the other causes of night sweats. Sweating at night is an early symptom of multiple forms of cancer. The most prevalent type of cancer associated with night sweats is lymphoma. Lymphoma is cancer that begins in the lymphocytes, the immune system cells that fight infections. People who have undiagnosed cancer often exhibit other symptoms, like unexplained weight loss and frequent fever. The treatment for night sweats caused by cancer is the treatment of the cancer itself.

7. Antidepressants

Night sweats can result from taking antidepressants. Studies have shown that up to 22% of men and women taking antidepressants experience night sweats as a side effect. This kind of sweating is called secondary hyperhidrosis, or excessive sweating caused by a secondary and unrelated medical problem. Two antidepressants, sertraline and venlafaxine, are notably linked to nights sweats. The good news is that if antidepressants are causing night sweats or other negative side effects, they can be managed and even reversed.

As reported by the International Hyperhidrosis Society, Dr. Jonathan Scarff found that an anticholinergic medicine called benztropine reduced or eliminated antidepressant sweating. If you take an antidepressant and you’re suffering from night sweats, talk to your doctor about finding a therapy that can help you get a good night’s sleep without sweating.

8. Medication

In addition to antidepressants, there are over 100 medications that can cause night sweats. These types of medications include:

  • Analgesics (pain medication)
  • Antimicrobials (antibiotics and antivirals)
  • Asthma Inhalers
  • Cardiovascular (heart and blood pressure) medication
  • Chemotherapeutic (Oncological/cancer) medicine
  • Diabetes medication
  • Endocrine (hormonal) medication
  • Gatrointestinal (stomach and GI track) medicine
  • Head and neck medicine
  • Hematologic/Immunologic/Immunosuppressant medication
  • Neuropsychiatric medication
  • Ophthalmologic (eye) medicine
  • Pulmonary (lung) medication
  • Urologic medication

What can you do if a medication you are taking causes excessive sweating at night? Your options include reducing the dose, finding a substitute drug, or discontinuing the medications altogether. Don’t do any of these things without first consulting your doctor.

While night sweating is a known side effect of many of the medicines in the above categories, most will cause night sweats in a very small percentage of users. Medicines that are most likely to cause night sweats in 50% or more of those taking them are listed below:

  • Zinc supplements (Cold-Eeze, Galzin, Orazinc, Zincate) for the head and neck
  • Desipramine (Norpramin) A neuropsychiatric drug
  • Nortriptyline (Pamelor) A neuropsychiatric drug
  • Please note: The above lists are not intended to be all-inclusive.

9. Neurologic Disorders

Another rare cause of night sweats in men and women is a neurological disorder. Some of these disorders are dysreflexia, post-traumatic syringomyelia, stroke, and autonomic neuropathy. If you’re experiencing night sweats and you’ve been diagnosed with one of these disorders, it’s likely to be the cause.

10. Hyperthyroidism

The thyroid gland is two inches long, shaped roughly like a butterfly, and located in the front area of your neck. It produces hormones that control and regulate the body’s metabolic rate, heart, muscles, digestive functions, development of the brain and bone maintenance. The thyroid even helps regulate cholesterol levels. It’s an essential part of the endocrine system.

If your thyroid gland produces too much thyroid hormone, the overproduction of the hormone creates a condition known as hyperthyroidism. An estimated 30 million Americans suffer from some form of thyroid disorder. Hyperthyroidism most common occurs most commonly in women over 35.

One of the symptoms of hyperthyroidism is excessive sweating, especially at night. An underproduction of thyroid hormones can also cause night sweats. Treatments for hyperthyroidism range from taking radioactive iodine or other antithyroid medicines by mouth to invasive thyroid surgery. Successfully treating the thyroid will stop this cause of night sweats.

11. Caffeine

Here’s some bad news for people, especially women, who drink coffee, tea and/or caffeinated sodas. Caffeinated drinks might be causing those troublesome hot flashes and night sweats. Researchers have discovered a link between caffeine consumption, hot flashes, and night sweats in women.

According to well-known obstetrician and gynecologist Dr. Julia Schlam Edelman:

“Coffee is an especially common trigger of night sweats, and it’s a beverage that is more popular than ever. The number of specialty coffee shops is multiplying, and the coffee cups are getting larger — an extra-large Dunkin’ Donuts cup of hot coffee is 24 ounces; a “Venti” at Starbucks is 20 ounces. The more coffee you drink, the longer it takes to eliminate the caffeine from your body. Half the caffeine in a cup of coffee consumed by a healthy, non-pregnant adult is eliminated in six hours. If you drink a large cup of coffee (which may have 200 milligrams of caffeine) at 4:00 p.m., 100 milligrams of caffeine will be eliminated from your body by 10:00 p.m., leaving another 100 milligrams in your body that evening. This will disrupt your normal sleep pattern and promote night sweats.”

If you’re having hot flashes or night sweats and you’re consuming lots of coffee or tea, you’ll probably want to significantly reduce your caffeine habit. It probably doesn’t matter what temperature your caffeine is, so large servings of Coke, Pepsi or Dr. Pepper (among many others) can have the same effect.

12. Tuberculosis

Tuberculosis (TB) is a bacterial infection that primarily affects the lungs, though it can affect other organs as well. The infection is spread when a person inhales tiny droplets expelled when an infected person coughs or sneezes. TB can be difficult to diagnose in its early stages, and you could have TB and not know it. An infected person can be afflicted with tuberculosis for weeks before they begin to feel sick or experience symptoms.

In addition to the lungs, TB also affects the lymph nodes. A lymph node (lymph gland) is a small gland about the size and shape of a bean. Lymph nodes are an important component of the body’s immune system. They contain lymphocytes (white blood cells) that enable the body to fight disease and infection. They act as filters, trapping bacteria, viruses and other disease-causing substances before they can infect other regions of the body. Lymph nodes are connected to each other by a network of lymph vessels. Lymph nodes are found in groups and concentrations of lymph nodes are located in the neck, underarms, chest, groin and the abdomen area.

Symptoms of TB, while sometimes difficult to detect, usually include swollen glands and night sweats. Other common tuberculosis symptoms are fatigue, weight loss, and chronic fever. Tuberculosis can be treated with antibiotics, though particularly virulent and drug-resistant strains require prolonged treatment with a cocktail of several medications.

13. Obstructive Sleep Apnea

Obstructive sleep apnea occurs when the throat narrows, restricting breathing while sleeping. During sleep, breathing dangerously stops and starts repeatedly. Many people suffer from sleep apnea without knowing it. Loud snoring is one of the main symptoms. Those who suffer from untreated sleep apnea are three times more likely to have night sweats than others.

Sleep apnea is treated by wearing a CPAP (Continuous Positive Airway Pressure) device during sleep. The device sends a gentle current of pressurized air into the throat keeping it open.

14. Anxiety Disorder

Feeling anxious from time to time is something we all experience. We become especially anxious when faced with a difficult problem, taking an exam, preparing for a job interview or even before a first date. Anxiety disorder is something altogether different.

Anxiety disorders are classified as mental illnesses and interfere with everyday living. People with an anxiety disorder live in constant fear, worry and even dread. Just leaving the house can bring on an episode and leave them paralyzed. When your nervous system becomes hyperstimulated because of stress, the body can respond erratically causing dysfunctions like sweating profusely during sleep.

Sweating while sleeping is a predominant symptom of anxiety disorders and panic attacks. Night sweats caused by anxiety can occur infrequently or every night. They can come and go with no real pattern, ranging from slight to severe. You could wake up with just a little sweat on your brow or be completely soaked from head to toe.

Night sweats due to anxiety will stop when the stress stops. If you think you might be suffering from night sweats due to anxiety disorder, make an appointment with your doctor to explore ways to treat your anxiety.

15. Obesity

Obesity by itself can lead to night sweats. BMI (Body Mass Index) is a measure of a person’s weight in relationship to height and measures total body fat in adults. A BMI score of 26 to 27 would be considered overweight and can lead to moderate health risks. It’s estimated that 20% of Americans are classified as overweight.

A BMI score of 30 or higher is considered obese. Night sweats are a common result of obesity. Body fat acts as insulation and will keep heat in. More heat means more hot flashes and night sweats. In women, obesity can increase the severity of menopause symptoms.

The treatment is not complicated nor is it simple. Losing weight will stop hot flashes and night sweats caused by obesity.

16. Low Testosterone (Low-T) Levels in Men

We’ve explored several causes of night sweats and hot flashes in women, now it’s time to talk about night sweats in men. While women go through menopause, the change in estrogen levels can cause night sweats. Men, on the other hand, don’t normally experience dramatic drops in testosterone, but when low testosterone does occur, it can have a similar impact.

Doctors and scientists don’t know why a drop in testosterone levels causes hot flashes and night sweats. There is speculation that the hypothalamus, the region of the brain responsible for regulating body temperature, is the guilty organ. When operating normally, the hypothalamus signals blood vessels to dilate when the body becomes overheated. The increased blood flow causes a man’s face to become flushed. To deal with the elevated temperature, sweat glands are activated. Sweating is, of course, the body’s way of regulating its temperature.

Low-T may somehow cause the hypothalamus to “jump the gun” and cause unwelcome and profuse sweating during sleep by triggering the 2 to 4 million sweat glands in your body. Hormone replacement therapy may provide relief but can also increase the chance of prostate cancer. For men who have already been diagnosed with prostate cancer, hormone replacement therapy is not an option.

Low-T is not the only condition that can cause night sweats in men. If you’re experiencing night sweats, be sure to see your doctor.

Treating Your Night Sweats

Night sweats are not uncommon and affect an estimated 3 percent of the population. Although most cases of night sweating are not caused by life-threatening conditions, you should always talk with a qualified physician to determine the cause. Cancer, tuberculosis and other serious diseases could be the underlying causes.

There are effective treatments that can alleviate or significantly reduce night sweats in men and women. These treatments include oral medication, changing your diet, or using a clinical-strength antiperspirant like SweatBlock. Take advantage of the tried and true remedies so that you don’t have to “sweat it” when you go to sleep.

If you suffer from excessive and uncontrollable sweating, a condition known as hyperhidrosis, you’ve probably investigated various treatments. Stopping the embarrassing and life-altering effects of hyperhidrosis is a daily, never-ending quest. Iontophoresis hyperhidrosis treatments might be the solution for you. If you’ve never heard of iontophoresis therapy, this article will help answer your questions.

Iontophoresis.

Iontophoresis: Frequently Asked Questions

  • 1. What is iontophoresis? Who invented it and when?
  • 2. How does iontophoresis therapy work?
  • 3. Does iontophoresis work for hyperhidrosis?
  • 4. How often should I have treatments?
  • 5. When will iontophoresis start working?
  • 6. What areas of the body can be treated with iontophoresis?
  • 7. Can iontophoresis work on my underarms?
  • 8. What is an iontophoresis patch and how does it work?
  • 9. Does iontophoresis hurt?
  • 10. Can I be electrically shocked by iontophoresis?
  • 11. Is the iontophoresis treatment permanent?
  • 12. Are there side effects from iontophoresis?
  • 13. Who performs iontophoresis?
  • 14. Will my insurance pay for iontophoresis?
  • 15. How much do iontophoresis treatments cost?
  • 16. What is the best iontophoresis machine for me?
  • 17. How much will an iontophoresis machine cost and where can I buy one?
  • 18. What if I’m pregnant? (and other iontophoresis contraindications)
  • 19. What other hyperhidrosis treatments can I try?

1. What is iontophoresis? Who invented it and when?

Iontophoresis is a medical procedure which uses a mild electrical current to gently push medications through the skin while the treated body area is submerged in water. You might think of it as an injection without a needle. The procedure is most often used to treat hyperhidrosis or uncontrolled, profuse sweating. It can also be used to treat injuries related to sports by delivering anti-inflammatory medicines directly through the skin.

The idea of using weak electrical energy to deliver medicine dates back to the mid-18th century. Significant progress was made by several researchers in the 19th century and the concept gained serious traction soon after. In the early 1900’s, Dr. Stéphan Leducafter, a French physician, published a series of scientific papers on the subject. Other contributors to the science were Benjamin Ward Richardson, Hermann Munk, William James Morton, and Fritz Frankenhäuser.

Recently, researchers have given iontophoresis a fancy new name: “electrically-assisted transdermal drug delivery.” This is what too many years of education can do. 😉

2. How does iontophoresis therapy work?

Iontophoresis works on the principle of ions. In this instance, the ions are water-soluble substances that carry either a positive or negative charge. Like the poles of a magnet, the positive electrode repels and the negative electrode attracts. By running a mild galvanic (direct) current through a shallow container of water, an ion can be pushed into the skin if the active electrode has the same charge as the target ion. The principle is the same as when two positive ends of a magnet push away from each other when they are placed together. Because the skin is an excellent barrier and protects the body from outside intrusion, iontophoresis has limited value in delivering medications directly into the skin.

Generally speaking, a patient receiving iontophoresis treatment for hyperhidrosis sits with one or both hands or feet immersed in a shallow pan or tray filled with tap water. Normally anticholinergic medicines are placed in the water that block the transmission of nerve signals to the sweat glands. By stimulating the iontophoresis electrodes, the electrical current “pushes” the medication into the skin. Treatments can last from 15 to 40 minutes.

3. Does iontophoresis work for hyperhidrosis?

The short answer is yes. While iontophoresis has limited usefulness in treating other conditions, it can be effective in treating certain types of primary or focal hyperhidrosis. The procedure is routinely used for the treatment of palmar hyperhidrosis (excessive sweating of the hands) and plantar hyperhidrosis (excessive sweating of the feet).

4. How often should I have treatments?

Always consult with your doctor before beginning a regimen of iontophoresis treatments. Usually, the process is repeated 3 times a week in the beginning, and until sweating is reduced to the desired degree. Then patients are switched to a schedule of one treatment each week.

To maintain effectiveness, treatments must be consistent and performed regularly before your sweating begins to return.

5. When will iontophoresis start working?

Patience is a virtue. That may not be a comforting thought as you deal with excessive, unrelenting sweating, but it’s important to keep in mind. How long it takes to see results varies significantly from person to person. Some patients report positive results in the first day of treatment. For others, it may require three to four weeks of consistent treatment before the sweating is significantly reduced. Most patients see a discernable difference by the end of the first week. If it’s going to work for you, that’s the benchmark to keep in mind. Long-term improvement is usually achieved after a few weeks of regular treatments.

6. What areas of the body can be treated with iontophoresis?

Iontophoresis has been used to treat hyperhidrosis since the 1940’s. Most medical studies have focused on the procedure for hyperhidrosis of the feet (plantar) and the hands (palmar). Fewer studies have examined hyperhidrosis of the armpits (axillary).

In one year-long study of 27 patients with palmoplantar hyperhidrosis (affecting the hands and feet), there was a “good” response. Desired improvement took from 2 to 4 weeks. In every successful case, ongoing treatment was necessary to maintain dryness. When used correctly, iontophoresis can have a positive effect on 85% to 90% of hyperhidrosis patients.

7. Can iontophoresis work on my underarms?

The evidence collected so far shows that iontophoresis of the underarms might be an effective option for some people. The International Hyperhidrosis Society notes that iontophoresis is generally less effective than other methods for managing underarm sweating. A clinical strength antiperspirant may be more effective in treating excessive underarm sweating.

8. What is an iontophoresis patch and how does it work?

An iontophoresis patch is an electrodynamic patch made from fabric material mingled with photovoltaic cells. Micro-currents are created by the transdermal patch when it comes in contact with the skin. These currents use the iontophoresis principle to suppress the sweat glands from secreting sweat. Iontophoretic patches can be used on hands and feet, but are especially suited for underarm iontophoresis treatments.

A pouch containing a dosage of medication can be attached to an iontophoresis patch which delivers the medication directly through the skin. Iontophoresis dexamethasone is a cortisone-like medication that is often used in conjunction with this treatment. It can provide relief from inflammation and helps prevent unwanted side effects. Sometimes a Diclofenac gel is applied topically to reduce the inflammation.

The ActivaPatch is a self-contained single-use drug delivery patch that contains an electrical source (a battery), electrode and chamber into which desired medicines can be placed. Once adhered to the skin in the desired location, it can provide up to 2.5 hours of iontophoresis treatment.

9. Does iontophoresis hurt?

No, iontophoresis treatments are not known to cause pain. But at the same time, it’s not what you would call “pleasant” either. When performed correctly, the treatment is rarely painful, though many patients report feeling mildly uncomfortable.

You will likely experience a tingling sensation during the process. Be sure you don’t have any open sores or wounds in the area to be treated. The sensation will be much stronger if the current passes through open skin. You can cover any open skin with petroleum jelly to protect it.

10. Can I be electrically shocked by iontophoresis?

You can’t be seriously electrically shocked, but you may feel surprised by the tingling. The voltage of the electrical current used in iontophoresis is low and not strong enough to cause a harmful shock. But if it’s not done correctly, or if you remove your hands or feet from the water during treatment– or if equipment malfunctions– the sensation might be a trifle unexpected. You may temporarily experience minor heel pain during an improper foot treatment, for example. Be sure to remove any metal jewelry beforehand.

As the electrical current is increased, any unpleasant sensation will increase. But you’ll be in control and you’ll be able to decrease the current if the treatment becomes too uncomfortable. It’s a good idea to have another person present during treatments. If you’re using an iontophoresis machine at home, be sure to completely read the manufacturer’s user guide and follow all suggested instructions and precautions.

11. Is the iontophoresis treatment permanent?

No, iontophoresis for hyperhidrosis is not a permanent solution. After the initial treatment period when the desired level of sweat reduction is achieved, maintenance treatments must be continued indefinitely (usually once a week). It is important not to wait until the excessive sweating returns. Permanent hyperhidrosis treatments require more invasive treatments or surgical options.

12. Are there side effects from iontophoresis?

While iontophoresis is a safe and relatively pain-free treatment, some patients may experience some minor adverse effects. The good news is that any side effects are easily alleviated and generally not serious. The most common side effect is itching and drying of the skin. Apply a moisturizing cream or lotion after each treatment to hydrate and soothe dry skin. Other possible side effects include blistering, skin irritation and peeling.

13. Who performs iontophoresis?

Many primary care or family practice doctors can administer the iontophoresis treatments. Some neurologists, internists, and surgeons will also offer the treatment. Seeking out a dermatologist will probably be your best bet.

After initial treatments performed by a qualified physician, it is not uncommon for patients to continue treatments at home with equipment that can be purchased for personal use.

14. Will my insurance pay for iontophoresis?

That depends on your insurance carrier. Sadly, iontophoresis for hyperhidrosis is a treatment that some insurance carriers consider unproven or investigational. If that’s the case for you, you’ll have to pay out-of-pocket. Some physicians will allow you to negotiate the cost of treatment if your insurance will not cover it.

15. How much do iontophoresis treatments cost?

Iontophoresis treatments in a doctor’s office will set you back about $150 to $200 per session. Costs can vary significantly depending on the selected practitioner and location. It’s going to cost you more in Los Angeles than in Fargo, North Dakota.

If you decide to administer the treatments yourself after your initial doctor visits, you can purchase your own equipment. When you consider the cost of several treatments at the doctor’s office, this investment can be a cost-saving alternative.

16. What is the best iontophoresis machine for me?

The best machine for your specific condition depends on a lot of variables. Be aware that the manufacturer of any iontophoresis device is going to claim that their machine is the best. Here are important factors to consider when looking to purchase an iontophoresis machine for home use:

  • Affordability – Find a device that works within your budget. You’ll find many that will work.
  • Machine size – If the machine will be used at home, size may not be an issue. If you travel a lot, you’ll want something you can pack and take with you.
  • Safety – Find a machine that has safety features that eliminate the possibility of electrical shock.
  • Timers – The duration of treatments is critical to potential success. An onboard timer will be helpful in making sure treatments aren’t too short or too long.
  • Power source – Some machines are battery powered only. Replacing those batteries can be expensive.
  • Warranty and Service – Choose a machine that includes a warranty (at least 12 months) and be sure the manufacturer offers a user-friendly customer service program.

17. How much will an iontophoresis machine cost and where can I buy one?

A quality iontophoresis machine with basic features should cost somewhere between $500 – $700. If your budget won’t allow for an investment of several hundred dollars, there are low-cost machines available online starting at about $100. Be cautious of low-priced machines, as safety features and build quality may have not been high on the maker’s priority list. Do your research. There are many choices available online, and they can also be purchased from local medical supply brick-and-mortar stores. Also, if you’re handy, it’s fairly simple and easy to build one of your own.

18. What if I’m pregnant? (and other iontophoresis contraindications)

Always consult a doctor before commencing iontophoresis treatments. There are several conditions and situations for which either extra caution or total avoidance of the treatment are necessary.

  • If you wear a pacemaker – The electrical current used in iontophoresis, although mild, may interfere with a pacemaker.
  • Pregnancy – Iontophoresis has not been tested on pregnant women. If you’re pregnant, iontophoresis treatments are not recommended.
  • Metal orthopedic implants – Because electrical current will pass through the parts of the body being treated, any metal implants in those areas can cause problems. Talk to your physician about the treatment if you have any metal implants in your body.
  • Cardiac arrhythmia – Electrical impulses trigger your heart to beat. If you have an irregular heart condition, you should avoid iontophoresis unless your doctor specifically recommends it and supervises the treatment.
  • Skin rash or disease – Iontophoresis therapy should be avoided if a skin rash or skin disease is present in the affected areas.

19. What other hyperhidrosis treatments can I try?

Iontophoresis is considered a tier 3 treatment. That means there are other treatments for hyperhidrosis that are recommended before resorting to the use of an iontophoresis machine.

One of the most effective treatments for hyperhidrosis is a clinical strength antiperspirant like SweatBlock. It is highly effective for controlling underarm sweating, as well as hand, feet, and head sweating. Clinical strength antiperspirants are not expensive, and they’re easy to use, and they’re readily available online and in local drugstores.

There are other hyperhidrosis treatments that may be worth considering. Many are more expensive and more invasive than iontophoresis. These include Botox injections, and using electromagnetic or microwave energy for killing sweat glands. Irreversible surgery is also an option. Once again, talking with a doctor about your specific situation is the best course of action. He or she can prescribe the treatment that best suits you.

The Bottom Line

Iontophoresis is a widely accepted and proven treatment for sufferers of hyperhidrosis. Whether it’s a good treatment for you will depend on the seriousness of your sweating condition and other symptom relief treatments you may have already tried. Now that you have a better understanding of iontophoresis, you’ll be able to make an informed decision about how best to treat your hyperhidrosis. You do have options, and the good news is that there’s a treatment that will likely work well for you. Don’t give up… life can be good again!

Are you sweating profusely for no apparent reason? Is it the kind of sweating that can’t be explained by exercise or external temperature– or even unusual stress?

The cause of your excessive sweating may be diaphoresis.

In this article we’ll explore the following topics surrounding diaphoresis…

  • What is Diaphoresis?
  • What Causes Diaphoresis?
  • What Medications Can Cause Diaphoresis?
  • How is Diaphoresis Different than Hyperhidrosis?
  • When Should I Get Medical Help or Talk to My Doctor?
  • What are the Treatment Options for Diaphoresis?

Why do we sweat? Sweating is the natural way the body manages and regulates its temperature. When functioning normally, your body perspires when you’re engaged in exertion or physical exercise, exposed to external heat, and even when you’re feeling unusual mental or emotional stress.

When you perspire, your brain signals the millions of sweat glands located all over your body (except ear canals, lips, and genitals) to secret moisture composed mostly of water and electrolytes. Once this sweat reaches the surface of the skin, it evaporates. The evaporation of your sweat dissipates heat which in turn cools the body.

If unusual and excessive sweating occurs for no apparent reason, then something else is going on. It may be primary hyperhidrosis (more about that later) or diaphoresis. It’s important to understand the difference to know exactly what’s happening with your body.

Diaphoresis

What is Diaphoresis?

Diaphoresis is excessive sweating caused by one or more secondary (meaning separate and not related) medical conditions. It can also be a side effect of certain medications. Diaphoresis is not a problem of a malfunctioning nervous system or overactive sweat glands, and treating it successfully usually requires medical attention to discover the specific cause.

Diaphoresis is also known as secondary hyperhidrosis because it is a symptom of a secondary disorder. Once the cause is identified and properly treated, the excessive sweating stops.

What Causes Diaphoresis?

There are dozens of diseases and medical conditions that can cause diaphoresis. Some of the most common causes are:

Menopause

A majority of women (85% or more) experience periods of increased sweating, night sweats, and hot flashes during menopause. As a woman transitions from fertility to infertility, fluctuating hormones send false signals to the brain that the body is overheating. This results in excessive perspiration and night sweats. Once the menopausal change progresses, the bouts of profuse sweating and night sweats usually cease. Some women find relief through hormone therapy for a short time.

Obesity

Obesity can cause diaphoresis in both men and women. Defined as having a body mass index (BMI) of 30 or higher, obesity is very common in the United States and affects one-third of all adults. Losing sufficient weight almost always causes the excessive sweating to stop.

Diabetes

For people with diabetes, sweating profusely is an early symptom of low blood sugar (hypoglycemia). Critically low blood sugar is a result of either too much insulin or too little sugar. This causes the body to lapse into a fight-or-flight state, releasing hormones that increase sweating. Proper management of diabetes significantly reduces the occurrence of diaphoresis.

Parkinson’s Disease

Coping with Parkinson’s disease is very difficult, but when you add excessive sweating to the equation it becomes even worse. Parkinson’s disease affects the autonomic nervous system, causing the body to lose its ability to properly regulate many body functions. Changes in the sweat glands often occur and can cause Parkinson’s sufferers to sweat uncontrollably.

Pregnancy

Increased hormone levels (some may say raging hormones) in a woman’s body during pregnancy can cause heavy perspiration. As a pregnant woman’s metabolism speeds up, her body temperature rises, which can cause abnormal sweating. The extra weight gained during pregnancy may also increase the likelihood of diaphoresis. Fortunately, it’s only a 9-month-long condition, then the sweat glands return to normal.

Rheumatoid Arthritis

Rheumatoid arthritis is an autoimmune disease that affects the body’s joints, causing swelling, pain, and stiffness. A common symptom of this disorder is excessive sweating.

Hyperthyroidism

Hyperthyroidism is a medical condition in which the thyroid gland shifts into hyperactivity, producing too much of the hormone thyroxine. The overabundance of thyroxine speeds up the body’s metabolism and causes heavy sweating (among a number of other symptoms).

Heart Attack

A heart attack, aka myocardial infarction, happens when a portion of your heart muscle becomes damaged or dies. Symptoms include heavy sweating, faintness, chest pain, pain in one or both arms, shortness of breath, nausea or vomiting, and a pale or ashen colored face.

Cancer

Diaphoresis is linked to several types of cancer. Among them are lymphoma, leukemia, bone cancer, liver cancer, testicular cancer, as well as carcinoid tumors.

Anaphylaxis

Anaphylaxis is an intense and acute allergic reaction. One of the first signs of an anaphylaxis reaction is an instant onset of heavy and profuse sweating. Anaphylaxis is a life-threatening reaction that requires immediate attention and treatment.

Alcohol and Drug Withdrawal

Profuse sweating often occurs when those addicted to alcohol or drugs go through withdrawal. Going “cold turkey” not only leads to excessive sweating but also includes other reactions that can be temporarily life-threatening.

Gout

Diaphoresis (secondary hyperhidrosis) can also be caused by gout. Gout is a common form of arthritis that develops from high levels of uric acid in the blood. It can strike anyone. In addition to excessive sweating, other symptoms of gout include sudden swelling and joint pain, usually in the big toe.

What Medications Can Cause Diaphoresis?

There are hundreds of medicines that have been known to cause excessive sweating. The most common medicines that can cause diaphoresis include:

Antidepressants

All varieties and classes of antidepressants may cause diaphoresis. Antidepressants increase serotonin levels in the brain. Serotonin affects the hypothalamus, which is the part of the brain that regulates the body’s core temperature.

Migraine Medication

Medicine for migraines can cause excessive sweating if they contain triptan– such as sumatriptan, rizatriptan, frovatriptan and eletriptan. These substances also increase serotonin levels.

Pain Relievers

Aspirin or ibuprofen are known to cause excessive sweating. The over-the-counter pain medicines reduce a fever by dilating blood vessels, causing heat to be dissipated through the skin. Opioids may also cause heavy sweating.

Diabetes Medication

Insulin, glyburide, glipizide, pioglitazone, and other diabetes medication are known to cause diaphoresis. Heavy sweating can occur as the body adjusts to altered blood sugar levels.

Asthma Inhalers

Certain asthma inhalers which contain beta-agonist drugs may trigger excessive sweating. Albuterol and levalbuterol directly stimulate sweat glands to produce more sweat.

Heartburn Medication

Heartburn and reflux medicines like Prilosec and Prevacid are known to cause sweating as a side effect.

Sildenafil (Viagra)

Viagra, known as sildenafil in its generic form, may also cause diaphoresis. The drug dilates blood vessels to heighten blood flow, which can cause flushing and spontaneous sweating.

Ropinirole

Also known as Requip, this medication is commonly prescribed to treat restless leg syndrome and Parkinson’s disease. It activates dopamine receptors which can lead to profuse sweating.

Breast Cancer Medication

Excessive sweating can be a side effect of certain breast cancer medications, such as anastrozole, exemestane, letrozole, and tamoxifen. These drugs are anti-estrogen compounds designed to prevent breast cancer from recurring.

Leuprolide

Luprolide, known commercially as the brand name Lupron, is a drug prescribed to treat endometriosis and prostate cancer. It lowers hormone levels in both men and women and can lead to heavy sweating and night sweats.

How is Diaphoresis Different than Hyperhidrosis?

There are two types of hyperhidrosis– primary hyperhidrosis (also called focal hyperhidrosis) and secondary hyperhidrosis (sometimes called generalized hyperhidrosis).

Diaphoresis and secondary hyperhidrosis are synonymous they are different medical terms for the same condition. But diaphoresis is different from primary (focal) hyperhidrosis. Let’s explore how diaphoresis is like secondary hyperhidrosis but different from primary hyperhidrosis.

Primary or focal hyperhidrosis is a serious medical disorder that is characterized by excessive, uncontrollable sweating not related to heat or exercise. Recent research indicates that it affects about 5% or the world’s population. It can be focused on the underarms (axillary hyperhidrosis), the hands or palms (palmar hyperhidrosis), the feet (plantar hyperhidrosis) or the head and face (craniofacial hyperhidrosis).

What causes primary hyperhidrosis is unknown, but it is thought to be hereditary. The nervous system triggers localized sweat glands, known as eccrine glands, into hyperactivity for no apparent reason and without external stimuli such as elevated body temperature and exertion. This extreme perspiration can negatively affect the physical, emotional, mental and social aspects of life. There is no cure. However, there are numerous effective treatments that can reduce or eliminate the excessive sweating due to primary hyperhidrosis.

The cause of secondary hyperhidrosis, or diaphoresis, is something else entirely. While the symptoms of diaphoresis and primary hyperhidrosis are identical– profuse, uncontrollable sweating– diaphoresis is caused by a secondary or underlying cause not related to over-active sweat glands. The possible causes include the disorders and medications identified above as well as dozens of other less common ones. Unlike primary hyperhidrosis, once the underlying disorder is successfully treated, the excessive sweating usually stops.

When Should I Get Medical Help or Talk to My Doctor?

It’s normal to sweat when you work out, become hot, or find yourself in a nervous or anxious situation such as a job interview, important presentation, or on a first date. Nervous sweating is also normal, though darn inconvenient at times. But you should become concerned if you find yourself frequently soaking through your shirts or socks, or trying to hide your perpetually wet, clammy hands. Yes, it’s embarrassing, but thankfully your excessive sweating can be treated. Don’t suffer in silence out of shyness or shame. Start by seeing your primary care doctor. He or she can refer you to a specialist if necessary.

What are the Treatment Options for Diaphoresis?

The best and most effective treatment of diaphoresis is to treat the underlying disease or disorder that is triggering the profuse sweating.

In the meantime, here are some remedies that may help reduce your excessive sweating. When it comes to some of these natural and home remedies, your mileage may vary. The International Hyperhidrosis Society has concluded there is “little research to recommend such natural remedies, but this does not discount their potential.”

Natural Remedies for Treating Diaphoresis

Camphor

Camphor was once made by distilling wood from the camphor tree. Today it is synthesized chemically. It’s used in such products as Vicks VapoRub. Dissolve a small portion of camphor or some camphor oil in some fractionated coconut oil. Apply the mixture to affected areas and leave it on the skin for 40 to 60 minutes. Then wash the area gently with cool, clean water. Camphor can also be added to bath water to help reduce sweating.

Vinegar

When applied directly to your skin, vinegar acts as an astringent that eliminates many bacteria and will also close up pores. Use a cotton ball to dab a little apple cider vinegar on the desired areas overnight. Simply wash it off when you shower or bathe in the morning.

Tomato Juice

A glass of tomato juice or a tomato-rich diet can help control profuse sweating by regulating your internal body temperature.

Green and Black Tea

Green tea contains magnesium and vitamin B. These act as astringents and constrict sweat glands. A cup of green tea in the morning may help reduce sweating. Black tea is also an astringent. Brew one or two black tea bags, allowing the tea to steep for 10 minutes. Apply the tea directly to your underarms with a clean washcloth.

Essential Oils

Those who prefer natural remedies often recommend essential oils as a remedy for excessive sweating. If you want to try essential oils, you should thoroughly study the potential benefits and hazards of each beforehand.

Here are 3 of the most popular essential oils for controlling sweat:

  • Sage oil has long been used to ease the symptoms of menopause.
  • Cistus oil is an astringent that can shrink pores.
  • Clary Sage oil contains linalyl acetate which has calming properties.

Other Effective Remedies

There are several effective remedies for primary hyperhidrosis. However, because of their permanence, expense, or invasiveness, they likely wouldn’t be appropriate for treating diaphoresis. It’s important to remember that curing diaphoresis means identifying and successfully treating the underlying, unrelated disease or disorder that triggers the excessive sweating.

Short of overcoming the disorder that’s responsible for diaphoresis, here are two remedies that can treat the profuse sweating without permanently altering, removing or destroying sweat glands:

Clinical-Strength or Prescription-Strength Antiperspirants

These powerful antiperspirant products, like SweatBlock, are different than the antiperspirants you find on the shelves of your local grocery or drug store. They contain higher concentrations of the aluminum chloride, a compound that temporarily blocks the sweat glands from secreting sweat. When aluminum chloride comes in contact with water (your sweat), it forms a gel-like plug that blocks sweat from reaching the surface of the skin. A single application of a prescription strength antiperspirant may last up to a week before it must be reapplied.

Botox Injections

Botox is a natural, purified protein that can temporarily impede the chemical that “turns on” the body’s sweat glands. It blocks the nerves that cause sweating. Botox injections are shallow and the medicine is injected just below the surface of the skin. The desired effects will last 6 to 12 months before the treatment must be repeated. While effective, this treatment is very expensive and can be painful.

A Final Note

Diaphoresis, by definition, is always caused by another illness or medication. The best treatment is always to identify and appropriately treat the underlying condition. Once that happens, the excessive sweating almost always stops. If treatment for the secondary cause is not possible or requires a prolonged period to take effect, there are treatments and remedies that can help in the meantime. Talk to your doctor about your symptoms and available treatment options.

When sweating reaches epic proportions, you need something more than pedestrian store-shelf antiperspirants. You need a heavy weight contender – a prescription, or prescription “strength” antiperspirant. Here’s your guide to prescription-only and clinical strength antiperspirants.

prescription antiperspirant

What is prescription antiperspirant?

As the name implies, prescription antiperspirants require a prescription and a doctor’s supervision. They cannot be purchased anywhere but a pharmacy. The concentration of active aluminum ingredient in these products is generally around 20%. Prescription options are not to be taken lightly. Misuse of prescription antiperspirants can lead to serious unwanted side effects. (we’ll talk about this later)

How does prescription antiperspirant work?

All antiperspirants, regardless of brand name or strength level, use aluminum salt as the active ingredient. The most common aluminum salt compounds found in today’s antiperspirants are aluminum chloride, aluminum chlorohydrate, aluminum chloride hexaydrate and aluminum zirconium tricholorhydrex glycine.

While the effectiveness of these varies, each of these aluminum compounds works to reduce sweating in the same basic way. When they get close to water, in this case perspiration, they soak up the moisture and thicken into a gel-like substance. By spreading aluminum chloride, or one of its cousins, on areas that sweat, the resulting reaction forms a gel-like plug that blocks the sweat glands and prevents sweat from reaching the skin’s surface. Once this happens the body’s feedback mechanism stops the flow of perspiration.

The plugs dissipate over time and the sweat glands begin to function as before. That’s when the antiperspirant must be reapplied. Depending on the strength of the antiperspirant, the reapplication time may range from several hours to several days.

Prescription Antiperspirant vs. Prescription “Strength” Antiperspirant. Is there a difference?

It’s not uncommon for people to confuse the two. But they are different.

Prescription strength simply means really strong. A prescription strength antiperspirant will have more Aluminum salts or use a more potent form of Aluminum. For example, Aluminum Chloride is a lot stronger than Aluminum Zirconium Tetrachlorohydrex (Used in antiperspirants like Dove, Old Spice and Degree.)

Most clinical and prescription strength products will use Aluminum Chloride (usually around 12%-15%)

Prescription Strength and Clinical Strength are often used interchangeably, but they’re pretty much the same thing.

Prescription-only antiperspirants are even stronger, require a prescription, and can only be purchased at a pharmacy. They usually contain a higher concentration of Aluminum Chloride (20% or more) and can be more effective in extreme sweating cases. Last of all, a prescription option will most likely carry with it additional health risks and side effects. (more on this below…)

Prescription Antiperspirant Options:

Some of the more common prescription antiperspirant brands include:

  • Drysol is a popular prescription antiperspirant designed to treat hyperhidrosis and excessive sweating. Can be used on the underarms, scalp, hands, and feet. Active Ingredient: Aluminum chloride hexahydrate (20%)
  • Xerac AC is a topical, prescription-only treatment designed for use on the underarms, palms and feet.
    Active Ingredient: Aluminum Chloride Hexahydrate (6.25%)
  • Formalaz is a sweating treatment specifically designed to combat foot odor and sweat. A prescription-only option for plantar hyperhidrosis or foot sweating. Active ingredient: Formaldehyde (10%)

Prescription antiperspirant is strong stuff and should only be considered after exhausting all other over-the-counter hyperhidrosis and excessive sweating treatments.

Best Prescription Strength Antiperspirant Products:

Try some of these popular prescription strength and clinical strength antiperspirants before resorting to prescription-only. Many of these products can be purchased online via Amazon or at your local drug store.

  • SweatBlock Clinical Antiperspirant
    “When nothing else works!” The original 7-day antiperspirant. Formulated to reduce excessive sweating and axillary hyperhidrosis. According to users, SweatBlock keeps you dry for an average of 6.4 days and seems to work when nothing else will.
    Effective for: Armpit sweating and hyperhidrosis
    Application: Towelette (wipe)
    Active Ingredient: Aluminum Chloride (14%)
  • Driclor
    This another over-the-counter prescription strength option. It’s made in Australia and can be used for treating excessive sweating of the hands, feet and armpits. If you’re worried about sweat stains in your shirt, you’ll want to avoid this one.
    Effective for: Hands, Feet, and Armpit Sweatin
    Application: Roll-on
    Active Ingredient: Aluminum hexahydrate (20%)
  • Certain Dri Prescription Strength
    The strongest antiperspirant in the Certain Dri family. Designed for underarm use and can last up to 72 hours per application.
    Effective for: Underarm Sweating / Axillary Hyperhidrosis
    Application: Roll-on
    Active Ingredient: Aluminum Chloride (12%)
  • Odaban Antiperspirant Spray
    Offers 24-hour protection and may be the strongest non prescription antiperspirant available. It contains high concentrations of aluminum chloride which can increase effectiveness. But with increased effectiveness comes increased chance for skin irritation and burning.
    Effective for: Armpits, Hands, Feet
    Application: Spray
    Active Ingredient: Aluminum chloride (20%)
  • Maxim Prescription Strength Antiperspirant
    Over the counter hyperhidrosis treatment designed for underarm use.
    Effective for: Underarm Sweating / Axillary Hyperhidrosis
    Application: Roll-on
    Active Ingredient: Aluminum Chloride (15%)
  • ZeroSweat Antiperspirant AKA “Z Sweat” or “0 Sweat”
    For excessive sweating. This Certain Dri knock-off claims to “Keep You Dry – Guaranteed”.
    Application: Roll-on
    Active Ingredient: Aluminum Chloride (15%)

If none of the above options work for you, it’s time to look at a prescription only product.

Should I Use a Prescription Strength Antiperspirant?

Choosing a prescription antiperspirant isn’t the same as picking out a pair of shoes or doing price comparisons on vacuum cleaners.

This is a personal question and you and your doctor are the only ones qualified to tackle it. But here’s a few things to consider as you venture down the path of prescription hyperhidrosis treatments.

How severe is your sweating? You wouldn’t be here reading this fascinating article if sweat wasn’t somewhat excessive. But how bad is it? If it’s an occasional inconvenience, you probably don’t need prescription strength. If profuse sweating has transformed you into a cave-dwelling hermit who avoids all social interaction, you’re barking up the right tree.

Which sweating treatments have you already tried? Again, if you’re reading this, you’ve probably tried A LOT. But if you’ve only experimented with Old Spice and Degree, you still have a lot of non prescription options on the table. It’s best to exhaust all over-the-counter antiperspirant options before reaching for a prescription solution.

Have you talked to your doctor? Your doctor will be able to help you more than any blog post or article. If you’ve tried everything and nothing seems relieve your excessive sweating, talk to your doctor about available prescription anti-perspirants.

Ultimately, your doctor will know which antiperspirant options are safe and can guide you through the process of finding one that works best for your body chemistry and severity of sweating.

Prescription Antiperspirant Risks & Side Effects:

The best part about prescription anti-perspirants is that they’re super strong. The worst part… they come with side effects and potential health risks like:

  • Allergic reactions like hives, rash, itching, chest tightness, swelling of the face, lips, tongue or throat.
  • Severe burning, itching, redness or swelling of treated areas.

These precautions should be observed when using Prescription antiperspirants:

  • Always consult a doctor before using any Prescription antiperspirant.
  • Tell your doctor if you are using Antabuse (disulfiram) before using.
  • Do not use any other deodorant or antiperspirant (unless your doctor says otherwise)
  • Avoid getting Prescription antiperspirant in your eyes, nose, mouth or on your lips.
  • Do not use any antiperspirant on irritated or broken skin.
  • Wait at least 24 to 48 hours when applying to shaved areas.
  • Prescription antiperspirants may stain clothing and metal surfaces.
  • It is not known if the use of Drysol and other Prescription antiperspirants may harm an unborn baby.

Alternative Treatments to Prescription Antiperspirant:

It might be worth exploring outside the realm of prescription antiperspirant. Hyperhidrosis has been around for a long time and many treatments have been developed over the years. Their effectiveness varies, but some have proven very efficient at stopping embarrassing sweat. Here’s a few of them…

  • Clinical Strength Antiperspirants. Over-the-counter clinical antiperspirants are stronger than your average Dove or Speedstick, but don’t require a doctor and don’t come with as many side effects or potential health risks. We like this one (wink… wink)
  • Qbrexza Cloth. A prescription-only treatment for axillary hyperhdirosis. This medicated cloth is designed for underarm topical use. It contains a nerve blocking solution that stops underarm sweat in its tracks. It can be extremely effective, but comes with a long list of unwanted side effects.
  • Iontophoresis is a treatment that uses electric currents in water to drive medications into the skin. Can be very effective, yet very expensive.
  • Botox injections in affected areas can curtail sweating for months before they must be repeated. Effective, but painful and not permanent.
  • Miradry is a procedure that uses microwaves to nuke your sweat glands. No more sweat glands leads to no more sweat.