sweat

Martina Feichter studied biology with an elective subject pharmacy in Innsbruck and also immersed herself in the world of medicinal plants. From there it was not far to other medical topics that still captivate her to this day. She trained as a journalist at the Axel Springer Academy in Hamburg and has been working for since 2007 - first as an editor and since 2012 as a freelance writer.

More about the experts All content is checked by medical journalists.

Sweating is a natural protective mechanism of the body against overheating. When the organism heats up in the blazing sun, during strenuous physical activity or in the sauna, the excessive body heat is given off through sweating. Most people also begin to sweat when they are excited or when they eat spicy foods. There are also people who sweat generally and excessively. Such hyperhidrosis (hyperhidrosis) can significantly reduce the quality of life of those affected. Read here what causes heavy sweating, sudden sweats and night sweats can have and what can be done about them.

Brief overview

What is sweating Regulatory mechanism of the body to give off excessive heat. But it can also be due to illness.
Causes: e.g. B. physical exertion, nervousness, menopause, pregnancy, but also various diseases (such as hyperthyroidism, Parkinson's disease, hypoglycaemia in diabetes, malnutrition), medication or withdrawal from alcohol or drugs
When to the doctor In the case of profuse sweating for no apparent cause, sudden outbreaks of sweat for no apparent reason, recurring night sweats or accompanying fever over 40 ° C
Therapy: Depending on the cause, e.g. B. Antiperspirants for external use, medication for ingestion (antihidrotics), tap water iontophoresis, botox injections, surgical interventions (e.g. removal of the sweat glands in the armpit)
Tips: e.g. B. Avoid air-permeable clothing, leather shoes instead of footwear made of synthetic materials, avoid fatty and spicy meals, use deodorant, lose weight, medicinal plants (sage, black silver candle, etc.), regularly go to the sauna and / or to exercise in order to train the function of the sweat glands

Sweating: description

Sweating is primarily a natural regulatory mechanism of the body: it is used to release excessive body heat, but it can also be triggered by emotional factors such as stage fright. According to this, experts differentiate between the following forms of normal sweating:

Thermoregulatory sweating: This regulates an increased body temperature (for example in extreme heat or after physical activity) down again.
Emotional sweating (emotional sweating): Nervous excitement, such as occurs with bias, exam anxiety, stage fright, anger or fright, causes most people to sweat primarily on the palms of the hands and armpits, but also on the soles of the feet and on the forehead.
Gustatory sweating (taste sweating): Chewing sour or spicy foods and drinking alcohol stimulate the metabolism and thus the production of heat. This mainly results in sweating in the face (forehead, cheeks, upper lip), less often on the trunk (upper body). Sweating after consuming hot food or drinks is not part of taste sweating in the narrower sense, as sweat production is not directly triggered by a taste stimulus.

In addition to "normal" (physiological) sweating, there is also pathological (pathological) sweating. The transitions between them are fluid, as the amount of sweat produced differs greatly from person to person.

Abnormal sweating

Disturbances in sweat production can vary in severity - the person affected either does not sweat at all, or sweats less or excessively. Depending on the situation, doctors speak of:

Anhidrosis: The secretion of sweat is suppressed, which means that those affected do not sweat at all.
Hypohidrosis: The secretion of sweat is reduced, so the patients sweat less than normal.
Hyperhidrosis (also hyperhidrosis): The perspiration is increased. However, not everyone who sweats profusely suffers from hyperhidrosis from a medical point of view. Because the term is not defined by the amount of sweat, but the malfunction of sweating, which goes beyond the heat regulation that would be necessary.

Hyperhidrosis

Hyperhidrosis can be divided into different aspects.On the one hand, a distinction is made between primary and secondary hyperhidrosis according to the cause:

Primary hyperhidrosis: Also called essential or idiopathic hyperhidrosis. No underlying disease or external cause for increased sweating can be found here. Primary hyperhidrosis is much more common than secondary. It usually begins during puberty and lasts for a lifetime. The increased sweating is often triggered by excitement, nervousness and other forms of emotional tension.
Secondary hyperhidrosis: Here, excessive sweating is a symptom of an illness. Infections (flu, malaria, etc.), tumors (leukemia, lymph gland cancer, etc.), metabolic diseases (e.g. diabetes), hormonal disorders (such as hyperthyroidism or menopause) or neurological diseases (such as Parkinson's disease) are triggers ) in question. In contrast to primary hyperhidrosis, night sweats sometimes also occur in secondary hyperhidrosis.

On the other hand, hyperhidrosis can be classified according to where the body secretes increased sweat: People who sweat excessively all over the body suffer from generalized hyperhidrosis. This is particularly noticeable in secondary hyperhidrosis, i.e. when the excessive sweating is due to a certain disease. On the other hand, there is focal hyperhidrosis, in which those affected sweat heavily only in certain parts of the body, for example in the armpits (hyperhidrosis axillaris) or on the hands (hyperhidrosis manuum). This is particularly the case with primary hyperhidrosis.

If excessive sweating is accompanied by symptoms such as reddening of the skin including a feeling of heat (flush), an altered perception of sensory stimuli (sensory disturbances) or pain, doctors speak of sweating sickness. If the heavy sweating is accompanied by an unpleasant odor (rancid, musty, cheesy, etc.), it is known as bromhidrosis.

Sweating: When do you need to see a doctor?

Sweating is often a completely normal and often situation-related reaction of the body. However, a visit to a doctor is advisable in the following cases:

Sudden profuse sweating for no apparent cause
sudden sweats that cannot be explained
Sudden and repeated night sweats that cannot be explained (e.g. due to a room temperature that is too high)
Sweating with a fever that rises above 40 ° C, lasts for more than three days, or has an unclear cause

Call the emergency doctor immediately:

Outbreak of sweat with restlessness and clouding of consciousness in diabetics
Sudden sweating with dizziness and loss of consciousness, if the fainting lasts for more than a minute or if the person faints more often
Shock with cold sweat, gray, cool skin, tremors, restlessness, fear and possibly drowsiness or even loss of consciousness

Sweating: causes and possible diseases

No clear cause can be found for primary hyperhidrosis. However, high temperatures, physical exertion, nervousness and excitement often trigger increased sweating in those affected.

The main causes of secondary hyperhidrosis are:

Fever: When the body increases its temperature to 38 ° C and more in the fight against invading pathogens, doctors speak of fever. While the rise in temperature is accompanied by cold, dry skin and sometimes chills, warm, reddened skin and sweating herald that the fever is falling.
Infectious diseases: Fever with sweating is a common symptom of infectious diseases such as flu, cold, blood poisoning (sepsis) and malaria. Chronic infections such as AIDS and tuberculosis are often accompanied by sweating (mainly during sleep) as well as fatigue and reduced performance.
Menopause: The changes in the hormonal balance during menopause manifest themselves in many women in symptoms such as increased sweating and possibly sweating (hot flashes).
Pregnancy and the puerperium: The hormonal fluctuations during pregnancy and the puerperium can also trigger increased sweating and possibly sweating.
Hyperhidrosis (Hyperhidrosis): About five percent of the population suffer from a hereditary tendency to sweat.
Very overweight: Together with joint problems, shortness of breath and poor performance, excessive sweating is one of the unspecific symptoms of being very overweight. The reason for this is a disturbed heat regulation by the increased sub-fatty tissue.
Overactive thyroid (hyperthyroidism): Excessive sweating with noticeable sensitivity to heat may indicate an overactive thyroid. Other possible signs of hyperthyroidism are nervousness, hand tremors, and weight loss despite increased appetite.
Hypoglycemia in diabetes: Sweating with restlessness in diabetics is usually a sign of hypoglycemia. Further symptoms are cravings, palpitations, tremors and possibly drowsiness or even loss of consciousness. Hypoglycemia can develop in people with diabetes if they skip a meal, use the wrong dose of blood sugar-lowering medication, drink alcohol, or have increased glucose requirements, for example due to infection or physical exertion. If the hypoglycaemia is accompanied by a clouding of consciousness, you should call the emergency doctor!
Parkinson's disease (Parkinson's disease): Even at the beginning of Parkinson's disease, reduced heat tolerance and sweating can occur. Patients particularly often complain of night sweats. In Parkinson's patients, in whom the motor mobility changes strongly in phases, profuse sweating is particularly evident in phases of poor mobility (off phases).
Shock: People in shock (such as a heart attack, severe blood loss, severe allergy) break out in a cold sweat. They have gray, cool skin, are trembling, restless and / or are afraid. There may also be drowsiness or even loss of consciousness (fainting). If there are any signs of shock, you should call the emergency doctor immediately!
Fainting (vasovagal syncope): This is the most common form of loss of consciousness in otherwise healthy people. The brief loss of consciousness is usually preceded by weakness, dizziness, sweating and paleness, as well as a sudden drop in blood pressure and an abrupt drop in pulse rate. Such fainting can be triggered, for example, by emotional stress, fear and pain. Call an ambulance if the unconsciousness persists for more than a minute or if the person faints more often.
Drop in blood pressure when changing position (orthostatic dysregulation): Even when getting up from lying down or sitting, blood pressure can suddenly drop. The result is a sudden outbreak of sweat, dizziness, and blackness. Ringing in the ears, palpitations and nausea as well as brief loss of consciousness (orthostatic syncope or fainting) are also possible. The same applies here as above: If you faint for more than a minute or occur more frequently, an emergency doctor must be alerted!
Cardiac arrhythmia: If the heart beats too fast, too slowly or irregularly, the affected person can suddenly break out in a sweat or go black, similar to orthostatic dysregulation. Such cardiac arrhythmias should be clarified by a doctor!
Heart failure (heart failure): Increased sweating, palpitations and shortness of breath even with little exertion can be caused by a weak heart.
Anemia: As with heart failure, even the slightest exertion can trigger increased sweating, palpitations and shortness of breath.
Malnutrition (e.g. anorexia): If the body is insufficiently supplied with nutrients, even slight exertion triggers increased sweating, palpitations and shortness of breath.
Rheumatic diseases: Rheumatic diseases such as rheumatoid arthritis and lupus erythematosus can cause sweating (especially night sweats), fatigue and poor performance.
Tumor diseases: Malignant tumors such as leukemia or lymph gland cancer often cause sweating (especially night sweats), fatigue and reduced performance. Sweating or constant sweating, palpitations and headaches can be caused by rare hormone-producing tumors (such as pheochromocytoma: tumor of the adrenal cortex).
Anxiety Disorder, Panic Attack: Sweating or constant sweating combined with palpitations and headaches can be signs of an anxiety disorder or panic attack.
Withdrawal syndrome (as in alcohol addiction, drug addiction): Constant or spasmodic sweating with palpitations, headaches and often tremors and nervousness set in, for example, in alcoholics when they do not get their drug (alcohol). The same withdrawal symptoms can occur in other addicts such as drug or pill addicts.
Medication: Some medications can cause excessive sweating as a side effect, such as beta blockers (cardiovascular drugs), antidepressants, thyroid hormones, and cortisone supplements.

Sweating: what does the doctor do?

In order to clarify excessive sweating or unexplained sweating attacks, the doctor will first ask the patient about their medical history (anamnesis). For example, it can be used to describe the situations in which excessive sweating and / or outbreaks of sweat occur in order to derive assumptions about possible causes. For example, night sweats are most commonly seen in alcoholism. Heart failure, bronchitis, HIV infection / AIDS, autoimmune diseases, tumors (such as lymph gland cancer) and other diseases can also trigger sweating at night.

If excessive sweating and outbreaks of sweating are accompanied by other symptoms such as fever, shortness of breath, poor performance, this information also helps the doctor to make a diagnosis. The patient should also inform the doctor about any medication he or she has taken. Further examinations can then confirm or refute any suspicions made by the doctor:

Physical examination: This is a routine step when a patient see a doctor about symptoms such as excessive sweating, sweating and / or night sweats.
Measure fever: With the clinical thermometer, the doctor (or the patient himself) can determine whether an increased body temperature (37.5 to 38 ° C) or a fever (from 38 ° C) accompanies the sweating.
Blood pressure measurement: As part of the physical examination, the doctor usually also measures the blood pressure. Blood pressure measurement is particularly important in emergency situations in which sudden sweats, dizziness and blackening occur in front of the eyes with possible loss of consciousness. The alarmed emergency doctor will also measure the blood pressure of patients with signs of shock such as cold sweat, gray and cool skin and tremors.
Blood tests: If sweating and night sweats in women are caused by entering menopause, this can be seen by the concentration of sex hormones in the blood. The amount of thyroid hormones in the blood helps diagnose hyperthyroidism as a cause of profuse sweating and sensitivity to heat. Sudden sweats in diabetics can be caused by hypoglycaemia, which can be seen in the blood sugar level. Blood tests are also indicated for other diseases that may be the cause of profuse sweating - such as anemia, rheumatic diseases, infections, leukemia and other tumor diseases.
Imaging procedures: X-rays, ultrasound (sonography), computed tomography (CT), magnetic resonance tomography (MRI, magnetic resonance imaging) and the like are used if the doctor has a specific suspicion about the cause of increased sweating - for example, lymphatic cancer or heart failure. If the suspicion is confirmed, imaging tests can help estimate the extent of the disease more precisely.
Examination of the bone marrow: A sample of the bone marrow is taken and analyzed (bone marrow puncture, bone marrow biopsy) if, for example, leukemia or lymph gland cancer is a possible cause of excessive sweating (especially night sweats).
Electrocardiography (ECG): The electrical activity of the heart is recorded and analyzed, for example, if there is a suspicion of cardiac arrhythmia.
Neurological examination: The functional and performance status of nerve tracts is examined if Parkinson's disease could be responsible for sweating outbreaks and night sweats.

Abnormal sweating: treatment

Depending on how much the sweating is pronounced, the underlying cause and how much the patient suffers from it, the doctor has different options for treating the excessive sweat production.

In secondary hyperhidrosis, the underlying disease (obesity, anemia, cardiac arrhythmias, cancer, rheumatoid arthritis, etc.) is treated whenever possible. But sometimes that's not enough to get rid of excessive sweating, sweats, and / or night sweats. Then one can try one of the treatment options that are also used for primary hyperhidrosis. These include, for example:

Antiperspirants (antiperspirants, sweat inhibitors): They ensure that the sweat glands release less sweat. This effect is based on the contained metal salts, which are mostly aluminum salts such as aluminum chloride hexahydrate. Antiperspirants are used externally, for example as a roll-on deodorant, cream or powder.
Tap water iontophoresis: It is mainly used for sweaty hands and feet, and less often for profuse sweating in the armpits or other parts of the body. A weak current is passed through the affected skin areas with the help of water baths or moist electrodes.
Medication for ingestion: So-called antihidrotics are given for example when there is excessive sweating all over the body and the cause is unknown (generalized primary hyperhidrosis). However, they are only moderately effective and cause side effects quite quickly. If excessive sweating occurs mainly in psychological stressful situations or is the result of a mental illness (such as anxiety disorder, panic attacks), psychotropic drugs, tranquilizers or sedatives (sedatives) are sometimes prescribed.
Botulinum toxin: The bacterial toxin, also known by the drug name Botox, is injected into the palms of the hands or armpits, for example, where it blocks the secretion of sweat. Such botox injections can be quite painful and are usually only used for more severe forms of hyperhidrosis.
Surgical therapy: Surgical procedures only come into question if non-operative (conservative) treatment methods are unsuccessful. For example, profuse sweating in the armpits can be stopped by cutting out (excision) or “scraping out” (curettage) the sweat glands. With sweaty hands, certain nerves in the chest area can be severed (endoscopic thoracic sympathectomy, ETS). The sweating in the armpits and face also decreases as a result. After the operation, however, many patients sweat more intensely in other parts of the body to compensate.

Sweating: You can do that yourself

The following tips against excessive sweating (hyperhidrosis) can be helpful:

Airy clothing: Wear loose, air-permeable clothing, preferably made of cotton and wool, but not synthetic fibers.
Onion look: Dress according to the onion principle (for example a T-shirt plus a thin cardigan instead of a thick wool sweater).
Correct footwear: Especially if you have sweaty feet, you should wear leather shoes with full-length leather soles (no rubber, plastic or wooden soles!) And sandals in summer. Change shoes more often during the day.
Go barefoot: Walk barefoot as often as possible because the stimulation of the soles of the feet regulates the activity of the sweat glands.
Eat right: Avoid foods and drinks that stimulate sweating, such as high-fat, lavish and / or spicy meals, alcohol, nicotine and coffee.
Breaking down fat deposits: If you are overweight, you should lose weight if possible. Then you also sweat less.
Drink enough: Do not restrict your fluid intake for fear of sweating and profuse sweating! The amount of sweat released does not depend on the amount of sweat you drink.
Shower daily: shower at least once a day. Use deodorizing syndets (cleaning agents made from synthetic raw materials) or pH-neutral soaps, for example.
Removing armpit hair: If you have profuse armpit sweat, you should shave your armpit hair to prevent bacterial growth.
Combating odors: Use deodorants (roll-on deodorants, deodorant sprays, etc.) whose odorous substances and antibacterial additives reduce or mask the smell of sweat.The antibacterial effect is important because the unpleasant smell of sweat only arises when bacteria attack the sweat.
Exercise glands: Go to the sauna and / or exercise regularly to exercise the normal function of the sweat glands. Caution: In the case of existing underlying diseases such as heart failure or venous disorders, you should consult your doctor beforehand.
"Water cures": Cold and warm showers, Kneipp showers for arms and legs as well as full baths with brine, moor or hay flower additives are also recommended if you sweat excessively (for example during menopause).
Sage: Sage tea is an old home remedy for sweating: for a cup of tea, brew one to two teaspoons of sage with hot water, let it steep for five to ten minutes and then strain. Drink a cup of sage tea in small sips three times a day for four weeks. Alternatively, you can take ready-made sage preparations (pharmacy).
Black cohosh: For increased sweating and other menopausal symptoms, you can take herbal preparations based on black cohosh (pharmacy). They contain substances with hormone-like effects that can partially compensate for the increasing lack of estrogen during menopause.
Soothing medicinal plants: outbreaks of sweating, increased sweating and night sweats can put a lot of stress on the soul and, conversely, can be caused by emotional tension. In these cases, the use of soothing medicinal plants such as valerian, passion flower and lemon balm can be useful. A mixture of one teaspoon each of St. John's wort, lemon balm, lavender and passion flower is recommended as a hot tea for sweating (hot flashes) during menopause. Pour a cup of hot water over the whole thing and strain after five minutes. Drink such a cup in small sips three times a day for four weeks. Then take a break for at least a month.
Relaxation techniques: Use relaxation techniques such as autogenic training or progressive muscle relaxation according to Jacobson on a regular basis to calm the autonomic nervous system. This prevents sweating, because the sweat release is controlled by the vegetative nervous system. Relaxation techniques are also particularly useful when sweating and excessive sweating are caused by menopause.
Homeopathy: Homeopathy recommends against sudden sweats with hot flashes Acidum sulfuricum D12. The homeopathic Sepia D12 is indicated in case of foul-smelling sweat, if the symptoms improve with movement. On the other hand, in the case of foul-smelling sweat, when the symptoms improve through cold, the remedy is used Sulfur D12 used. The same means as well Calcium carbonicum D12 can help against sweaty feet. Regarding the dosage, you should speak to an experienced therapist.
Bach flowers: If fear-inducing situations (such as exams, visits to the dentist, public appearances) cause sweating, you can try Bach flower therapy: Rescue drops (emergency drops) are particularly suitable, but Rock Rose and Mimulus are also suitable.
Essential oils: To prevent increased sweating, the essential oils of sage, citronella, rose, rosewood, thuja and cypress are recommended, for example as additives in baths, shower cream and skin cream. You can also take a foot balm and mix in two to four drops of spruce, pine, rosemary, lemongrass or tea tree oil. This helps with profuse sweating on your feet.