Excessive sweating (hyperhidrosis)

What it is

Hyperhidrosis is sweating beyond what is needed to cool the body, often on the palms, soles, underarms or face. Primary hyperhidrosis usually starts in childhood or adolescence and is not dangerous, but can affect work and confidence.

How it works

In primary hyperhidrosis, sweat glands are normal but the nerves controlling them are overactive, so sweating is far more than needed to cool the body, often in the palms, soles, armpits and face.

Why it matters on darker skin

It affects all skin types. In hot climates it may go unrecognised because heavy sweating is assumed to be normal.

Causes and triggers

Usually genetic, starting in childhood or teens. Secondary sweating can be caused by medicines, thyroid disease, infections or diabetes.

What helps — and why it works

Start with a strong antiperspirant containing aluminium chloride applied at night to dry skin. Breathable clothes, sweat pads and moisture-wicking socks help. A doctor can offer further treatments such as iontophoresis (for hands and feet), injections, medicines or other procedures. Aluminium chloride antiperspirant at night: blocks sweat ducts. Expected timeline: 1–2 weeks. Doctor treatments: iontophoresis, tablets, botulinum toxin. Expected timeline: weeks.

What to avoid and why

Avoid applying aluminium chloride to wet or broken skin, which causes stinging.

Common mistakes

• Applying antiperspirant to wet skin in the morning.
• Ignoring night sweats, which need a doctor.

Body care basics in a hot climate

Heat and humidity mean the body sweats more, which feeds the bacteria and yeasts that cause odour, rashes and some types of body acne. A daily lukewarm shower with a gentle, soap-free or mild cleanser, thorough drying of skin folds and between toes, and fresh, breathable cotton clothing prevent many problems. Moisturise straight after bathing while skin is still damp so water is sealed in; this matters even in humid months because frequent washing strips natural oils, and it matters most during harmattan. Avoid sharing towels, razors and sponges, which spread fungal and bacterial infections. When shaving, use a sharp blade, shave with the grain and do not stretch the skin; for curly hair a guarded trimmer is often better. Be cautious with body-lightening, 'carrot' or 'toning' lotions: many contain undeclared steroids or mercury. If a rash spreads, keeps coming back, or appears with fever, see a doctor rather than trying more creams.

Choosing body products

For most people an unscented, gentle cleanser and a plain moisturiser are enough. Antiperspirants containing aluminium salts are the most effective way to reduce sweating and are best applied at night to dry skin. Fragranced body sprays and deodorants are a common cause of allergy; fragrance-free options are kinder to sensitive skin. Aerosol products are easy to over-apply and some have been recalled for benzene contamination, so roll-ons and creams are a sensible default. For fungal rashes, plain antifungal creams such as clotrimazole are better than combination creams containing strong steroids, which can make infections spread. Always check for a NAFDAC number and a full ingredient list.

Questions to ask your doctor or pharmacist

Useful questions include: What do you think is causing this? Is it likely to come back, and how can I prevent it? Which products should I stop? How long before I should expect improvement, and when should I come back if it isn't better? Are there side effects to watch for? Is this treatment safe if I am pregnant, breastfeeding or for my child? Writing your questions down, bringing your products (or photos of their labels) and taking dated photos of the problem make an appointment much more useful.