Everyone experiences anxiety at different points in their life. You might feel it before an interview, or presentation, before a wedding or childbirth, or meeting your in-laws for the first time. You might get the shakes, feel sick to your stomach, or experience racing thoughts.
Sometimes, anxiety can be helpful, as it helps us to react and deal with the stress by helping us stay focused. However, chronic anxiety that doesn’t go away and is difficult to control can cause significant distress and impairment.
One of the most common symptoms of chronic anxiety is sweating. Whether it’s constantly sweaty palms, a sheen of sweat over your forehead, or sweat patches under your arms, this symptom can impact your day-to-day life.
Thankfully, there are a few ways you can reduce the impact of this particularly frustrating symptom of anxiety.
We make it easy for you to participate in a clinical trial for Anxiety, and get access to the latest treatments not yet widely available - and be a part of finding a cure.
When the body perceives a threat, its response is to activate what is known as a flight-or-fight response. In simple terms, the response is designed to prepare the body to either stay put and fight the stressor or to flee from it altogether. When the body enters fight-or-flight mode, stress hormones are released which cause sweating across the whole body.
Sweat is released to help:
Cooldown the body
Maintain good skin health
Clear metabolic waste and toxins from the body
Balance out nutrients such as electrolytes
When placed in a high-stress environment, the release of hormones like adrenaline is triggered. This activates apocrine sweat glands, especially prominent in the armpits.
When anxiety is causing a significant disturbance in someone's life, it will often be treated with medication or talk therapy. However, sweating is also a very common side effect¹ of some medications used in the treatment of anxiety.
Wear loose clothing
It’s important you wear comfortable clothes. In addition to minimizing how obvious sweating is, comfy clothing will reduce discomfort.
Layering your clothing is also useful so that you can dress up or down depending on the different temperatures at any given point in the day. It can also be helpful to have an extra layer to cover up any visible sweat marks on your clothing.
Choose your colors wisely. While white and black items of clothing may be easier to disguise sweat than colored items of clothing, printed clothing can also be great for distracting the eyes.
Try to keep fabrics either loose and light or moisture-wicking and/or sweat-proof to help with ventilation. Plan to keep a backup pair of clothing or footwear nearby just in case you end up sweating a little too much.
By making smart clothing choices, you can maximize your comfort and minimize how noticeable your sweating is.
There is a multitude of different products available on the market designed to help you fight sweat, or at the very least hide it from the public eye.
Sweat pads are single-use pads that can be stuck to the part of your clothing most likely to show sweat stains; typically the underarms of your dress, shirt, blouse, jacket, or top. The pad works to trap the sweat before it reaches your clothing, preventing marks and stains.
Armpit dress shields work in a similar way to sweat pads but are typically multi-use. Some contain an adhesive strip to stick to clothing while others are designed to be pinned so they can be washed frequently or sewn so they are washed with the garment. Either way, they provide an additional barrier to sweat reaching your garments.
Antiperspirants are chemicals that reduce sweating by blocking the sweat ducts, meaning less sweat can reach the surface of the skin.
Antiperspirants have been used since the early 1900s. Historically, the active part of antiperspirants was metallic salts, including aluminum chloride and aluminum chlorohydrate.
Newer antiperspirants contain aluminum zirconium and this is less likely to irritate the skin. Antiperspirants are available in different strengths depending on how severe the sweating is.
Antiperspirants come in a range of different forms including:
Some roll-ons will also contain deodorant to help mask the smell of the sweat-eating bacteria.
Antiperspirants are best applied at night, or when sweating is going to be minimal so the chemicals have a better chance to soak into the sweat glands. They should be applied to dry and clean skin.
Antiperspirants should be applied daily for several days, before reducing to every other day and then once in 7-12 days. However, this may vary from product to product and your doctor or pharmacist can give you further instructions.
Keep in mind that it is possible to react to antiperspirants. You may get irritated skin or a form of dermatitis. If you have sensitive skin it’s best to start with a less concentrated product.
Other topical treatments exist to help reduce sweating. These include a form of a drug called anticholinergics which works by blocking some of the messengers which start the sweating process. Common types include:
These agents come in different forms, including pre-moistened cloths containing glycopyrronium tosylate and an oxybutynin gel. Like antiperspirants, topical agents can irritate the skin.
Oral anticholinergic medications
If topical forms of anticholinergics don’t reduce sweating caused by anxiety, an oral form of the medication will sometimes be prescribed by doctors. These medications can have side effects, which is why they are typically used as a second resort. They can cause your mouth to dry out and (less often) result in visual disturbances, constipation, dizziness, and heart palpitations.
Beta-blockers can also be used for the treatment of anxiety as they block stress hormones like adrenaline from acting on the body. This prevents the body from activating the fight-or-flight response, and therefore the body’s physical response changes:
Heart rate remains stable
There is no dizziness
Sweating doesn’t occur.
Beta-blockers are thought to be most effective for short-term anxiety, such as that felt before delivering an important presentation.
When topical therapies and medications have been tried without success, a procedure known as Iontophoresis may be used. This is particularly helpful when trying to reduce sweating on the palms of your hands and the soles of your feet. During iontophoresis, an electric current passes through the skin with the aid of a fluid, which allows tiny charged particles to cross the skin barrier.
It’s not entirely clear why this procedure works but iontophoresis has been shown to help reduce sweating and increase the effectiveness of medications, by increasing their ability to be absorbed. This treatment is to be used over the long term².
Botulinum toxin injections
Botulinum toxin³ is another substance that can be injected into the muscles to help them to relax. You may have heard it referred to by the name BOTOX®.
In the use of sweating treatment, Botulinum A can target excessive sweating in specific areas. It works by blocking the connection between the muscles and the nerve cells. It can be specifically directed at the sweat glands in the skin to help prevent the production of sweat.
It is not recommended to use Botulimin A toxins while pregnant, breastfeeding, or if you take certain medications. Most commonly observed side effects are related to the injection rather than the toxins themselves and include but aren’t limited to bruising, swelling, and pain around the site of injection.
The effect of Botulinum injections can last from 6 - 24 months⁴, making it a great longer-term treatment measure. Unfortunately, this long-lasting result does come at a financial cost, meaning it isn’t accessible to all.
Failing other treatments for sweating, surgical measures are available. Perhaps the most popular is a sympathectomy⁵. In this procedure, a surgeon makes a snip or clamps the nerves that make up part of the sympathetic nervous system. This is the system responsible for activating that flight-or-fight response in your body that was talked about earlier.
The location you experience sweating at will determine where the procedure will be performed, with different snips made for:
Sweating on the palms of your hands (palmar sweating)
Sweating under the armpits (axillary sweating).
Surgical measures, like other treatments, are not as effective on their own as they are when accompanied with a treatment for the underlying cause of the sweating – in this case, anxiety.
Managing and treating sweating related to anxiety is complex, as many different factors can contribute to its development. You and a friend may react completely differently to stress and anxiety. Therefore, you are likely to require different treatment options.
However, there are a wide variety of different treatment options which can lessen the impact of your sweating on day-to-day life.
What is hyperhidrosis? | DermNet NZ
Endoscopic thoracic sympathectomy | MedlinePlus