Hyperhidrosis (Excessive Sweating) Treatment in Chicago

Q: Is excessive sweating a medical condition?

Yes. Hyperhidrosis is a recognized medical condition where sweating goes beyond what your body needs to stay cool. It can interfere with work, daily tasks, and how you feel, and it is treatable. We start with an evaluation to confirm the pattern and check for any underlying cause. From there, we build a treatment plan.

Q: Do I need blood work for hyperhidrosis?

Not always. Classic primary focal hyperhidrosis can often be diagnosed from your history and a focused exam. Blood work or other testing may be suggested if your history raises concern for a different underlying medical cause, such as thyroid dysfunction.

Excessive sweating can wear on your comfort, work, and confidence. You do not have to manage it alone, because hyperhidrosis is a recognized medical condition, and it is treatable. Our South Loop team evaluates the cause first, then builds a plan with you.

Dermatologist-led care in Chicago's South Loop. New-patient appointments on Zocdoc.

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FIRST VISIT: Medical evaluation visit
MOST OFTEN AFFECTS: Underarms, palms, soles, scalp, or face
BILLED TO: Medical insurance for treatment with topical or oral medications; Botox® for hyperhidrosis is self-pay
TREATMENT OPTIONS: Antiperspirants, topicals, medication, procedures
BOTOX® FOR SWEATING: Separate self-pay page
FOLLOW-UP: Based on your response to treatment

Understanding Hyperhidrosis

Some people sweat more than their body needs to stay cool. Dermatologists call this hyperhidrosis. It can show up even when you are resting or when the room is cool.

Hyperhidrosis is not contagious, and it is treatable. Most often it affects focal areas such as the underarms, palms, soles, scalp, or face.

Sweating like this can make handshakes, writing, and everyday tasks harder, and it can wear on comfort and confidence over time.

Common Signs and Symptoms

Visible sweating that soaks through clothing or drips
Sweaty palms or soles that affect grip, writing, or daily tasks
Damp underarms, scalp, or face during cool or calm moments
Sweating that is often symmetric, affecting both sides
Frequent clothing or shoe changes through the day
Skin softening or peeling, chafing, or repeat infections in damp areas; contact us for pus, drainage, increasing pain, swelling, or a spreading color change
Sweating that often eases or stops during sleep, which supports but does not by itself confirm primary focal hyperhidrosis

What Can Contribute to Hyperhidrosis

Primary focal hyperhidrosis: focal sweating not caused by another condition or medication, thought to involve overactive nerve signaling, often beginning in childhood or adolescence
A family history of similar sweating
Secondary hyperhidrosis: sweating driven by another medical condition or a medication
Possible secondary causes include endocrine or metabolic conditions, such as thyroid disease, diabetes, or low blood sugar
Other possible causes include infection or fever, menopause, medication effects, and alcohol or other substance use or withdrawal
Less commonly, neurologic, heart, lung, or other body-wide illnesses can contribute

If you think a medicine may be the cause, do not stop it on your own. Review it first with the clinician who prescribed it.

Some patterns point toward a secondary cause. Arrange prompt evaluation, through primary care, urgent care, or dermatology as appropriate, if you notice any of the following:

New sweating that begins in adulthood
Sweating that covers most of your body
Sweating during sleep
Sweating that is mostly on one side of the body
A sudden start
A recent change in a medication or substance
Sweating alongside fever, unexplained weight loss, or feeling unusually unwell
A new or persistent racing heartbeat, when none of the emergency symptoms below is present

Some symptoms need emergency care rather than an appointment. Call 911 for sudden heavy sweating with dizziness or lightheadedness, nausea, shortness of breath, or chest, throat, jaw, arm, or shoulder pain. Call 911 as well for sweating with cold or clammy skin together with a rapid or weak pulse.

How Dermatology Can Help

Treatment is tailored to where you sweat, severity, and whether it is primary or secondary hyperhidrosis. We typically start with simple therapies and step up as needed, with treatment options explained clearly at every stage.

Antiperspirants. Clinical-strength or prescription antiperspirants, often aluminum chloride applied to very dry skin at night, are a common first step. If irritation occurs, we adjust early, and we may pause use while your skin settles. Irritation can trigger post-inflammatory darkening that may take months, and occasionally longer, to fade, especially in highly pigmented skin.

Prescription topical treatments. Topical anticholinergic treatments are available. We review safe use before you start.

Apply only to clean, dry, unbroken underarm skin, and do not cover the treated area with a bandage or airtight dressing. You will wash your hands right after applying and keep the medicine away from your eyes.

Possible effects include skin irritation, dry mouth, and blurred vision or dilated pupils after eye exposure. Urinary retention and heat-related illness can also occur.

We also screen for conditions these medicines can worsen, including glaucoma, myasthenia gravis, Sjögren syndrome, and some severe bowel conditions. We review your other medications and any urinary retention risk before you start.

Stop the medicine and contact us promptly if urinating becomes difficult. If your vision blurs, stop the medicine, contact us, and do not drive or operate machinery until your vision is clear. Seek care if you overheat while sweating less than usual.

Oral medication. Oral anticholinergic medicines, such as glycopyrrolate or oxybutynin, may be considered when topical care is not enough or sweating affects several areas. Their use for hyperhidrosis is off-label in the United States. Evidence and dosing are less standardized than for FDA-approved underarm treatments.

Because these medicines reduce sweating throughout the body, side effects can be body-wide. They can include dry mouth, constipation, drowsiness or confusion, blurred vision, a rapid heartbeat, urinary retention, slowed digestion, and heat-related illness.

They may be a poor fit with certain forms of glaucoma, urinary or bowel blockage, myasthenia gravis, or similar conditions. We review your health history and other medications for interactions first. Extra caution applies for adults 65 and older, since these medicines can contribute to confusion, memory problems, and falls, particularly with oxybutynin.

Procedural options. Procedural options such as Botox® are available. We do not offer iontophoresis at this time.

Botox® for sweating. Botox® (onabotulinumtoxinA) is FDA-approved for severe primary underarm hyperhidrosis in adults when topical treatments have not worked well enough. Use at other body sites, or in patients under 18, is off-label or not established in FDA labeling. Site-specific risks exist, including hand weakness after palm treatment and eyelid drooping after facial treatment.

Botox® also carries a boxed warning about possible spread of toxin effect away from the injection site, including swallowing or breathing difficulty. We cover full risks, contraindications, and self-pay details with you at your visit.

Treatment Goals

The goal is steady control: less sweating, more comfort, and easier daily activities. Responses vary, and many treatments work best in combination with long-term maintenance.

Individual results and duration of results may vary. Outcomes are not guaranteed.

For secondary hyperhidrosis, the plan may also include treating the underlying cause or reviewing a medication with the clinician who prescribed it.

When to See a Dermatologist

Consider a visit if sweating disrupts work, school, social life, or daily tasks, or if antiperspirants have not been enough. A plan tailored to your pattern can make a real difference.

Arrange prompt evaluation, through primary care, urgent care, or dermatology as appropriate, if you notice any of the following:

New sweating that begins in adulthood
Sweating that covers most of your body
Sweating during sleep
Sweating that is mostly on one side of the body
A sudden start
A recent medication or substance change
Sweating alongside fever, unexplained weight loss, or feeling unusually unwell
A new or persistent racing heartbeat, when none of the emergency symptoms below is present

How It Works

Your evaluation. Your provider reviews where you sweat, how long it has happened, your history, triggers, and any medications.
Your treatment plan. Your plan may include prescription topicals, oral medication, a Botox® treatment recommendation, or referral, depending on your pattern.
Ongoing support. Your provider partners with you over time, adjusting care based on your response, side effects, and goals.

Insurance or Self-Pay

Evaluation and treatment with topical or oral medications is usually billed to insurance when your plan's criteria are met. Botox® for sweating is discussed on a separate self-pay page and is not part of our services billed to insurance. We participate with select plans, and coverage depends on your plan, network, and the reason for your visit.

We participate with select plans from insurers such as Aetna, Blue Cross and Blue Shield (PPO and Options), Cigna, Corvel, Humana, Imagine Health, Multiplan, The Alliance, TriWest Healthcare Alliance, United Healthcare, and Zelis. We also accept Medicare Part B and select Medicare Advantage plans. Participation varies by plan and network.

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Why Patients Choose Advanced Dermatology

01 Physician-led

Dermatologist-Led Care.

Every treatment performed or supervised by a board-certified dermatologist — Dr. Monica Rani, MD (Medical Director) and Dr. Stavonnie Patterson, MD — or Sydney Freedman, PA-C.

02 Skin of Color