context: Excessive sweating (hyperhidrosis) isn't life threatening, but it can threaten your quality of life. How do you know when it's time to see a doctor about excessive sweating? How can you tell if your sweating is excessive? No one can say how much sweat is "too much." There's really no effective and convenient way to measure the total amount of sweat. Excessive sweating is instead defined as any amount of sweating that causes problems or distress. The exact causes aren't known, but up to 3% of people suffer from hyperhidrosis. Hyperhidrosis usually starts in adolescence or young adulthood. Sweating is worst in the palms, soles, or underarms. When excessive sweating is limited to these areas, it's called focal hyperhidrosis. Most people with focal hyperhidrosis are otherwise completely healthy. Studies suggest that they are no more nervous or easily upset than people who sweat normally. At the same time, hyperhidrosis can cause real problems. Most people feel extremely embarrassed by their excess sweating. They frequently report frustrations or problems with things most people take for granted: Frequently changing clothing because of underarm sweating Avoiding shaking hands Missing out on social gatherings due to concern about sweating Challenges with romantic relationships Difficulty writing because the pen slips or sweat soaks through ink on the page In fact, about one-third of people with focal hyperhidrosis describe their symptoms as significantly affecting their quality of life. Despite the serious negative impact hyperhidrosis has on the lives of those who suffer from it, most never seek treatment. Generally, people with focal hyperhidrosis have been living with their problem since they were young. After learning to live with excessive sweating, they often don't recognize their problem is treatable. That's too bad, because effective hyperhidrosis treatments are available. Although no treatment is perfect, hyperhidrosis medications and procedures can help many people with the condition. Some primary care physicians or general practitioners are familiar with the initial treatment of focal hyperhidrosis, which may include: Over-the-counter ( OTC) antiperspirants: these can be applied to the hands and feet, as well as the armpits. Hyperhidrosis that's controllable by OTC treatment doesn't need a doctor's visit. Antiperspirants can even be used at bedtime. Prescription antiperspirants: Most people with hyperhidrosis will sweat through OTC antiperspirants. A doctor can prescribe a higher-strength, aluminum salt-based antiperspirant. This can be effective for mild cases of excessive sweating. Dermatologists are generally the best doctors for treating excessive sweating that's not controlled by OTC products. They are usually more familiar with hyperhidrosis treatment, especially when sweating is severe. Depending on your insurance, you may need a referral to a dermatologist from your regular doctor. Some more advanced treatments for hyperhidrosis include: Iontophoresis: This involves soaking the hands or feet in a basin of water through which a mild electric current is passed. It requires frequent treatments, but it's often effective at reducing sweating. Botulinum toxin type A ( Botox): Injections of this anti-wrinkle drug turn off sweat glands of the underarms for months at a time. Botox is more than 90% effective as a hyperhidrosis medication. The injections can be painful, though, sometimes requiring local anesthesia. mira Dry system: This device uses electromagentic energy to permanently eliminate underarm sweat glands. It is not approved for use on other areas of the body. Oral hyperhidrosis medications can also reduce excessive sweating, although side effects frequently limit their use. In extreme cases, referral to a surgeon is an option. Surgical procedures are available to treat hyperhidrosis and can be quite effective. They often have serious side effects, though, and are considered a last resort. Focal hyperhidrosis isn't medically serious. Other forms of excessive sweating, though, can signal underlying medical problems. Sweating all over the body at once is called generalized hyperhidrosis. It's frequently caused by diseases affecting the whole body. Infections, hormone problems, cancer, or nerve problems can be responsible. It often occurs during sleep, unlike focal hyperhidrosis, which occurs only when awake. Anyone with all-over body sweating should see a doctor as soon as possible.