Breaking into a Sweat… Treatments for Excessive Head or Facial Sweating


Excessive head or facial sweating can be an uncomfortable problem to deal with, as it’s very difficult to hide and may lead to feelings of embarrassment and social withdrawal. Fortunately, there are ways to treat this condition so you can always put your best face forward, writes Dr Anushka Reddy…

The human body has millions of sweat glands dispersed over its entirety, all of which play a vital role in the natural process of thermo-regulation. When the body gets too hot, hormones stimulate these glands to release sweat which evaporates and in turn, cools the body down.

There are two main types of sweat glands: the eccrine sweat glands, which are situated with the highest density in the palms, soles and head – and the apocrine sweat glands, which are mostly limited to the armpits. However, only the eccrine glands provide cooling from water evaporation of sweat secreted by the glands on the body surface, as well as emotional induced sweating (anxiety, fear, stress, and pain).

Eccrine glands at work

Did you know that your face is the first place you can sweat through your eccrine glands?

Even though your body’s sweat glands can function before birth, physicians don’t consider sweating possible until one full day after birth, with the face being the first place it can occur. Although unfortunately for some, it may seem like once the sweating has started, it has never stopped.

That said, it’s very normal to sweat on your face from sitting outside in high temperatures or from exercising, as the forehead contains the highest concentration of eccrine glands. However, if facial sweating occurs regularly or in unusual situations like in a cool, indoor environment, it’s time to see a doctor for a full medical check-up.

When sweating becomes a problem

Excessive sweating, known as hyperhidrosis, is a medical condition that can extend to the face and scalp (called craniofacial hyperhidrosis). This is the rarest form of hyperhidrosis, and includes excessive sweating of the forehead, scalp and back of the neck.

The underlying cause of craniofacial hyperhidrosis depends on which type of hyperhidrosis you have. Primary hyperhidrosis is thought to come from emotional triggers such as anxiety, stress or fear. Secondary hyperhidrosis is the result of several medical conditions such as malignant tumors, infections, heart disease, Parkinson’s disease and hyperthyroidism. Since the hypothalamus controls glandular function as well as the regulation of body temperature, an endocrine disorder may also be responsible for excessive sweating.

Treatment protocol

If you feel like the excessive facial sweating has taken over your life, the first step is to undergo a full medical check-up, including an assessment to make sure that excessive sweating is not due to another medical condition or a side effect of a medication.

If your doctor subsequently determines that your extreme sweating is not the result of other medical conditions or medications, the treatment will then be similar to the one used for other body areas of excessive sweating.

Treatment options

One of the methods of treating the condition is with products used on the skin at the area of sweating (topical solutions). These may include common antiperspirants containing aluminum chloride, and prescription-strength antiperspirants containing aluminum chloride hexahydrate.

However, it must be noted that strong antiperspirant products can be irritating to the skin of the face, head, or scalp, so it’s important to understand how antiperspirants work to use them effectively and avoid irritation. Always follow your doctor’s instructions and, if trying a new topical product, try it on a small area of the skin first to see how your body reacts.

Conversely, if topical antiperspirant solutions don’t work, botulinum toxin injections may be a solution. Botulinum toxin has become a widely recognised treatment for hyperhidrosis, gaining FDA’s stamp of approval in 2004.

It treats extreme sweating by blocking the secretion of the chemical that activates sweat glands. Overall, the procedure is relatively quick and painless.

In the case of craniofacial hyperhidrosis, physicians use botulinum toxin injections to block the neural signals that are responsible for triggering the unneeded working of sweat glands. Once the working of sweat glands is under control, managing the excessive flow of sweat on the forehead, scalp, and face is relatively easy.

Furthermore, almost all the patients with primary hyperhidrosis are labeled as the ideal candidates, however, breastfeeding moms and pregnant women are not allowed to undergo this procedure.

Key points

The results for reducing sweating with botulinum toxin can be determined after 3-4 days, with most patients experiencing between 50% to 80% reduction in the primary hyperhidrosis provided the neurotoxin is properly injected. The results are then visible for 6-7 months, which can be extended if proper maintenance is done.

In addition to the above, the injection technique of botulinum toxin requires skill in order for it to be effective.  A potential side effect of botulinum injections in the treatment of excessive sweating is asymmetry, particularly ofthe forehead. Fortunately, such asymmetry is temporary and can be easily fixed with additional injections. Working with an experienced doctor can minimise these risks.

Take home message

If you’re living with excessive head, scalp, or facial sweating, it’s time to head off the problem. From anti-persirant products to botulinum toxin injections, there are ways to treat this condition so you can always put your best face forward. For the best available treatments, talk to your dermatologist or healthcare professional.

A2 Disclaimer: This article is published for information purposes only, and should therefore not be taken as an endorsement or advertisement for any product or medical treatment –  nor should it be regarded as a replacement for sound medical advice. 

CURRENT Issue 25 – March 2018 (Autumn)

This article was written by Dr Anushka Reddy and edited by the A2 team EXCLUSIVELY for the A2 Aesthetic & Anti-Ageing Magazine March 2018 Edition (Issue 25). 

A2 Magazine prints only four magazines each year – reporting seasonally on everything you need and want to know about aesthetics, anti-ageing, integrative medicine, quality and medical skin care, cosmetic dentistry and cosmetic surgery in South Africa – where to go, who to see, what to expect, something new and so much more! Never miss an edition – click here for more info about where you can buy the print and/or digital copy of A2 Magazine (including back copies).

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About Author

Dr Anushka Reddy MBChB - Dr Anushka Reddy is the owner of Medi-Sculpt and the President of the South African Association of Cosmetic Doctors (SAACD). She regularly contributes to various publications and has also appeared on TV programs such as Carte Blanche Medical, Top Billing Eastern Mosaic, Maatband, CNBC Africa and Hello Doctor. Dr Reddy travels both locally and internationally to discover new techniques and products to fulfil her patients’ aesthetic wishes.

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