Excessive sweating with anxiety

Anxiety, Stress, and Hyperhidrosis

Sweat happens, for pretty much everyone.

It may not always feel (or smell) all that pleasant, but it’s a natural response to rising body temperature. When the weather heats up, or when you exert yourself during physical activity, your body produces sweat to help you stay cool. In short, sweat serves a pretty important purpose.

Sometimes, though, you might find yourself sweating when your body doesn’t need to cool off. Sweating commonly happens as a response to fear or stress, which is why you might notice increased sweating as a physical symptom of anxiety.

Like typical sweat, anxiety sweat can appear all over your body, but you’ll usually notice it most on the:

  • palms
  • soles of your feet
  • face
  • armpits

Of course, worrying about sweating too much can also contribute to feelings of anxiety — not to mention become a self-fulfilling prophecy. If you sweat a lot when facing stress, you might begin to worry about sweating in front of other people. But that very concern might lead you to break out in a sweat.

A sweaty face and palms can feel pretty uncomfortable, but anxiety sweating can also contribute to emotional distress. Not only can frequent sweating complicate your daily routine, but it can also diminish your confidence.

You might begin to avoid social situations or anything that might prompt a sweat response. In time, anxiety sweating could trigger feelings of loneliness, even depression.

Keep reading to learn more about why anxiety sweating happens, plus get a few tips to manage — and prevent — it.

You have your sympathetic nervous system to thank for anxiety sweating.

If that term rings a bell, it’s because you may have come across it before, also in the context of anxiety. When you face a threat, whether real or perceived, your sympathetic nervous system prompts the fight-flight-freeze response.

Sweating is one key sign of this response. Fighting a threat, or fleeing from it, requires you to expend energy, which can raise your body temperature. But overheating would make it difficult to escape or keep fighting, so your body signals your sweat glands to produce sweat and keep you cool so that you can carry on.

Living with an anxiety disorder can mean your body and brain remain on constant alert for potential threats. As a result, you might regularly notice a full range of emotional and physical symptoms — beyond your sweat glands working overtime.

It’s also worth considering the flip side, too: Worries about extreme sweating, or other bodily responses, can easily characterize generalized anxiety disorder (GAD). This condition involves extreme and consistent worry about everyday events and situations.

With GAD, you might, for example, find yourself worrying about sweating constantly, perhaps to the point where it:

  • keeps you up at night
  • disrupts your concentration at school or work
  • makes it difficult to relax and enjoy hobbies and leisure time

To sum up: Anxiety can trigger sweating, but the knowledge that you sweat a lot can also lead to anxiety.

Social anxiety

Excessive sweating, or hyperhidrosis, can also happen as a symptom of social anxiety disorder. In fact, according to the International Hyperhidrosis Society, up to 32 percent of people with social anxiety experience hyperhidrosis.

If you live with social anxiety, you likely feel intense stress and fear at the thought of embarrassing yourself or drawing negative feedback from others. These feelings might intensify when you have to join a group, speak in front of others, or meet new people.

Accordingly, you might go to great lengths to avoid drawing attention to yourself, but you still might worry about doing something other people can judge — like sweating a lot.

Yet since fear and stress can trigger sweat, you might quickly notice increased perspiration, along with other physical symptoms, like:

  • warmth and flushing, especially around your face (blushing)
  • head pain
  • lightheadness
  • trembling
  • clamminess in your hands
  • nausea
  • shortness of breath

Again, it’s also possible for sweating to prompt emotional distress that resembles social anxiety symptoms. If you know you sweat a lot, you might certainly feel nervous about sweating so much that others notice.

This fear could eventually prompt you to avoid social events, or any situations where people might notice you sweating.

Here are nine tips to manage social anxiety.

Other anxiety disorders

Evidence also links increased sweating to other anxiety disorders, namely panic disorder and specific phobia.

In a review of 86 studies, people with panic disorder tended to sweat more when they encountered a situation that triggered feelings of fear or panic. They also tended to sweat more on a daily basis — even when not facing a stressful situation.

People with a phobia, on the other hand, tended to sweat more when they encountered the object of their phobia.

Can other mental health conditions cause sweating?

Some emerging research also suggests a link between attention deficit hyperactivity disorder (ADHD) and increased sweating, though experts have yet to explore this potential connection in depth.

Anecdotal reports do suggest that many people notice increased sweating when taking Adderall, a medication that treats ADHD symptoms.

The thought of mentioning extreme sweating to a healthcare professional, or anyone at all, may provoke some anxiety and emotional discomfort.

This may help explain why many people living with hyperhidrosis don’t get treatment — yet excessive sweating that goes unaddressed can have a far-reaching impact on your quality of life.

Excessive sweating can lead to social withdrawal, for one. If you worry about sweating during your daily activities, you might choose to cancel them and stay home instead. You might feel sad, even guilty, about avoiding them, but helpless to do anything else.

These feelings might, in turn, prompt a sense of general hopelessness, along with other symptoms of depression.

All that said, treatment can help ease anxiety sweating, so it’s worth reaching out for support.

Options for treatment include:

  • Antiperspirants with aluminum salts. If your regular antiperspirant doesn’t do much to curb your sweating, try an antiperspirant that contains a higher concentration of aluminum chloride — anywhere from 10 to 20 percent. You can apply these under your arms, of course, but you can also use them on your palms and the soles of your feet. A doctor or clinician can prescribe these antiperspirants when over-the-counter options aren’t strong enough.
  • Iontophoresis. This procedure delivers weak currents of electricity to your hands, feet, and underarms while you hold them underwater for up to 40 minutes. Experts believe this helps block the glands that produce sweat, but the effects are only temporary, so you may need regular sessions.
  • Topical or oral anticholinergics. These medications help block certain cell signals, including those that prompt your glands to produce sweat. A healthcare professional might prescribe oral oxybutynin or topical glycopyrrolate as an off-label treatment for sweating.
  • Botulinum toxin (Botox) injections. Like anticholinergics, Botox also helps prevent sweating by blocking the release of the neurotransmitter acetylcholine, which triggers sweat production. Treatment involves several injections, but the effects of Botox can last up to 2 years.

Learn more about treatments for excessive sweating.

Working with a therapist to address symptoms of anxiety (or any other mental health condition) can also make a difference. Treatment for anxiety generally includes therapy, medication, or a combination of the two.

If you experience anxiety because of sweating, treating the sweating will likely help ease these feelings. Still, it’s always a good idea to get support from a therapist for any persistent emotional or mental health symptoms, regardless of their direct cause.

A therapist can recommend treatment approaches to manage uncomfortable feelings around sweating. They can also offer tips for coping with distress, so you don’t feel the need to avoid social situations.

In search of quick tips to avoid getting sweaty in the first place? Here are a few ideas to consider.

Prepare with an antiperspirant

Using an antiperspirant regularly can help prevent sweating before it happens.

As noted above, it may be time to try a stronger antiperspirant if your regular brand doesn’t keep you dry. Follow the directions on the label to make sure you use it at the right time — applying it at night may yield better results.

Practice relaxation techniques

When you start to feel anxious, techniques that soothe and ground you can help calm racing worries and fears before they become overwhelming.

Not only do relaxation exercises help ease emotional distress, but they can also provide relief from physical symptoms, like sweating.

Options to try include:

  • progressive muscle relaxation
  • guided imagery
  • visualization
  • deep breathing exercises

Get more tips to help reduce anxiety naturally.

Take steps to stay cool

While anxious sweating doesn’t happen because you’re warm, feeling too hot could absolutely make matters worse. What’s more, if you’re overly warm, you might worry even more about sweating, which only feeds into the anxiety sweating loop.

You might try:

  • dressing in easily removable layers
  • sticking close to doors and windows
  • keeping a cold drink nearby
  • stepping outside for some fresh air

Find a positive distraction

Fixating on the source of your anxiety — from fears about sweating to anything else — generally only serves to intensify that worry.

It might not always feel easy, or even possible, to change the course of your thoughts. Still, making the effort to focus on something that inspires peaceful or positive feelings could have some benefit.

A few ideas:

  • Watch a favorite funny video.
  • Listen to a song that calms or energizes you.
  • Think about something great that happened recently, or an upcoming event you’re looking forward to.
  • Text a close friend or loved one.
  • Grab a favorite book and re-read a chapter or two.
  • Take a short walk.

When to reach out

In-the-moment coping tips often do make a difference, but they don’t replace professional support for anxiety.

A trained therapist can offer more guidance with identifying anxiety triggers and exploring helpful strategies for coping with unwanted thought patterns, sweating and other anxiety symptoms, and emotional distress that relates to excessive sweating.

Reaching out for support is a good next step when either anxiety or sweating begin to affect your:

  • daily routine
  • personal and professional relationships
  • ability to attend school or work
  • overall mood and quality of life
  • view of yourself

In search of online support? Our review of the best online therapy options can help you find the right fit.

Anxiety sweating is pretty common, but you can find ways to cope with it — and the distress it can cause.

Plenty of different treatments can help prevent excess sweating. Treating the sweating can, in turn, lower your chances of getting stuck in that sweat-anxiety-sweat cycle, or even experiencing depression related to sweating.

Keep in mind, too, that getting support for anxiety can help with all anxiety symptoms, including sweating — but it never hurts to consider addressing both anxiety and sweating at the same time.

Not sure where to start? A healthcare professional can help you explore your options for treatment.

Anxiety and Sweating: What’s the Connection?

Anxiety is a normal symptom in a physical threat situation, "whereby adrenaline is injected into the bloodstream and prepares one with the flight, fight, freeze reaction, this can often lead to physiological symptoms, including sweating,” says Monica Vermani, PsyD, clinical psychologist and author of A Deeper Wellness: Conquering Stress, Mood, Anxiety and Traumas.

When some people become overly anxious, they are not aware of their body’s reactions. “Anxiety can impact your heart rate, blood pressure, and temperature, all of which contribute to sweating,” says Seth Feuerstein, MD, JD, assistant clinical professor of psychiatry at Yale University.

Why Do I Sweat More When I’m Anxious?

Debbie Hampton, author of Beat Depression and Anxiety by Changing Your Brain, explains it in scientific terms.

“Anxiety can absolutely cause sweating. When anxiety strikes, a fear signal zips to an ancient part of your brain, causing the instinctual freezing or jumping out of your skin behavior, and speeds on to the hypothalamus, which controls your autonomic nervous system,” Hampton explains. “That’s the system that produces the classic bodily fear responses—thumping heart, skyrocketing blood pressure, sweating, and rapid breathing.”

The adrenal glands pump out adrenaline and “glucose is released into your bloodstream,” she adds. “[Adrenaline] gives you a big boost in case you need to get the heck out of there or fight for your life, and cortisol floods your system keeping you ready for action.

In other words, yes, anxiety and sweating go hand—or rather, sweaty palm—in hand!

Other Common Causes of Anxious Sweating

Everyone has their own personal list of anxiety triggers—stressful events or experiences that make them sweat more than usual.

Here’s a list of common stressors that can really amp up the sweat and make people feel more anxious than normal:

  • Public speaking. Addressing a group is a frightening experience for most people.

  • Trying to control the uncontrollable. For example, a traffic-filled daily commute with road-rage drivers at the wheel.

  • Social anxiety. Meeting new people can be overwhelming for some. If you aren’t a fan of making small talk with strangers, that’s fine. But in some cases—at work, for example—it’s pretty tough to avoid interacting with new people.

  • Rejection. Fearing rejection—in all types of relationships—can be an anxiety trigger. Handling rejecting by learning to “let it go” is easier for some than others.

  • Uncomfortable situations. If you hate confrontation, you may dread giving negative feedback like complaining to a customer service representative or disagreeing with a colleague or peer.

  • First impressions. When you are trying to impress someone—be it your boss, a colleague, a potential employer, or a person you’d like to date—making a good impression can get the sweat glands working overtime.

Where Does Anxious Sweating Occur?

Anxious sweating can occur just about anywhere on your body. The places where excessive anxiety sweating can be most embarrassing are when they are visible to others. Wet areas under your arms, on your hands and palms (in a handshake, for instance), or beads of sweat on your forehead or running down your face.

Some people even feel this sweat on their feet.

Becoming self-conscious or ruminating about it only exacerbates the problem and adds to your insecurity, which of course produces even more sweat.

Other Mental Health Conditions Cause Sweating, Too

Many mental health conditions are linked to sweating. Vermani says some of the most common include:

  • Social anxiety disorder

  • Panic disorder

  • Generalized anxiety disorder (GAD)

  • Obsessive-compulsive disorder (OCD)

  • Post-traumatic stress disorder (PTSD)

  • Specific phobias (fear of flying, anyone?)

“Your emotions are intricately expressed through your body. There is no separation,” explains Hampton. “Research suggests that people with hyperhidrosis—an excessive sweating condition—also seem to have higher-than-average rates of anxiety and depression. It’s important to understand that any emotion that activates a stress response could cause sweating, getting angry or becoming more stressed, for example.”

Does Anxiety Sweat Smell Different?

People often wonder if anxiety sweat has a different smell than regular sweat. “It can,” explains Dr. Feuerstein. “Much of this specific sweat can come from a set of glands that have ingredients that do not smell initially. But over time, as bacteria break them down, they can have an odor.”

Vermani agrees. “Stress-induced or anxiety-induced sweat can have a slightly different odor than when sweating from overheating. When you are stressed, the body is activated into a natural response to a perceived threat. This triggers a rush of adrenaline, cortisol, and other stress hormones which can make your sweat smell different. The scent may be subtly different in many cases, but some sufferers describe stress sweat as a stronger, more sulfur-like odor.”

Anxiety Sweat Treatment

Using a deodorant or an antiperspirant is a good first step in the battle against anxious sweating. But sometimes you need something a bit stronger.

Anti-anxiety pills can help reduce sweating caused by anxiety. Benzodiazepines (i.e., alprazolam or Xanax) can be prescribed for panic disorder, generalized anxiety disorder, and social anxiety disorder. Doctors may also recommend a beta-blocker like propranolol, or using tools like mindfulness or deep breathing to slow the nervous system.

For excessive sweating, Botox injected into the areas where sweating is a problem can block the nerves from communicating with sweat glands. While effective, Botox injections must be repeated every six months or so.

Expert Tips to Prevent Sweating from Anxiety

Vermani recommends this list of tried-and-true tips to her clients.

  • Pause and reflect: Focus on your breath to calm physiological symptoms when you are anxious to reduce the flow of sweating.

  • Cool down your body: Get some fresh air.

  • Hydrate: Balance your body's electrolytes with fluids.

  • Relax: Let go, surrender, and relax your body. Learn to accept that sweat is a normal physiological response to stress.

  • Dress strategically: Choose clothing that makes you comfortable and helps you sweat less and makes sweating less apparent. When possible, avoid synthetic fabrics like nylon and polyester, which don’t absorb sweat.

  • Manage sweat: Carry a handkerchief to control sweat, and use a prescription-strength antiperspirant.

  • Seek professional help: An anxiety medication can lower the incidences of anxiety and reduce incidents of sweating.

  • Work with a therapist: In therapy, you will learn to challenge negative self-talk, work on your self-esteem, and build confidence in feared and stressful situations.

Calming Your Anxious Brain

“It’s important not to completely dismiss and overlook your fears,” says Hampton. “They can be valid information that warrants further exploration. Reasonable concerns are in your best interest and can keep you from potentially dangerous situations. However, being consumed and paralyzed by fear is actually the opposite. The wear and tear anxiety puts on your mind and body undermines your health and safety. The goal is to manage and process your fear in a way that is good for you.”

Take a Deep Breath and Keep Moving Forward 

You never know when a stressful situation can lead to anxiety sweating. One minute you can be on top of the world, and then something happens to send you into a tailspin and feel out of control.

No matter what is taking place in your life, take a deep breath, relax, and keep moving forward.

Notes: This article was originally published August 16, 2022 and most recently updated August 31, 2022.

John Riddle

John is the author of 34 books, including several health and medical titles. His byline has appeared in major publications across the US, and he has written articles for over 200 websites.

Sweating under stress: how not to sweat when you're nervous

Stress and its symptoms

First date, job interview, big event or presentation - events in which we experience strong emotions such as anxiety and stress. Our body reacts to such situations with increased sweating. A sweaty face, palms, and wet sweat marks on clothes can make you feel awkward when you're trying to impress or want to appear calm and confident. nine0003

What causes sweat during stress?

There are two types of sweat glands: apocrine and eccrine. When we are stressed, the larger apocrine glands—mainly in the underarms and groin—produce more sweat.
Stressful situations can increase the heart rate, provoke the release of hormones and adrenaline, causing profuse sweating of the eccrine glands.

Does stress smell like sweat?

The sweat from the apocrine glands contains more nutrients, proteins and lipids than the sweat from the eccrine glands, which is mainly composed of salts and water. The nutrients make sweat from the apocrine glands a more attractive substrate for bacteria that naturally live on our skin and feed on sweat. The decay products of bacteria cause an unpleasant odor. As a result, stress sweat smells worse than exercise sweat. nine0003

Excessive sweating during stress. Anxiety symptoms

  • When you are nervous, excessive sweating and wet armpits can make you feel uncomfortable. Some people even avoid public speaking and work situations because they worry that they will be stressed, anxious, nervous, and sweating excessively. But there are ways to combat excessive sweating during stress:
  • Avoid spicy foods, nicotine and alcohol. Caffeine also increases adrenaline levels, making you more prone to sweating. nine0022
  • Wear clothes made of natural fabrics that allow the skin to breathe - cotton, linen, wool are the best materials.
  • Try a stronger antiperspirant like Rexona Clinical Protection. 3X more protection than base antiperspirant*. The unique Defense+ technology forms a microfilm on the surface of the skin, providing 96 hours of continuous protection against sweat and odor.
  • During the day or before a big event, renew protection by applying a small amount of antiperspirant under the arms to dry and clean skin. nine0022
  • Carry tissues with you to dry your skin or wet sweat marks on your clothes.
  • Avoid dehydration. If the body is dehydrated, the body will sweat even more to cool off.

Clinical protection / Defense + (clinical protection / Defense +) - protection against excessive sweating.

*3x more effective than base antiperspirant aerosol among Unilever products at protecting against sweat, 96h room test Unilever R&D, United Kingdom, 2018. Clinical Protection - Protection against excessive sweating. nine0003

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Excessive sweating - should it be treated and how?

Excessive sweating of the entire body or certain areas of it - this may be a completely natural reaction of the body to heat or stress. But if suddenly high sweating is observed in a cool room and in a calm emotional state, most likely this is already a disease called hyperhidrosis. What is this disease and how to deal with it we will tell in this article.

Hyperhidrosis is excessive sweating caused by a functional disorder of the sweating system. It manifests itself throughout the body or in a separate area. This disease can be aggravated by a negative emotional state - stress, excitement, or simply with increased physical exertion. nine0003

The disease has several degrees of severity. The first, mildest degree, a person does not recognize as a disease at all, and accordingly does not take any action aimed at treatment. High sweating is attributed to natural causes. Meanwhile, the disease progresses.

Severity of hyperhidrosis

I degree. Sweating is almost imperceptible and does not interfere with normal life.
II degree. It is characterized by increased sweating, which can cause some discomfort. II degree of hyperhidrosis is tolerated relatively easily. nine0011 III degree. High sweating causes serious inconvenience.
IV degree. Significantly interferes with a person's daily life, causes problems in communication, which entails psychological problems, nervousness, anxiety. There may be redness, swelling, pain in the affected areas of the body. A severe form of hyperhidrosis can cause a person to be unfit for work.

Therefore, do not take hyperhidrosis lightly, it is better to make an appointment with a dermatologist in advance and get expert advice. This can prevent serious complications in life. Even if sweating is not perceived as a disease, and even if it is, a consultation with a dermatologist will never be superfluous. nine0003

Causes of hyperhidrosis

Hyperhidrosis can be primary or secondary (generalized). The causes of primary hyperhidrosis are the individual characteristics of the organism. This may be a large number of sweat glands or high sensitivity to factors that cause sweating. Often this type of hyperhidrosis is hereditary.

Secondary hyperhidrosis may be due to certain diseases of the endocrine system, chronic infections (eg, tuberculosis, malaria), or disorders of the nervous system. nine0003

The real cause of excessive sweating can only be determined by a doctor after an examination and additional tests. But whatever the reason, modern methods of treating hyperhidrosis allow you to get rid of this unpleasant disease.

How to get rid of excessive sweating

Deodorant Antiperspirant
Protects against sweat odor by attacking odor-causing microorganisms. nine0108 Blocks the secretion of sweat by acting on the sweat glands.
Validity is limited to a few hours. Valid during the day
Can be used anywhere on the body Used in the underarm area.
Can be used multiple times throughout the day Used once a day. Recommended to use in the evening.
Not a drug - only a care product. nine0108 Can be used as a drug providing a therapeutic effect of one to several days.

However, although an antiperspirant can be regarded as a drug for hyperhidrosis, its effectiveness will be sufficient only for the first degree of severity of the disease. More severe cases may require other treatments.

Intradermal injections of botulinum toxin

This is an effective and popular method for the treatment of local hyperhidrosis without significant adverse reactions, in the absence of an effect on external therapy. The effect of the procedure is based on the long-term gentle blocking of nerve impulses to the sweat glands by botulinum toxin, which reduces sweating to a minimum. nine0003

Indications for the procedure are axillary, palmar, plantar hyperhidrosis, as well as excessive sweating in the face, lower back, buttocks, inguinal folds, etc.

Learn more