How psychosomatic sweats

Excessive (profuse) sweating

Sweating is a natural and vital process to protect the human body from overheating. Accordingly, it is quite normal if, for example, more sweat than usual is produced during physical activity or high temperatures. However, if the amount is greater than the body needs for thermoregulation, doctors refer to this as excessive sweating (hyperhidrosis). This can occur only in one part of the body (locally) or affect the whole body (generalized hyperhidrosis).

Various triggers can be considered for the increased perspiration. Often there is idiopathic or primary hyperhidrosis without an identifiable cause, and the increased amount of sweat can also be a symptom of a disease such as an infection, hyperthyroidism or diabetes. This usually results in massive restrictions, as "normal" everyday things such as shaking hands or wearing certain clothes are hardly possible. But there are some procedures and approaches to alleviate the symptoms and thereby help those affected to regain a better quality of life.

Definition: Excessive sweating

The term "hyperhidrosis" describes excessive sweating, which occurs mainly on the hands (sweaty hands, hyperidrosis manuum), feet (sweaty feet, hyerhidrosis pedis) and under the armpits (hyperhidrosis axillaris). Heavy sweat attacks often occur, especially at night, with the entire body and, to a greater extent, the perineum affected. In addition, there is often itching (pruritus) and skin inflammation, and the sweat is sometimes foul-smelling. There is no dependency on the outside temperature.

Sweating is usually a completely natural and important process, because it helps the body regulate temperature by causing water to evaporate on the body's surface, thereby removing heat from the skin. At the same time, unneeded or harmful substances are excreted with the water. In this respect, sweating is an important drainage and detoxification function for the body. The amount of sweat that is produced for cooling can vary from person to person. For the medical assessment of hyperhidrosis, therefore, it is not a certain limit value that is decisive, but rather whether there is a disorder of the sweat glands.

Causes of profuse sweating

In most cases, excessive sweating is associated with disorders of the autonomic nervous system (vegetative dystonia). In addition to hyperhidrosis, there is then nervousness or inner restlessness, psychological and nervous overload and disorders in the sexual area. In addition, there are unstable circulatory conditions, circulatory disorders and anemia (anemia). A connection with menstrual disorders can be observed in women. Psychological disorders such as anxiety disorders with and without panic attacks as well as some organic diseases that cause profuse sweating are also possible.

Organic diseases that can occur with increased sweating are diseases of the nervous system such as Parkinson's, circulatory disorders, myocardial infarction, liver diseases (hepatitis, liver cirrhosis), kidney diseases (nephritis, nephrolithiasis, shrunken kidneys, wandering kidneys), chronic bronchitis, pulmonary tuberculosis, rheumatoid arthritis, infectious diseases of Graves' disease Hyperthyroidism, rickets, tumors of the spinal cord and inflammation of the spinal cord (myelitis). The use of certain medications (e.g. neuroleptics, salicylic acid) can also be the cause.

Excessive sweating while exercising

Increased sweat production can therefore have very different causes. Excessive sweating is a harmless and natural process when the body temperature increases, e.g. due to warm temperatures, physical exertion (e.g. carrying heavy loads, sports) or clothes that are too warm. In this case, sweating helps to balance out temperature differences and to conduct excessive heat from the inside of the body to the outside. If more energy than usual is consumed during sport or physically difficult work and the body warms up as a result, the excess heat is released again to prevent overheating.

How fast or how heavily someone sweats during physical exertion can vary greatly. Accordingly, the water runs down the body when people warm up, in other cases it takes a long time before the sweat glands start to work. In addition, individual perspiration is influenced by various factors such as stress, hormonal changes (pregnancy, menopause, etc.), diet or body weight, which can change sweating behavior at any time.

Profuse sweating under armpits

If strong sweating attacks occur regularly in certain places, it is usually a so-called "idiopathic" or "primary hyperhidrosis", which occurs without any recognizable cause. Those affected often sweat heavily under the armpits or on the forehead and head, and constantly wet or damp hands and soles are typical. In pronounced cases, the sweat runs "freely" during the outbreaks, but the problem rarely occurs at night. Since the skin on the affected parts of the body softens quickly due to the constant moisture, the risk of fungal infections increases. In most cases, the pronounced perspiration has a massive effect on everyday life, e.g. by avoiding shaking hands or constantly being afraid that others will discover the large patches of sweat under the arms. As a result, many sufferers withdraw more and more, which often intensifies fears and creates depressive moods.

In idiopathic hyperhidrosis, the sweat glands produce more sweat than necessary, although the cause is unknown. Genetic factors play an important role. In addition, experts often suspect that this disorder is due to an overactivity of the sympathetic nervous system and the neurotransmitter acetylcholine, which stimulates the sweat glands. In many cases, minimal or “harmless” stimuli such as being with other people or a stressful situation at work are sufficient for the sweat to break out suddenly with this form of hyperhidrosis. In other affected persons, recognizable triggers are completely absent, so that perspiration seems to be stimulated "out of nowhere".

Excessive sweating all over the body

If those affected sweat profusely on the head and whole body, what is known as "secondary hyperhidrosis" is usually present. In this case, perspiration occurs as a result of or accompanied by a physical change or stress or another illness. For example, an imbalance in the hormonal balance such as during menopause (climacteric) or during pregnancy, obesity (overweight) or excessive alcohol consumption come into question. Stress or emotional stress can also be the trigger for secondary hyperhidrosis. Sweating is a natural body reaction to excitement or nervousness, but if there is permanent nervous tension or psychological pressure, this often occurs in an uncontrollable manner and to a greater extent. In this case, those affected often suffer from other complaints such as insomnia, tiredness, severe internal restlessness, nervousness, cardiovascular complaints or dizziness.

In addition to this, there are hormonal and metabolic diseases such as an overactive thyroid or chronic inflammation of the thyroid gland ("Hashimoto's thyroiditis"), infectious diseases (e.g. pneumonia, flu), neurological diseases (e.g. Parkinson's disease) or metabolic diseases such as diabetes mellitus ("sugar") ) as the cause. Excessive sweating can also be a "side effect" ("secondary" = Latin: "second") of various tumor diseases (e.g. pheochromocytoma, insulinoma), nerve damage (cerebral infarction, cerebral hemorrhage, spinal cord damage, etc.) or psychiatric disorders such as anxiety, Neurosis or depression occur.

In addition to this, increased perspiration can also be an undesirable side effect of certain medications. Here, for example, cortisone, thyroid drugs or some cancer drugs come into question, as well as drugs that stimulate blood flow, so-called "parasympathomimetics" (e.g. for glaucoma, intestinal problems, dry mouth) or drugs that affect the central nervous system in the brain. These include antidepressants, strong pain relievers (opioids) and some neuroleptics, which are used in psychoses and states of excitement.

Cold sweats

If cold sweat suddenly and suddenly occurs, e.g. on the forehead or even all over the body, this can indicate an acute emergency such as a heart attack. Typically, severe chest pain behind the sternum occurs here, which often also radiates into the arms (increasingly on the left), shoulders, the lower jaw or the upper abdomen. In addition, there are other symptoms such as tightness and strong pressure in the chest, nausea and vomiting, abdominal pain, dizziness and paleness. Those affected often report shortness of breath, fear of death and extreme restlessness. A sudden cold sweat often occurs during a stroke as well. Other typical symptoms here are, for example, paralysis on one side and numbness, speech and comprehension disorders, visual disturbances, dizziness and very severe headaches. If there is only the slightest suspicion of a heart attack or stroke, the emergency number 112 should be dialed as soon as possible, because these are acute emergencies that can be fatal if delayed.

Heavy night sweats

If excessive sweating occurs at night or during sleep ("nighttime hyperhidrosis"), various causes can also be considered. In many cases, however, it is a normal and harmless reaction of the body to certain external influences such as warm air in the bedroom or a blanket that is too thick. In addition to this, the consumption of spicy or heavy, fatty foods shortly before going to sleep can also stimulate the production of sweat, as can nicotine or the previous consumption of alcohol or certain drugs (speed, ecstasy, etc.).

Especially when people very often suffer from night sweats and / or the amount of sweat is extremely large, various diseases can also be the cause. Often it is a question of hormonal disorders such as a thyroid malfunction or metabolic diseases such as diabetes, and an infectious disease (flu, tuberculosis, HIV, etc.) or an inflammation of the inner lining of the heart can be the reason for the uncomfortably strong perspiration at night. Certain cancer (e.g. leukemia, Hodgkin's disease) and autoimmune diseases (e.g. rheumatoid arthritis) as well as neurological diseases such as Parkinson's disease are also possible, and some people who have had a stroke experience increased (one-sided) night sweats.

Often the psyche also plays an important role in heavy sweating attacks at night. Because if there is a high degree of stress and emotional exhaustion, those affected often do not come to rest at night, but instead are caught up with their worries and thoughts and toss and turn restlessly. If the stress is not reduced accordingly and the body is instead kept under permanent tension, the release of stress hormones increases accordingly and thus the burden or overload of body and psyche. In addition to sleeping problems and night sweat attacks, this can lead to various symptoms, typical are headache and stomach ache, digestive problems, chronic fatigue, nervousness and severe irritation.

If the emotional conflicts are resolved or the psychological tension is reduced accordingly, the stress-related heavy night sweats usually go away again. In some cases, however, fears are also due to illness and are accordingly so pronounced that they limit the lives of those affected to the greatest extent. This can be, for example, a pronounced fear of exams or a heart neurosis; fears often arise in connection with other mental illnesses such as eating disorders, depression or psychoses. Accordingly, the fear can express itself in very different ways and intensities, e.g. in the form of a steadily increasing inner restlessness or through a regular, sudden panic attack. In addition to (nocturnal) sweats, massive physical symptoms such as palpitations, breathing difficulties, dizziness and tremors and, in more serious cases, hyperventilation, cramps or fainting occur.
If those affected regularly take certain medications such as antidepressants, antihypertensive agents or hormone preparations, the nightly heavy sweating can also be a side effect of these. Often there is also a connection with hormonal changes such as during pregnancy or menopause, whereby the symptoms here usually only appear temporarily.

Treatment for excessive sweat production

If there is secondary hyperhidrosis, the therapy is carried out, if possible, depending on the underlying disease (high blood pressure, cardiac arrhythmias, cancer, hyperthyroidism, etc.). If the causal therapy cannot adequately eliminate the excessive sweating, various other, both conservative (non-operative) and surgically operative treatment methods are available. The same applies if the problem is idiopathic or primary without an identifiable cause. For example, injections of the nerve toxin botulinum toxin A (e.g. in the skin under the armpit), which blocks the nerve conduction and thus almost completely stops sweat production for a long time, are possible. Antiperspirants such as the active ingredient aluminum chloride are also often used to regulate sweat production. If these do not have an adequate effect and / or if the whole body is affected by the strong perspiration, the doctor can also prescribe medication with the active ingredient anticholinergic. However, these are only effective to a limited extent and can instead quickly cause undesirable side effects such as headaches or intestinal and stomach problems.

If the increased perspiration mainly affects the hands and feet, so-called "iontophoresis" can still be used, in which weak, continuous direct current is passed through the affected areas of the skin with the help of water baths or sponges. If conservative treatment methods are unsuccessful, surgical therapy can also be useful for hyperhidrosis to alleviate the symptoms. Here, for example, increased armpit sweat can be stopped by removing the sweat glands (sweat gland excision). If the armpits, hands or face are particularly affected, a so-called “endoscopic transthoracic sympathectomy” (ETS) can also be used. This cuts through certain nerves in the chest area, which are normally responsible for stimulating the sweat glands. As a result, sweating is prevented in the corresponding areas of the body, but in many patients this occurs in other places after the procedure (compensatory sweating).

Naturopathy for hyperhidrosis

As an alternative to conventional medical approaches, homeopathic medicines are increasingly being used in cases of increased sweat production without an organic cause. These consist in many cases of plant-based basic substances, which regulate the activity of the sweat glands and thereby reduce unpleasant sweating. Another advantage is that they are generally well tolerated, which means that, unlike conventional medicines, homeopathic remedies can usually be taken over a longer period of time without any problems. Among other things, Salvia officinalis (real sage), which generally restricts the activity of the sweat glands, is recommended here. If the sweat attacks are hormonal (e.g. due to menopause) or a symptom of an existing underlying disease (e.g. hyperthyroidism), Jaborandi (Ruta herb) can help.

If the heavy sweating occurs mainly on certain parts of the body (e.g. on the hands, armpits) or mainly at certain times (e.g. at night), Calcium carbonicum Hahnemanni has proven itself in many cases.Boletus laricis (boletus) can also help with strong perspiration (especially at night), as can Mercurius solubilis and Acidum sulfuricum. However, the selection of the globules should not be done on your own, but instead be made by an experienced homeopath or naturopathic doctor. This is because the doctor first gets a precise picture of his patient before deciding which remedy in which potency best corresponds to the symptoms and the constitution of the person concerned.

Certain hydrotherapy procedures according to Pastor Sebastian Kneipp are also suitable for increased perspiration. Here, for example, cold and warm showers or compresses with cold water come into question, which are changed every five minutes. Alternatively, the pads can also be made from oak bark, mallow or (cold) black tea. The traditional medicinal plant sage is particularly suitable for internal and external use (e.g. washing, rinsing, baths), as it has both antiperspirant and astringent (astringent) and disinfectant effects. A tried and tested home remedy for internal use is a tea, for example. For this, one to two teaspoons of sage are scalded with hot water and strained after five to ten minutes. If you sweat heavily, the tea is drunk three to four times a day for four weeks, for example.

In addition, oak bark, magic shrub (Hamamelis virginiana) and walnut leaves come into consideration from the field of herbal medicine due to their astringent effect. Acupuncture can also be helpful in the case of increased perspiration, as can aromatherapy applications. Various essential oils such as sage, chamomile, willow or hyssop come into question here, which can help, for example, as an additive in baths or skin creams, to bring body, soul and spirit back into harmony.

If the excessive sweating can be traced back to certain lifestyle habits, consistent changes should be made here. This means, for example, reducing obesity and changing one's diet, especially avoiding "sweat drivers" such as spicy food, coffee and alcohol. In addition, it is recommended to wear air-permeable clothing, regular physical activity and appropriate hygiene. If you have sweaty feet, you should always wear leather shoes or leather soles as well as sandals in warm weather. It is advisable to walk barefoot as often as possible to normalize the functioning of the sweat glands.

Since excessive perspiration is often closely linked to increased stress and inner tension, relaxation exercises are very helpful in many cases to reduce stress. Yoga, autogenic training or progressive muscle relaxation can help to strengthen the inner core and thereby regulate sweat production. In the case of deep-seated conflicts or serious, stressful problems that “depress” the person concerned, psychological counseling or therapy can also be very helpful and relieving. One possible approach here is to visualize your own behavior first, e.g. by documenting on a daily basis when or in which situations the strong sweating attacks occur. Subsequently, those affected learn, e.g. as part of cognitive behavior therapy, how they can use breathing techniques or similar to strengthen their inner balance and reduce fears and insecurities. (No)

Author and source information

This text complies with the requirements of specialist medical literature, medical guidelines and current studies and has been checked by medical professionals.

Dipl. Social Science Nina Reese
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  • Berthold Rzany et al .: Update of the S1 guideline for the definition and therapy of primary hyperhidrosis, German Dermatological Society, (accessed September 18, 2019), AWMF
  • Tanja Schlereth: Hyperhidrosis - Causes and Therapy of Excessive Sweating, Dtsch Arztebl Int 2009; 106 (3): 32-7; DOI: 10.3238 / arztebl.2009.0032, (accessed September 18, 2019), aerzteblatt
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Important NOTE:
This article is for general guidance only and is not intended to be used for self-diagnosis or self-treatment. He can not substitute a visit at the doctor.

ICD codes for this disease: R61ICD codes are internationally valid codes for medical diagnoses. They can be found, for example, in doctor's letters or on certificates of incapacity for work.