Localised sweating is usually a treatable nuisance. Sweating all over, or drenching night sweats, is a different question.
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Sweating is normal and necessary. What brings people to a doctor is sweating that is out of proportion to temperature or activity, or that has changed.
The most useful distinction is between localised and generalised sweating.
Localised sweating — confined to the armpits, palms, soles or face — is usually primary hyperhidrosis. It is a genuine condition, it is not caused by anything else, and it is treatable, often more effectively than people expect.
Generalised sweating — all over, or waking you drenched at night — is more likely to reflect something systemic, and that is where the assessment focuses.
Most people never get past ordinary antiperspirant, and the aluminium chloride step alone transforms it for many.
Do not stop it — raise it. Sweating is a recognised effect, dose reduction or a switch often resolves it, and stopping abruptly causes discontinuation symptoms.
Thyroid function, full blood count, inflammatory markers, HbA1c, liver function and, in men, testosterone.
Where menopause is likely, the diagnosis over 45 is clinical and does not require blood tests.
We cannot feel for enlarged glands or an enlarged spleen, or examine the thyroid. Where drenching night sweats occur with weight loss or lumps, that examination matters and we will arrange to have it done.
For localised hyperhidrosis, remote assessment works well — the history is diagnostic and the treatment ladder is straightforward.
When they are drenching — soaking sheets or nightclothes — over several weeks, and particularly with weight loss, fever or persistent swollen glands. Feeling warm at night is common and not the same thing.
Yes, and better than most people realise. Aluminium chloride antiperspirant, iontophoresis, prescription tablets and botulinum toxin form a genuine ladder. Most people have only tried ordinary deodorant.
Almost always because it went on damp skin. Aluminium chloride must be applied to completely dry skin at bedtime and washed off in the morning. That change alone makes it tolerable.
Very likely if you take an SSRI or venlafaxine — sweating is a well-recognised effect. Raise it rather than stopping the tablet; a dose change or switch usually helps.
Quite possibly, if you are in your forties or fifties. Over 45 the diagnosis is clinical and needs no blood test. HRT is highly effective for flushes and night sweats.
Worth checking, particularly with weight loss, tremor, palpitations or heat intolerance. It is a simple blood test and an easily treatable cause.
That is primary palmar hyperhidrosis, and it is treatable. Iontophoresis is particularly effective for hands, and the impact on work and daily life is a legitimate reason to pursue treatment properly.
Clinically reviewed by Dr Mohammad Zubair Khan, GMC 7563469
Last reviewed
August 30, 2026
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It means the diagnosis can usually be made from your history and photographs, and that treatment can be arranged safely without examining you. Where a condition is not marked treatable online, it is because examination is the diagnosis — listening to a chest, feeling an abdomen, examining an ear or a joint — or because a procedure or device is needed.
Yes, where there is a genuine bacterial infection — cellulitis, impetigo, bacterial urine infections, confirmed strep throat. We will also frequently tell you that you do not need one. Most sore throats, coughs, colds and earaches are viral, and an antibiotic gives you the side effects with none of the benefit.
If your problem turns out to be genuinely outside what we can do remotely, the doctor will tell you straight away, point you to the right service, and refund your fee in full. We would rather do that than fill twenty minutes to justify the charge.
Call 999 or go to A&E — do not book an online appointment and do not wait for a reply to an email. For urgent problems that are not emergencies, NHS 111 is available 24 hours a day, online or by phone, and can direct you to the right service.
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