Sweating Doctor / Hyperhidrosis Specialist: Who & How to Find?

General Practitioner: Specialist in Excessive Sweating?

In many countries, for reimbursement purposes, you often need to consult your primary care physician (often a general practitioner) first for any health issue. Hyperhidrosis is one of the conditions covered during medical training.

General Practitioner Habilities

Your general practitioner should theoretically be able to provide you with effective information. They should be able to:

• Diagnose hyperhidrosis, the affected areas.
• Identify whether it’s primary or secondary hyperhidrosis (usually, additional tests are not necessary).
• Work with you to find possible causes of your excessive sweating.
• Inquire about how hyperhidrosis affects your personal and professional life.
• Discuss the benefits of hyperhidrosis treatments in your case.
• Refer you to a more specialized doctor if necessary or to a healthcare professional experienced in the therapeutic option you have chosen (iontophoresis, botox, Miradry, etc.).
• Prescribe oxybutynin (Ditropan) for sweating if it turns out that this medication is appropriate for your case.

Some general practitioners may tend to downplay the intensity of your hyperhidrosis:

“Oh, but it’s normal; everyone sweats!”

A doctor who downplays hyperhidrosis.

Insatisfaction with your general practioner

What should you do if there is a significant gap between your expectations and what your doctor suggests? Here are some suggestions:

☑️ Educate yourself through websites about hyperhidrosis (as you are doing right now!);

☑️ Consult another general practitioner or specialist (especially a dermatologist, endocrinologist, or thoraco-vascular surgeon);

☑️ Join a social media community of hyperhidrosis patients;

☑️ If you are proficient in English, join the International Hyperhidrosis Society.

General practitioners, even if they are not specialists in hyperhidrosis, are trained in its diagnosis and management.

Are dermatologists truly specialists in excessive sweating?

Dermatologists are the medical specialists in skin conditions. They are the healthcare professionals most likely to be knowledgeable about hyperhidrosis.

Like general practitioners, they can diagnose your hyperhidrosis and its causes, rule out secondary hyperhidrosis, and evaluate with you the risk-benefit balance of various hyperhidrosis treatments.

They may also, depending on their equipment and training:

• Perform botulinum toxin injections to reduce sweating.
• Conduct iontophoresis sessions.
• Offer the use of Miradry for underarm sweating.
• Less commonly, suggest other treatments such as radiofrequency.

However, from my experience working with hyperhidrosis patients, dermatologists can sometimes downplay the potentially very negative impact of hyperhidrosis on daily life.

🔗 See this article for more information on finding a dermatologist who specializes in hyperhidrosis (coming soon in English).

Dermatologists are the doctors most likely to be specialists in hyperhidrosis.

When to See Another Specialist for Excessive Sweating?

Sometimes (it’s rare, less than 10% of cases), hyperhidrosis is considered secondary. This means it is caused by another underlying condition.

In such cases, you may be referred to see another specialist doctor, such as an endocrinologist, neurologist, or another relevant specialist. These specialists will perform additional tests to confirm the diagnosis of secondary hyperhidrosis.

Endocrinologist for hyperhidrosis

Endocrinologists are specialists in hormones. They will conduct specific tests to determine whether your excessive sweating is related to an underlying hormonal condition. Treatment for this condition can be prescribed and indirectly reduce your excessive sweating.

The primary hormonal conditions that can trigger secondary hyperhidrosis include:

• Diabetes.
• Hyperthyroidism.
• Hyperpituitarism.

Neurologist or internist doctor

Neurologists and specialists in peripheral arterial, venous, lymphatic, and microcirculation diseases or internal medicine may also sometimes assist in diagnosing secondary hyperhidrosis.

In less than 10% of cases, hyperhidrosis is of secondary origin. In such cases, consultation with a specialist doctor (endocrinologist, neurologist, internal medicine) may be recommended.

Thoracic Surgeons and Excessive Sweating

Thoracic vascular surgeons are the ones who perform sympathectomies, operations against excessive sweating of the armpits, hands, feet, and even the face.

Sympathectomy carries the risk of significant side effects, such as compensatory hyperhidrosis.

This is why these surgeons are often consulted as a last resort.

ℹ️ To find a surgeon performing sympathectomy in your area, call the nearest hospitals (university or non-university) and clinics, inquiring whether sympathectomy is performed there.

Thoracic vascular surgeons are the ones who perform sympathectomy, the last-resort treatment for hyperhidrosis.

Physiotherapists and Podiatrists for Sweating

Physiotherapists and podiatrists are among the healthcare professionals who may have iontophoresis devices.

You can visit them for iontophoresis sessions.

Iontophoresis must be done regularly and over the long term for the effect to last. You may prefer to eventually consider buying an iontophoresis device or renting one, although the purchase of iontophoresis is not reimbursed by Health Insurance.

Physiotherapists and podiatrists can provide iontophoresis sessions but may not necessarily have an overview of hyperhidrosis and treatment alternatives.

Doctors and Aesthetic Surgeons Specializing in Excessive Sweating?

Doctors and surgeons specialized in aesthetic medicine and surgery can also consult with people with hyperhidrosis. They may offer treatments similar to those provided by dermatologists (Miradry, botulinum toxin injections, etc.).

⚠️ Check in advance if the doctor you are consulting:

• Charges additional fees, which may not be reimbursed by your insurance. This is likely the case.
• Performs non-conventional/non-contracted procedures. This means that these procedures are not covered by social security.The cost of Miradry sessions is high.

Doctors and aesthetic surgeons perform procedures similar to dermatologists for hyperhidrosis.

Psychologists Specializing in Excessive Sweating?

Cognitive-behavioral therapy (CBT) and, less commonly, biofeedback are sometimes suggested therapies for hyperhidrosis.

In theory, it is reasonable to think that they can have a positive impact on hyperhidrosis, especially by addressing stress.

However, no studies have been conducted to evaluate their effectiveness specifically in people with hyperhidrosis.

If you still want to try them, you can consult:

• A psychiatrist.
• A psychologist.

Psychotherapists may sometimes also practice these techniques. However, since the title is not protected, anyone can potentially call themselves a psychotherapist. Additionally, sessions conducted with psychotherapists are often not reimbursed by social security and insurance.

Psychiatrists and psychologists may sometimes offer CBT or biofeedback sessions for hyperhidrosis. Their effectiveness has not been evaluated in clinical studies.

Finding a Specialist for Sweating

I hope this article has provided you with some guidance to help you find the doctor or healthcare professional most likely to meet your expectations for the diagnosis, treatment, and support of your hyperhidrosis.

Here are some additional tips for finding a specialist in sweating near you:

• Type keywords into Google such as:
  • hyperhidrosis doctors near me
  • doctors who treat hyperhidrosis near me
  • doctor for excessive sweating
  • hyperhidrosis surgeons near me
  • hyperhidrosis dr
  • hyperhidrosis specialist near me
  • sweat clinic near me
  • underarm dermatologist
  • sweat doctor near me
• Go to Google Maps and also enter similar keywords:
• Visit the website of the international association dedicated to hyperhidrosis, Sweat-Help, which lists professionals within their network.

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Do you have any comments or questions? Your comments are welcome 🙂 !

You may also like:

• My blog on hyperhidrosis

 📚 SOURCES

Walling HW. Clinical differentiation of primary from secondary hyperhidrosis. J Am Acad Dermatol. 2011 Apr;64(4):690-5. doi: 10.1016/j.jaad.2010.03.013. Epub 2011 Feb 18. PMID: 21334095. & Paisley A N, Buckler H M. Investigating secondary hyperhidrosis. BMJ 2010; 341 :c4475 doi:10.1136/bmj.c4475

Shenefelt PD. Biofeedback, cognitive-behavioral methods, and hypnosis in dermatology: is it all in your mind? Dermatol Ther. 2003;16(2):114-22. doi: 10.1046/j.1529-8019.2003.01620.x. PMID: 12919113.