Sweaty Face and Head

Do beads of sweat pour over your forehead while you're sitting at your desk? Do perspiration rivulets run down your temples during a movie? Has streaming facial sweat gotten in the way of spending time with your family?

If you answered yes to any of these questions, you may suffer from craniofacial hyperhidrosis, or excessive sweating of the face, head, or scalp.

Facial sweating is a common problem and often more irritating and embarrassing than other types of excessive sweating. Even people who sweat heavily in other areas of their body may find that it's their facial sweating that bothers them the most. That's because our faces are how we present ourselves to the rest of the world, and we cannot hide the effects of excessive sweating.

From a diagnostic standpoint, it can be difficult to find the fine line between heavy sweating as a reaction to heat, stress, or exercise and true primary hyperhidrosis of the face and scalp. But regardless of why a person's face sweats excessively — the treatments are the same if it is primary hyperhidrosis.

First, an assessment should be made as to whether a medical condition (other than hyperhidrosis) or medications are the root cause of the excessive facial sweating, which is called secondary hyperhidrosis. It is important to investigate and address underlying causes of the excessive sweating as it may be serious. Read our full discussion of secondary hyperhidrosis here on SweatHelp.org.

If the sweating is found to be independent of other medical conditions or medications, it is said to be primary hyperhidrosis and the treatment plan is similar to that of other types of excessive sweating. Products used on the affected skin (often called topical solutions) should be tried first. These may include common over-the-counter antiperspirants containing aluminum chloride and prescription-strength antiperspirants containing aluminum chloride hexahydrate. Of course, as with other parts of the body, strong antiperspirant products can be irritating to the skin of the face, head, or scalp and so may not be a good long-term solution.

If topical antiperspirant solutions don't work or are too irritating, onabotulinumtoxinA (commonly known as Botox brand) injections may be recommended. Botox injections work well on the head and face but the injection technique requires skill so patients should seek an experienced practitioner. A potential side effect of Botox injections in the face as a treatment for sweating is asymmetry, particularly of the forehead. This can happen if some of the Botox diffuses into the facial muscles. Such asymmetry, however, is always temporary and can, if necessary, be balanced-out by additional Botox injections.

Every once in a while, systemic medications (prescription medicines taken by mouth called anticholinergics) may be used to treat cranial/facial sweating. But because of their side effects, including dry mouth, blurry vision, and constipation, systemic medications aren't usually a good long-term treatment. They may, however, be useful for those people who want to temporarily treat their facial sweating in order to prevent discomfort or embarrassment at an important event, such as a critical presentation at work, wedding, graduation, or dramatic performance.

If you're living with excessive and embarrassing head, scalp, or facial sweating, isn't it time to head off the problem? From antiperspirant products to Botox injections, there are ways to treat head and facial sweating so you can always put your best face forward. Talk to your dermatologist.