Artboard 5SOCIAL acadStop the Drip: How to Treat Excessive Face and Head Sweating

Wet hair, smudged makeup, constant forehead-wiping, embarrassment, and stress… 

These are some of the challenges faced by people with craniofacial hyperhidrosis (Hh), also known as excessive sweating of the face, head or scalp. 

We hear from many people living with craniofacial sweating about how hard it is to face the world—wanting to put their best face forward, yet coping with a face dripping with sweat.  

Craniofacial sweating, despite not being talked about very much, is common. A recent study found that 50% of people with excessive sweating experience craniofacial sweating - either alone (4.6%) or in combination with excessive sweating of other body areas (46%). That means approximately 192 million people worldwide have excessive facial, scalp or head sweating. 

Many people who sweat heavily from multiple places say that it's facial or head sweating that bothers them the most. That’s because craniofacial sweating can be very obvious -- leading to issues at work and in social settings where sweating is often stigmatized and linked to wrongful assumptions that a sweaty person is unhealthy, lying, nervous, unprepared, or “on drugs.”

If you're living with excessive craniofacial sweating, we hope the following information can help you to head off the problem. From antiperspirants to botulinum toxin injections to oral medications (and combinations of these), there are many ways to treat head and face sweating so you can always put your best face forward. 

Here’s how to find the relief you need…

See a Medical Professional for Craniofacial Excessive Sweating

The first step for anyone with excessive sweating is to see a healthcare provider for a check-up to make sure that excessive sweating is not due to another medical condition or a side effect of a medication. When extreme sweating is caused by a separate medical condition or a medication, it's called secondary generalized hyperhidrosis. Secondary generalized hyperhidrosis can signify a more serious health problem and so should always be considered and addressed, as necessary.  To find a hyperhidrosis-aware provider, use our Clinician Finder. Clinicians who have attended at least one of our training seminars will have the “IHhS Educated” designation, meaning they are up-to-date on optimal practices for hyperhidrosis care.

Discover Craniofacial Hh Treatment Options

If your medical provider determines that your extreme head or face sweating is stand-alone or “idiopathic”—meaning it is not secondary generalized hyperhidrosis—your treatment plan will be similar to that used for other body areas with excessive sweating.

  • Topical Antiperspirants

Products used on the skin (topical solutions) will likely be recommended first. These may include over-the-counter and prescription-strength antiperspirants. Of course, be careful with strong antiperspirant products on sensitive facial skin and follow your doctor’s directions for use. Also, do your own reading to learn how antiperspirants work so you can use them effectively and limit irritation. A good rule of thumb is to try any new skin product on a small area initially, to see how you react. To help prevent skin irritation, apply antiperspirants to completely dry skin—using a towel or a blow dryer on a cool setting to achieve dryness—and consider applying just along the hairline. Use caution and avoid getting antiperspirants in your eyes. 

  • Botulinum Toxin Injections

    If topical antiperspirant solutions don't work or are too irritating, botulinum toxin injections (commonly known by the brand name Botox) may be recommended. 

Botulinum toxin injections work well on the head and face, but the injection technique requires skill so see an experienced practitioner, when possible. A potential side effect of injections in the face can be asymmetry or stiffness, particularly of the forehead. This is temporary and can usually be balanced out with additional botulinum toxin injections. 

In research, botulinum toxin has been shown to be an effective and safe treatment for facial hyperhidrosis, with sweat being significantly reduced 4 weeks after treatment. The effect lasted at least 5 months in 90% of patients. All of the patients in the study said the treatment was very effective. 

Similarly, in another study, the effect of botulinum toxin was studied on 12 patients with head/face hyperhidrosis. After 1-7 days, craniofacial sweating completely stopped in 11 patients and was reduced in the remaining patient. Effects lasted 9 months to 27 months. 

Additional data shows that botulinum toxin provides “a remarkable antiperspirant effect” for head and forehead sweating starting 2 weeks after treatment and lasting for approximately 30 weeks. 

And, a recent review of 8 medical studies concluded that botulinum toxin shows “consistent effectiveness" in treating craniofacial hyperhidrosis with minimal side effects.  

- Topical Anticholinergics

A newer potential treatment option for head and face sweating is topical glycopyrrolate. While this prescription product is FDA-approved only for underarm excessive sweating, some healthcare professionals may prescribe it off-label for the head/face. If you are prescribed topical glycopyrrolate, follow your clinician’s application instructions carefully—and take extra care to avoid getting the medication in the eyes, as it can cause serious irritation or other problems.

 

In  2022, researchers compared topical glycopyrrolate and botulinum toxin injections for facial hyperhidrosis and found that both treatments showed a “complete response” in 75% of patients. Side effects with both treatments were minor and temporary. One difference was that botulinum toxin takes about 2 weeks to start working while topical glycopyrrolate starts working more quickly. Botulinum toxin injections, however, last for months while glycopyrrolate must be reapplied daily or near-daily. 

In a review of “the best clinical evidence” regarding craniofacial Hh management,  experts report that topical glycopyrrolate, botulinum toxin injections, and oral oxybutynin (an oral systemic medication, discussed below) can each be considered “first-line therapies” for head/face sweating due to their effectiveness and safety. 

  • Oral Medications

    As mentioned above, oral systemic medications (prescription medicines taken by mouth, usually anticholinergics) are also used to treat facial sweating. Side effects, including dry mouth, blurry vision and constipation can occur but often are managed by drinking water frequently, using doctor-recommended oral rinses, applying eye drops, adjusting diet, or asking your medical provider to lower daily doses. 

Another type of oral medication called clonidine can also be useful in treating craniofacial sweating and is often recommended by one of our IHhS founders and physician experts. Clonidine is part of a class of medications called centrally acting alpha-agonist hypotensive agents. If taking clonidine, follow your prescribed regimen carefully to avoid severe changes in blood pressure.

Finally, the medicine propranolol can be an option when people want to temporarily treat their facial sweating for an important event, such as a job interview, wedding, graduation, or performance. 

Oral medications are also often useful when used in conjunction with other treatments like antiperspirants or botulinum toxin injections. Such combination regimens can improve overall symptom management while minimizing the different treatments’ side effects. Oral medications for sweating should not, however, be combined with topical anticholinergics as that could magnify the side effects. 

To learn more, watch our expert-led "Ask Me Anything" webinar on oral medications for hyperhidrosis and read our oral meds page. 

Leverage Sweat Management Products & Discounts

There are many useful and unique sweat-management products available to help make life with craniofacial hyperhidrosis easier, and many manufacturers give discounts to the International Hyperhidrosis Society community:

Advocate for Research & Development

There are a number of new treatments for hyperhidrosis in research and development. Unfortunately, few of them (so far) are focused on craniofacial sweating. While this can be frustrating, it’s important to remember that all research has to start somewhere. For hyperhidrosis, the starting point is often the underarms, since they’re considered relatively “uncomplicated.” Once a treatment is proven safe and effective—and researchers see that there is interest in applying the treatment to other focal areas— then research may move on to areas like the palms and face. 

What does this mean for you? Stay engaged with the hyperhidrosis community and watch for opportunities shared by the International Hyperhidrosis Society in our news blog and on social media. Treatment developers and researchers need to hear—loud and clear—that there is a critical need for effective treatments for facial and scalp excessive sweating. 

Remember These Key Steps to Take Action

  1. Recognize that craniofacial excessive sweating is common with about 2.4% of the global population experiencing it. You are not alone! 
  2. Talk to your dermatologist or healthcare professional to rule out secondary generalized hyperhidrosis. If needed, use our Clinician Finder. 
  3. Learn about craniofacial hyperhidrosis treatment options and COMBINATIONS of therapies including: antiperspirants, botulinum toxin injections, oral medications, and topical anticholinergics. Discuss them with your healthcare provider. 
  4. Shop for useful, targeted products (with discounts for our community) on our Fan Fave Products page. 
  5. Advocate for more research and development for craniofacial sweating treatments. 

Thank you. Together we can face this challenge!

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