Do beads of sweat pour over your forehead while you're sitting at your desk? Has streaming facial sweat gotten in the way of your success at work? Or has it prevented you from thriving socially? 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 can be even more stressful and embarrassing than other types of excessive sweating. Even people who sweat heavily from other body areas 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 on the face.
The first step for anyone with any type of excessive sweating is to see a doctor for a full medical check-up including an assessment to make sure that excessive sweating is not due to another medical condition or a side effect of a medication. When extreme sweating is due to a different medical condition or a medication it's called secondary hyperhidrosis. Secondary hyperhidrosis can signify a more serious health problem and so should always be considered first.
If your doctor determines that your extreme sweating is independent of other medical conditions or medications, then it's called primary hyperhidrosis and the hyperhidrosis treatment plan will be similar to that used for other body areas of excessive sweating. For example, products used on the skin in the area of sweating (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 areas of the body, strong antiperspirant products can be irritating to the skin of the face, head, or scalp. Understand how antiperspirants work so you can use them effectively and avoid irritation. Always follow your doctor's instructions and, if trying a new topical product, try it on a small area of the skin first to see who you react.
If topical antiperspirant solutions don't work or are too irritating, onabotulinumtoxinA (commonly known by the brand name Botox) 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 temporary and can, if necessary, be balanced out by additional Botox injections. Working with an experienced dermatologist can minimize these risks.
Systemic medications (prescription medicines taken by mouth called anticholinergics) may also be used to treat facial sweating. But because of their side effects, including dry mouth, blurry vision, and constipation, systemic medications may not be a good long-term treatment. They can, 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, a job interview, wedding, graduation, or dramatic performance. Read our full discussion about this hyperhidrosis treatment option here.
You may have heard about new treatments for hyperhidrosis in research. And you may be a bit discouraged when you see that few studies (so far) are for craniofacial sweating. Please take heart and remember that all research has to start somewhere. For hyperhidrosis treatments, the starting place has been underarms because they have been considered relatively 'uncomplicated'. Once treatment is proven safe and effective--and the researchers see that there is interest in applying the treatment to other focal areas--then the research moves to other focal areas like palms or face. What does that mean to you? It means you have to stay active in the hyperhidrosis community here and jump on any opportunity that the International Hyperhidrosis Society sends to you. Make sure that you are signed up to receive the alerts. If no one answers the call, no progress will be made.
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 or healthcare professional.