Everything you need to know about anxiety and sweating

Sweat happens. It's a natural part of life. And there are different kinds of sweat. Sweating from exercise is a necessary part of how we regulate our bodies. We also sweat when we're anxious—remember when you got that surprise meeting invite from your boss on a Friday afternoon?  

Sweating when you're nervous in stressful situations is a part of the body's natural processes, too. But when that sweating is excessive it can cause even more anxiety. If anxiety is making you literally sweat, here are some tips for how to take care of it, and when you might want to talk to a professional about any mental health conditions that may be a contributing factor.  

Is stress sweat a thing?

Stress and sweat go hand-in-hand. Stress activates your fight-or-flight response, part activating the body’s sympathetic nervous system. And when this switch flips, hormones like adrenaline and cortisol, are released into the bloodstream. In turn, these hormones trigger a whole host of physical effects—like sweat—that prepares you for the perceived threat. (Our hearts also beat faster and we tend to breathe more quickly when we’re in fight-or-flight mode.) Even though you may not be in any danger, your body reacts as if you are. Those sweaty palms are just a stress response.

Anxiety sweat isn’t just reserved for your waking hours. You may also experience stress or anxiety sweating as night sweats, which is when you sweat excessively while sleeping. Imagine lying in bed, wrapped in your sheets, and suddenly waking up drenched in perspiration.

Stress doesn’t only cause sweat; it can even cause chest pain. To learn more, check out: Does anxiety cause chest pain?

Does anxiety sweat smell worse?

It’s not always the most comfortable thing to talk about, but there actually are differences in the sweat you produce while exercising, and what you produce when you’re anxious. It can smell, and even feel, different. That’s because there are actually two different types of sweat.

The sweat we produce when we’re hot is made up of mostly water with some salt and potassium. It’s released by eccrine glands, which cover most of your body, including the soles of your feet, and play a crucial role in regulating our body temperature and helping us stay cool.

Anxiety sweat is produced by a completely different system. It’s made up of fatty acids and proteins, which make it feel different and smell different. This type of sweat is released by apocrine glands, which are bigger and found in areas where there are many hair follicles, like your armpits and groin.

Because anxiety sweat is thicker, it’s harder and takes much longer to evaporate compared to regular sweat. The sweat itself is odorless, but the longer it stays on your skin, the longer it’s exposed to bacteria. That smell we associate with nervous sweating comes from the sweat and bacteria mixing together.

Can anxiety cause hyperhidrosis?

Hyperhidrosis is a medical condition where your body sweats excessively because your eccrine glands are working over time. It primarily causes sweaty palms but it can affect other areas. About 3% of the U.S. population experiences hyperhidrosis with the highest prevalence observed among individuals aged 20 to 60.

There are two types of hyperhidrosis: one is genetic (primary) and the other is not (secondary). Secondary hyperhidrosis is caused by certain medications (such as antidepressants) and health conditions like diabetes, thyroid issues, and menopausal hot flashes. In order for sweating to be considered excessive and meet the criteria for primary hyperhidrosis, sweating episodes need to last at least 7 days and occur consistently for at least 6 months. Secondary hyperhidrosis usually happens later in life.

Not all cases of hyperhidrosis are related to anxiety, but studies show that people with hyperhidrosis were more likely to experience mental health conditions—including anxiety, depression, and attention-deficit/hyperactivity disorder (ADHD)—when compared to the general population. Additionally, other studies suggest that excessive sweating can increase your chances of feeling socially anxious and having social phobia, also known as social anxiety disorder.  

If you feel like there might be a connection between your excessive sweating and anxiety, it's a good idea to reach out to a doctor or psychiatrist. They can help you figure out what's happening and provide guidance on the best course of action.

When does excessive sweating become a problem?

If sweating affects your quality of life, it's time to talk to someone about it—whether it's the sweating itself that worries you, or the way it makes you feel about yourself. You can start with a dermatologist or general practitioner to rule out physical conditions and medical issues.

Make sure you talk to them about everything that's bothering you—not just physical effects of sweating like body odor and irritated skin, but any feelings of anxiety or panic attacks that accompany the nervous sweating. They may refer you to a psychiatrist, who can diagnose any underlying mental health conditions.

How to stop stress-induced sweating

The best place to start is actually stopping the problem at its source by reducing your worry, stress, and anxiety. Of course, this is easier said than done, but to help you get started, here are a few stress management methods can help:

• Engage in physical activity: Exercising can help reduce stress and anxiety. While you'll be sweating during the workout, it can help alleviate the anxious feelings that cause stress sweat. ‍
• Get enough sleep: Sleep helps your body function at its best and improves your ability to handle stress effectively.‍
• Speak to a mental health professional: Talking to a therapist can help you uncover any underlying anxiety triggers. Psychiatrists can help diagnosis conditions like generalized anxiety disorder or panic disorder and get you treatment.‍
• Practice deep breathing: Relaxation techniques like deep breathing patterns can help your lower heart rate, which can help reduce stress and help your sweating, too.‍
• Visualize peaceful scenes: Whether it’s a quiet forest or a sunny beach, try to picture all the details of your chosen scene to help you calm down.‍
• Try yoga and tai chi: Find some beginner videos online and try not to worry about whether you’re doing it quite right. Just engage in the movements. ‍
• Add meditation to your daily routine: Start with a couple minutes at a time, making space to be present in the current moment with both your body and your mind.

What treatments are available for excessive sweating?

To effectively reduce anxious sweating, it's important to address the root causes, including mental health conditions. Alongside that, there are various measures you can take to manage physical sweating, ranging from simple at-home remedies to more advanced medical procedures.

Simple steps to take care of sweating (and the smell)

• Wear an antiperspirant to block sweat from being released from your pores, rather than deodorant, which merely prevents or masks odors.
• Take a shower or bath regularly to wash away the bacteria that lives on your skin and mixes with sweat to produce body odor.
• Trim the hair in commonly sweaty areas since hair can trap sweat and bacteria.
• Avoid spicy foods and alcohol, which trigger the sweat glands to produce more sweat in order to cool the body down.
• Try not to wear tight clothes and synthetic fabrics, like nylon and spandex, that trap heat and can make you sweat more.

Medications and medical treatment options

There are a number of medically proven ways to treat hyperhidrosis. Oral medications called anticholinergics can help curb excessive sweating, and prescription-strength antiperspirants containing aluminum chloride can block your sweat glands from producing moisture. Many of these prescription strength antiperspirants are available over the counter. Botox injections are another popular option for tackling excessive sweating. They work by blocking the nerves that trigger sweat glands in the areas where you sweat the most.  

Clinicians usually start with local or topical treatments before considering oral medications or injections to help with your sweating. Apart from these, there are other treatments available for hyperhidrosis, ranging from medical devices to more invasive procedures.  

If you're already addressing your medical and anxiety issues but still struggling with excessive sweating, you should consult your primary care doctor or dermatologist for more medical advice. They can help determine what the next steps are and walk you through what other sweat-reducing treatments are available.

Anxiety and mental health treatment

Symptoms of anxiety and stress can manifest physically. If you believe that your excessive sweating is connected to stress, it may be beneficial to focus on addressing the underlying anxiety. One step you can take is to consult with a licensed psychiatrist who can provide a diagnosis, and guide you in managing your anxiety effectively.

Talkiatry is a national psychiatry practice that provides in-network care. We can help treat a variety of anxiety disorders along with other mental health conditions. Get started with a short online assessment to schedule your first virtual visit.  

The information in this article is for education and informational purposes only and should never be substituted for medical advice, diagnoses, or treatment. If you or someone you know may be in danger, call 911 or the National Suicide and Crisis Lifeline at 988 right away.