Research
Sweating and Social Anxiety: The Research
Excessive sweating and social anxiety travel together. In clinical trials of social anxiety disorder (SAD), hyperhidrosis was recorded in 24.8% to 32.3% of participants depending on the rating scale, and in dermatology clinics people with hyperhidrosis screen positive for anxiety far more often than other patients, about 21% versus 8%. But these are associations, not proof of cause: the research cannot say whether sweating drives anxiety, anxiety drives sweating, or both share an underlying cause. This page compiles the verified figures and explains exactly what they do and do not mean.
By the Sweat Explained Editorial Team · Published 2026-07-13 · Last reviewed 2026-07-13 · Educational information, not medical advice.
Key statistics at a glance
24.8–32.3%
of people with social anxiety disorder showed hyperhidrosis, depending on the rating scale (375 participants)
Davidson 2002
21.3%
of hyperhidrosis patients screened positive for anxiety, versus 7.5% of other dermatology patients
Bahar 2016
27.2%
of hyperhidrosis patients screened positive for depression, versus 9.7% of others
Bahar 2016
47%
of primary hyperhidrosis patients had comorbid social phobia on the SPIN, in one study within a systematic review
Lessa (via Kristensen 2020)
0–49.6%
range of reported anxiety across controlled hyperhidrosis studies (evidence is variable)
Kristensen 2020 review
An association, not a cause
Sweating and social anxiety are linked in the research, but the link runs in a direction the studies cannot resolve. Sweating that others might notice (on the face, hands, or underarms) is a plausible trigger for social fear, and social fear reliably drives sympathetic sweating in the moment. The studies below measure how often the two occur together, not which one comes first.
So every figure on this page should be read as co-occurrence. None of it shows that hyperhidrosis causes social anxiety disorder, or the reverse. Excessive sweating also has many purely physiological causes unrelated to anxiety, and social anxiety exists in people who do not sweat excessively.
How common is hyperhidrosis in social anxiety disorder?
The most-cited primary source is a 2002 analysis by Davidson and colleagues, pooling 375 participants from placebo-controlled trials of social anxiety disorder. Hyperhidrosis was found in 24.8% of participants on a clinician-rated scale (the Brief Social Phobia Scale) and 32.3% on a self-rated scale (the Social Phobia Inventory, or SPIN). The self-rated number is higher, which is common: people report more of a symptom about themselves than an interviewer records.
In that study, participants with hyperhidrosis also reported higher levels of disability, fear, and avoidance than those without, so within social anxiety disorder, sweating tends to mark a heavier symptom burden rather than a milder one.
Anxiety and depression screening in hyperhidrosis clinics
A 2016 study of 2,017 consecutive dermatology outpatients in Canada and China (437 of whom had hyperhidrosis) screened everyone for anxiety and depression using standardized questionnaires. People with hyperhidrosis screened positive far more often than other dermatology patients.
| Group | Value |
|---|---|
| Anxiety, hyperhidrosis | 21.3% |
| Anxiety, no hyperhidrosis | 7.5% |
| Depression, hyperhidrosis | 27.2% |
| Depression, no hyperhidrosis | 9.7% |
Source: Bahar R, et al. J Am Acad Dermatol 2016. Chart is an original rendering of the cited data.
What the studies report
The figures come from different populations (people already diagnosed with social anxiety, and people attending clinics for sweating), so they answer slightly different questions. They are not directly comparable, and the reported ranges are wide.
| Study (population) | Finding | Source |
|---|---|---|
| Davidson 2002 (375 people with social anxiety disorder) | Hyperhidrosis in 24.8% (clinician-rated) to 32.3% (self-rated, SPIN) | PubMed |
| Bahar 2016 (2,017 dermatology patients; 437 with hyperhidrosis) | Anxiety 21.3% and depression 27.2% with hyperhidrosis, vs 7.5% and 9.7% without (P < .001) | PubMed |
| Lessa (single study within a systematic review) | 47% of primary hyperhidrosis patients had comorbid social phobia on the SPIN | Review |
| Kristensen 2020 (systematic review of 7 controlled studies) | Reported anxiety ranged 0–49.6% and depression 0–60% across studies | Review |
Different scales, thresholds, and populations produce different numbers; the wide ranges reflect that variability, not disagreement about a single true value.
The fear of visible sweating
A recurring theme is that the anticipation of visible sweating can itself fuel social fear. When sweating is a focus of worry, attention turns inward to monitoring the body, which is exactly the self-focused attention that maintains social anxiety. This creates a feedback loop in which fear of sweating and the sweating response reinforce each other, though, again, the studies here document the association rather than proving the loop.
It is also why sweating that seems minor to observers can carry outsized distress: the burden tracks how much a person fears being seen sweating, not just how much they sweat.
When social anxiety is treated, reported sweating tends to fall
In the Davidson trials, treatment of social anxiety disorder was associated with a drop in reported hyperhidrosis, from 23.7% to 9.7% on the clinician-rated scale, and from 34.0% to 15.5% on the self-rated SPIN. Only one medication (fluoxetine) separated significantly from placebo on the change in sweating score, so the effect was modest and drug-specific.
This is a measure of a symptom changing inside anxiety trials, not evidence about treating hyperhidrosis itself. It does suggest the sweating and the social fear move somewhat together over time. Anyone weighing options for either problem should do so with a qualified clinician; this page is general information, not treatment advice.
Methodology and limitations
This page draws on a primary pooled analysis of social anxiety trials (Davidson 2002), a large two-country dermatology screening study (Bahar 2016), and a systematic review of seven controlled studies (Kristensen 2020, which reports the Lessa social-phobia figure). Each number was traced to its source and confirmed.
Limitations: these are cross-sectional and observational data, so they show association, not causation, and cannot establish direction. Studies used different instruments (BSPS, SPIN, GAD-7, PHQ-9) and different cut-offs, which is why reported rates range widely (anxiety 0–49.6% across the reviewed studies). Screen-positive is not the same as a formal diagnosis. Nothing here is a diagnosis or medical advice.
Frequently asked questions
- Does hyperhidrosis cause social anxiety?
- The research cannot say. Sweating and social anxiety occur together more often than chance, but the studies are observational: they show an association, not that one causes the other. Excessive sweating also has many causes unrelated to anxiety.
- How often do people with social anxiety disorder have excessive sweating?
- In a pooled analysis of 375 people with social anxiety disorder, hyperhidrosis was recorded in 24.8% on a clinician-rated scale and 32.3% on a self-rated scale (Davidson 2002). The self-report figure is higher, as is common with self-rated symptoms.
- Do people with hyperhidrosis have more anxiety and depression?
- In a study of 2,017 dermatology patients, those with hyperhidrosis screened positive for anxiety at 21.3% and depression at 27.2%, versus 7.5% and 9.7% in other patients (Bahar 2016). This is a screening association, not a diagnosis.
- Why do the reported percentages vary so much?
- Studies use different questionnaires, thresholds, and populations: people already diagnosed with social anxiety versus people attending sweating clinics. A systematic review found reported anxiety spanning 0% to 49.6% across studies (Kristensen 2020), reflecting that variability.
- Can treating social anxiety reduce the sweating?
- In social anxiety trials, reported hyperhidrosis fell during treatment (for example, 34.0% to 15.5% on the self-rated SPIN), but only fluoxetine beat placebo significantly on sweating change (Davidson 2002). That measures a symptom within anxiety treatment, not treatment of hyperhidrosis itself.
- When should someone see a professional?
- Excessive sweating that limits daily life, or persistent social fear and avoidance, are both worth discussing with a clinician, who can assess causes and options. This page is educational information, not a substitute for that assessment.
Sources
Primary peer-reviewed studies and official sources first, then reviews and institutional framing (secondary).
- Davidson JRT, Foa EB, Connor KM, Churchill LE. Hyperhidrosis in social anxiety disorder. Prog Neuropsychopharmacol Biol Psychiatry. 2002;26(7–8):1327–1331. PubMed
- Bahar R, Zhou P, Liu Y, et al. The prevalence of anxiety and depression in patients with or without hyperhidrosis (HH). J Am Acad Dermatol. 2016;75(6):1126–1133. PubMed
- Kristensen JK, Vestergaard DG, Swartling C, Bygum A. Association of primary hyperhidrosis with depression and anxiety: a systematic review. Acta Derm Venereol. 2020;100(1):adv00051. (Reports the Lessa social-phobia figure and the 0–49.6% anxiety range.) Full text
How to cite this page
Sweat Explained. Sweating and Social Anxiety: The Research. Published 2026-07-13; last reviewed 2026-07-13. Available at: https://sweatexplained.com/research/sweating-and-social-anxiety-research
Please cite the original studies for the underlying figures. Journalists are welcome to link to this page; the charts are original renderings of the cited data.