Learn About Hyperhidrosis

What is the definition of Hyperhidrosis?

Hyperhidrosis is a medical condition in which a person sweats excessively and unpredictably. People with hyperhidrosis may sweat even when the temperature is cool or when they are at rest.

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What are the alternative names for Hyperhidrosis?

Sweating - excessive; Perspiration - excessive; Diaphoresis

What are the causes of Hyperhidrosis?

Sweating helps the body stay cool. In most cases, it is perfectly natural. People sweat more in warm temperatures, when they exercise, or in response to situations that make them nervous, angry, embarrassed, or afraid.

Excessive sweating occurs without such triggers. People with hyperhidrosis appear to have overactive sweat glands. The uncontrollable sweating can lead to significant discomfort, both physical and emotional.

When excessive sweating affects the hands, feet, and armpits, it is called focal hyperhidrosis. In most cases, no cause can be found. It seems to run in families.

Sweating that is not caused by another disease is called primary hyperhidrosis.

If the sweating occurs as a result of another medical condition, it is called secondary hyperhidrosis. The sweating may be all over the body (generalized) or it may be in one area (focal). Conditions that cause secondary hyperhidrosis include:

  • Acromegaly
  • Anxiety conditions
  • Cancer
  • Carcinoid syndrome
  • Certain medicines and substances of abuse
  • Glucose control disorders
  • Heart disease, such as heart attack
  • Overactive thyroid
  • Lung disease
  • Menopause
  • Parkinson disease
  • Pheochromocytoma (adrenal gland tumor)
  • Spinal cord injury
  • Stroke
  • Tuberculosis or other infections
What are the symptoms of Hyperhidrosis?

The primary symptom of hyperhidrosis is wetness.

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What are the current treatments for Hyperhidrosis?

A wide range of common treatments for hyperhidrosis includes:

  • Antiperspirants -- Excessive sweating may be controlled with strong antiperspirants, which plug the sweat ducts. Products containing 10% to 20% aluminum chloride hexahydrate are the first line of treatment for underarm sweating. Some people may be prescribed a product containing a higher dose of aluminum chloride, which is applied nightly onto the affected areas. Antiperspirants can cause skin irritation, and large doses of aluminum chloride can damage clothing. Note: Deodorants do not prevent sweating but are helpful in reducing body odor.
  • Medicines -- Use of some medicines may prevent stimulation of sweat glands. These are prescribed for certain types of hyperhidrosis such as excessive sweating of the face. Medicines can have side effects and are not right for everyone.
  • Iontophoresis -- This procedure uses electricity to temporarily turn off the sweat gland. It is most effective for sweating of the hands and feet. The hands or feet are placed into water, and then a gentle current of electricity is passed through it. The electricity is gradually increased until the person feels a light tingling sensation. The therapy lasts about 10 to 30 minutes and requires several sessions. Side effects, although rare, include skin cracking and blisters.
  • Botulinum toxin -- Botulinum toxin is used to treat severe underarm, palmar, and plantar sweating. This condition is called primary axillary hyperhidrosis. Botulinum toxin injected into the underarm temporarily blocks the nerves that stimulate sweating. Side effects include injection-site pain and flu-like symptoms. Botulinum toxin used for sweating of the palms can cause mild, but temporary weakness and intense pain.
  • Endoscopic thoracic sympathectomy (ETS) -- In severe cases, a minimally invasive surgical procedure called sympathectomy may be recommended when other treatments do not work. The procedure cuts a nerve, turning off the signal that tells the body to sweat excessively. It is usually done on people whose palms sweat much more heavily than normal. It may also be used to treat extreme sweating of the face. ETS does not work as well for those with excessive armpit sweating.
  • Underarm surgery -- This is surgery to remove the sweat glands in the armpits. Methods used include laser, curettage (scraping), excision (cutting), or liposuction. These procedures are done using local anesthesia.
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What is the outlook (prognosis) for Hyperhidrosis?

With treatment, hyperhidrosis can be managed. Your provider can discuss treatment options with you.

When should I contact a medical professional for Hyperhidrosis?

Call your provider if you have sweating:

  • That is prolonged, excessive, and unexplained.
  • With or followed by chest pain or pressure.
  • With weight loss.
  • That occurs mostly during sleep.
  • With fever, weight loss, chest pain, shortness of breath, or a rapid, pounding heartbeat. These symptoms may be a sign of an underlying disease, such as overactive thyroid.
What are the latest Hyperhidrosis Clinical Trials?
Targeting Nociceptors in Hidradenitis Suppurativa

Summary: This mechanistic observational study will build on data from humans implicating TRPV1 nociceptors in the pathogenesis of the Type-17 chronic inflammatory skin disease Hidradenitis Suppurativa (HS). In this study, the investigators will test the hypothesis that inhibiting neuropeptide activity with botulinum toxin reduces pathogenic IL-17 inflammation, relieves pain, and improves quality of life fo...

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Implementation, Integration and Sustainability of a Minor Ailment Service in Usual Practice of Community Pharmacy

Summary: Self-care and self-medication are commonly the treatments of choice for the management of minor ailments. Minor ailments can be treated through community pharmacy using a Minor Ailment Service (MAS). The INDICA+PRO Impact Study, evaluated the clinical, economic and humanistic impact of a MAS, concluding that community pharmacies could greatly benefit the health system. Thus, the following objectiv...

What are the Latest Advances for Hyperhidrosis?
Clinical utility of botulinum toxin type A local injection therapy for head and forehead hyperhidrosis.
Two-week prospective observational study of 5% sofpironium bromide gel in Japanese patients with primary axillary hyperhidrosis.
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Unexpected improvement of hyperhidrosis with cannabidiol.
Who are the sources who wrote this article ?

Published Date: June 19, 2021
Published By: Ramin Fathi, MD, FAAD, Director, Phoenix Surgical Dermatology Group, Phoenix, AZ. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

What are the references for this article ?

James WD, Elston DM, Treat JR, Rosenbach MA, Neuhaus IM. Diseases of the skin appendages. In: James WD, Elston DM, Treat JR, Rosenbach MA, Neuhaus IM, eds. Andrews' Diseases of the Skin: Clinical Dermatology. 13th ed. Philadelphia, PA: Elsevier; 2020:chap 33.

Langtry JAA. Hyperhidrosis. In: Lebwohl MG, Heymann WR, Berth-Jones J, Coulson IH, eds. Treatment of Skin Disease: Comprehensive Therapeutic Strategies. 5th ed. Philadelphia, PA: Elsevier; 2018:chap 109.

Miller JL. Diseases of the eccrine and apocrine sweat glands. In: Bolognia JL, Schaffer JV, Cerroni L, eds. Dermatology. 4th ed. Philadelphia, PA: Elsevier; 2018:chap 39.