Hyperhidrosis: Symptoms, Causes & Treatment

Hyperhidrosis is a condition in which the body produces sweat in amounts much greater than its actual need to regulate its temperature. Sweating is a natural function that cools the body, but in hyperhidrosis the sweat glands are overactive, so a person sweats profusely even in the absence of heat, exertion, or tension. It is a more common condition than thought, and may be a source of great embarrassment and affect confidence and social, professional, and daily life, although it is not dangerous to health in its common type.

Hyperhidrosis is divided into two types. The primary (focal) type is the most common, affecting specific areas symmetrically such as the palms, feet, armpits, and sometimes the face, often begins in childhood or adolescence, has no underlying medical cause, and there may be a family predisposition. The secondary (generalized) type involves the whole body or wide areas, often begins at a later age, and results from an underlying cause or medication, such as thyroid disorders, some infections, hormonal changes, and some medications and medical conditions. It is important to distinguish between them, as sweating that begins suddenly at a late age, involves the whole body, or occurs at night during sleep, requires evaluation to look for an underlying cause.

The good news is that hyperhidrosis is effectively treatable, and graded options are available with the doctor starting with the simplest. They include: strong medical antiperspirants (containing a higher concentration than usually available) as a first line, especially for the armpits, oral medications that reduce sweat gland activity in some cases, special injections that reduce focal sweating for a period, devices that use a mild electric current for the palms and feet, and in severe resistant cases other procedures may be proposed. For the secondary type, treating the underlying cause often improves the sweating. Seeing a doctor (especially a dermatologist) to assess the type, severity, and effect of the hyperhidrosis on life and choose appropriate treatment is advised, with no need to endure this bothersome condition in silence.

• Profuse sweating exceeding the body's need, even without heat or exertion.
• Primary: symmetric areas (palms, feet, armpits, face).
• Secondary: whole body or wide areas, and may occur at night.
• An effect on confidence and social and professional life.

• Primary: overactivity of the sweat glands without an underlying cause (possible family predisposition).
• Secondary: an underlying cause or medication (thyroid disorders, infections, hormonal changes, medications).
• May increase with heat and tension but also occurs without them.

• Clinical assessment of the sweating pattern, its areas, and the timing of its onset.
• Distinguishing primary from secondary (late, generalized, or night sweating requires looking for a cause).
• Tests to exclude an underlying cause in the secondary type.

Graded options (start with the simplest)

• Strong medical antiperspirants (first line, especially for the armpits).
• Oral medications that reduce sweat gland activity in some cases.
• Special injections that reduce focal sweating for a period.
• Devices with a mild electric current for the palms and feet, and other procedures for resistant cases.

The secondary type

• Treating the underlying cause often improves the sweating.

There is no need to endure the condition in silence. This content is educational and does not replace consulting a dermatologist.

• Embarrassment and an effect on confidence and social and professional life.
• Skin or fungal infections in persistently moist areas.
• In the secondary type it may indicate an underlying condition requiring evaluation.

• Using suitable antiperspirants and caring for the hygiene of sweaty areas.
• Wearing absorbent cotton clothes and avoiding triggers (such as spicy foods in some people).
• Seeing a doctor for the secondary type to treat its cause.