Published: 18 Jun 2025

ICD9: 705.2      ICD10: R61.9      ICD11: EE00

Sweating, also known as perspiration, is a natural and essential bodily function that helps regulate body temperature.
However, hyperhidrosis refers to excessive sweating that's not necessarily related to heat or exercise. People with hyperhidrosis sweat even when the temperature is cool and they are at rest.

Here's a breakdown of key aspects of hyperhidrosis:

Definition: Sweating more than what is needed to cool the body. This often interferes with daily activities and can be embarrassing.

Types:
Primary focal hyperhidrosis: This is the most common type. It affects specific areas of the body, typically the:
Palms (palmar hyperhidrosis)
Soles of the feet (plantar hyperhidrosis)
Armpits (axillary hyperhidrosis)
Face (facial hyperhidrosis)
Scalp (cranial hyperhidrosis)
It usually starts in childhood or adolescence and is thought to be hereditary. The exact cause is unknown but may be related to overactivity of the sympathetic nervous system, which controls sweating.

Secondary generalized hyperhidrosis: This type is caused by an underlying medical condition or is a side effect of certain medications. It tends to cause sweating all over the body or in larger areas, rather than being localized. Possible causes include:
Diabetes
Thyroid problems (hyperthyroidism)
Menopause
Infections
Nervous system disorders
Certain cancers
Some medications (antidepressants, some blood pressure medications)

Symptoms:
Visible sweating, often soaking through clothing.
Clammy or wet palms of the hands or soles of the feet.
Frequent sweating, even when not hot or active.
Sweating that disrupts daily activities (e.g., difficulty holding objects, embarrassment in social situations).
Skin problems like fungal infections, due to consistently moist skin.

Diagnosis: A doctor can usually diagnose hyperhidrosis based on a medical history and physical exam. Sometimes, tests are performed to rule out underlying medical conditions (for secondary hyperhidrosis). A starch-iodine test might be used to visualize the areas of excessive sweating.

Treatment: Treatment depends on the type and severity of hyperhidrosis. Options include:
Prescription-strength antiperspirants: Contain aluminum chloride, which blocks sweat ducts.
Iontophoresis: A device that uses a mild electrical current to temporarily block sweat glands, primarily used for hands and feet.
Oral medications: Anticholinergics can reduce sweating, but they can have side effects.
Botulinum toxin (Botox) injections: Can block the nerves that stimulate sweat glands, especially effective for underarm sweating.
Surgery: In severe cases, surgery to cut the nerves that control sweating (endoscopic thoracic sympathectomy or ETS) or to remove sweat glands (axillary gland removal) may be considered. Surgery is generally reserved for severe cases that don't respond to other treatments.
Microwave thermolysis: Uses microwave energy to destroy sweat glands in the armpits.
Prescription cloths: Cloths with glycopyrronium tosylate to treat excessive underarm sweating.

Impact: Hyperhidrosis can have a significant impact on a person's quality of life, affecting their self-esteem, social interactions, and professional life.

Important Considerations:

If you're experiencing excessive sweating, it's important to see a doctor to determine the underlying cause and discuss appropriate treatment options.
Not all excessive sweating is hyperhidrosis. Stress, anxiety, certain foods, and other factors can also cause temporary increases in sweating.
Treatment for hyperhidrosis can often significantly improve a person's quality of life.