Table of ContentsView AllTable of ContentsSymptomsCausesDiagnosisTreatmentCopingA Word From VerywellNext in Hyperhidrosis GuideCauses of Hyperhidrosis
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Diagnosis
Treatment
Coping
A Word From Verywell
Next in Hyperhidrosis Guide
Hyperhidrosis is a term used to describeexcessive sweatingthat affects the body’s natural temperature. It is not simply heavy sweating that occurs with strenuous activity. Rather, it is a clinical disorder in which profuse perspiration occurs either in response to an underlying disease or for no known reason at all.
Hyperhidrosis is not the same thing as excessive sweating during exercise or in response to hot or humid climates. It suggests an abnormal response under conditions for which sweating would not occur (or occur as dramatically) in most people and can be properly diagnosed.
Verywell / Emily Roberts
Hyperhidrosis Symptoms
The eccrine sweat glands are distributed over most of the body and function as the body’s primary cooling system. The apocrine sweat glands located primarily in the armpits and around the anus serve no regulatory purpose.
From the broadest perspective, hyperhidrosis can be described as being either primary focal hyperhidrosis or secondary hyperhidrosis.
Primary Focal Hyperhidrosis
Primary hyperhidrosis is so-named because the sweatingisthe condition. While there may be triggers that set off an episode, the triggers are not considered unusual and will not cause symptoms in other people.
While primary hyperhidrosis is not considered dangerous, it can often be debilitating and severely impact a person’s quality of life. It is for this reason that the condition is often referred to as a “silent handicap.”
Primary hyperhidrosis often begins in childhood, especially palmoplantar hyperhidrosis. While people with primary focal hyperhidrosis will typically experience episodes once or several times a week, they usually do not sweat excessively while sleeping.
Hyperhidrosis in Young Children
Secondary Hyperhidrosis
Secondary hyperhidrosis is so-named because the sweating is the secondary consequence of an underlying cause, most often a disease, physiological disorder, or medication side effect.
As opposed to primary focal hyperhidrosis, secondary hyperhidrosis can occur at any age. It may also occur while sleeping in the form ofnight sweats.
The causes of hyperhidrosis are numerous. In some cases, the cause may never be found, particularly with primary hyperhidrosis. In others, the cause may be obvious and potentially treatable, as can happen with cases of secondary hyperhidrosis.
Primary Hyperhidrosis
While the exact cause of primary hyperhidrosis remains something of a mystery, it has been hypothesized that certain triggers can overexcite the sympathetic nervous system in some people.The sympathetic nervous system is part of theautonomic nervous systemthat regulates the body’s response to intense stimulus and triggers the so-called"fight-or-flight"response.
Anxiety, stress, and excitement are common triggers for primary hyperhidrosis, although the location and duration of the response can vary.“Flop sweat” is a colloquialism often ascribed to the sudden and profuse outbreak of sweat, most often in association with jitters and nerves.
Certain foods, drinks, caffeine, and nicotine can also trigger sweating in a way that is anything but normal.While it is natural, for instance, to sweat when you eat especially hot or spicy food, people with gustatory hyperhidrosis may do so when they eat something cold. In some cases, even smelling or thinking of food can elicit a response.
Primary hyperhidrosis is also believed to have a genetic cause given that 35 percent to 56 percent of those affected will have a family history of the condition.
With that being said, the diversity of symptoms suggests that there may be a variety of genetic causes. In 2006, scientists with Saga University in Japan were able to approximate the location of a genetic anomaly on chromosome 14q11.2-q13, which they believe predisposes an individual to primary palmar hyperhidrosis.
At its very heart, primary hyperhidrosis represents a complex dysfunction of the autonomic nervous system and the endocrine system which receives the nerve signals and regulates perspiration. Any problem occurring along this route can potentially trigger the overproduction of sweat.
Some of the more common medical conditions associated with secondary hyperhidrosis include:
Some of the medications known to cause secondary hyperhidrosis include:
Hyperhidrosis is diagnosed based on the severity of perspiration in the absence of heat or excessive exercise. Moreover, episodes must occur at least once weekly. The first step in the diagnostic process is to differentiate primary focal hyperhidrosis from secondary hyperhidrosis. This can often be done with a physical exam and lab tests.
Physical Examination
There are several clues that can help differentiate the two conditions:
Limited to one or several parts of the body
Will rarely involve night sweats
Will often affect other family members
Will occur in the absence of any other symptoms
Secondary HyperhidrosisMore generally widespread across the bodyRisk increases with ageWill often involve night sweatsLess commonly affects other family membersOften occurs in tandem with other symptoms
More generally widespread across the body
Risk increases with age
Will often involve night sweats
Less commonly affects other family members
Often occurs in tandem with other symptoms
The combination of medical history, family history, duration of symptoms, the age of onset, and absence or presence of an apparent cause are usually enough to make the differentiation.
Lab Tests
Blood tests may also be ordered to confirm or exclude underlying causes. Based on your symptoms and risk factors, your healthcare provider may want to test for low blood sugar (hypoglycemia), overactive thyroid function (hyperglycemia), or specific infections using blood antibody or antigen tests.
If hyperhidrosis is secondary to an underlying condition, the focus would be placed on treating the disorder rather than the sweating. In some cases, it may only require the resolution of a short-term febrile infection or the termination of a problematic drug. Other conditions may require chronic medications, surgery, or more extensive lifestyle changes.
Generally speaking, if the underlying condition is resolved or managed, the symptoms of hyperhidrosis will correct themselves.
However, if no clear cause is found, the treatment will be focused on controlling the sweating. A combination of treatments is often required. Even then, recurrence is common, and additional or repeated treatments may be needed.
Home Remedies
Don’t confuse antiperspirants for deodorants which are used to conceal smells. While most antiperspirants are equally effective, unscented ones may be less irritating to people with sensitive skin or who are prone tocontact dermatitis.
While people commonly use them on their underarms, the roll-ons and stick formulations can also be applied to the hairline, hands, groin, and feet. Always pre-test the antiperspirant on a patch of skin. Skin irritation and a burning sensation are common side effects. You will also need to wash regularly to prevent pore blockage.
Contrary to popular belief, shaving your armpits does not reduce the amount you sweat.
Medications
If over-the-counter antiperspirants fail to do the trick, your healthcare provider may be able to prescribe you a number of stronger and potentially more effective medications. Among them:
Procedures
A number of in-office procedures may be used to treat hyperhidrosis, either on their own or in combination with over-the-counter or prescription medications. Among them:
Surgery
In severe cases, surgery may be considered in hyperhidrosis is severely impacting your quality of life and ability to function normally. They should only be considered if all other forms of conservative therapy have failed to provide relief. Options include:
What Are the Hyperhidrosis Treatment Options?
Whether you’re dealing with primary or secondary hyperhidrosis, there are things you can do.
One of the best ways to avoid a sweating episode is to identify the triggers that set them off (such as caffeine or nicotine). If you are unsure of the cause, keep a “sweat diary” to record what you were doing when an episode occurred.
In addition:
It may surprise you to know that there are unofficial support groups for people with hyperhidrosis. You can find groups online on Facebook or reach out to the non-profit, Pennsylvania-basedInternational Hyperhidrosis Societyfor advice and referrals.
If you are suffering from excessive, uncontrollable sweating, it’s important to remember that you aren’t alone. There are treatments available that may at the very least minimize the occurrence of hyperhidrosis and lifestyle changes you can make to better cope.
If hyperhidrosis is causing you extreme anxiety or you find yourself increasingly isolated from others, ask your healthcare provider for a referral to a therapist who can help you better deal with the psychological and social stress. Even though hyperhidrosis is not life-threatening, it can be life-altering. Do yourself a favor and don’t ignore your condition.
Why You Get Sweaty When You Sleep
23 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
U.S. National Library of Medicine.Hyperhidrosis.
International Hyperhidrosis Society.Two types of hyperhidrosis.
National Institutes of Health, MedlinePlus.Hyperhidrosis.
Moraites E, Vaughn OA, Hill S.Incidence and prevalence of hyperhidrosis.Dermatologic Clinics. 2014;32(4):457-465. doi:/10.1016/j.det.2014.06.006
Swartling C, Rystedt A, Brismar K, Naver H, Norman P, Dizdarevic A.Hyperhidrose er et tavst handicap [Hyperhidrosis is a silent handicap].Ugeskr Laeger. 2016;178(6):V04150291.
International Hyperhidrosis Society.Sweating everywhere.
Wohlrab, J., Bechara, F.G., Schick, C.et al.Hyperhidrosis: A central nervous dysfunction of sweat secretion.Dermatol Ther (Heidelb).2023;13:453–463. doi:10.1007/s13555-022-00885-w
Kwon RW, Park JS, Lee HG, et al.Coffee intake may promote sudomotor function activation via the contribution of caffeine.Front Nutr. 2022;9:1051828. doi:10.3389/fnut.2022.1051828
International Hyperhydrosis Society.Gustatory sweating (Frey’s syndrome).
Higashimoto I, Yoshiura K ichiro, Hirakawa N, et al.Primary palmar hyperhidrosis locus maps to 14q11.2-q13.Am J Med Genet. 2006;140A(6):567-572. doi:10.1002/ajmg.a.31127
Kisielnicka A, Szczerkowska-Dobosz A, Purzycka-Bohdan D, Nowicki RJ.Hyperhidrosis: disease aetiology, classification and management in the light of modern treatment modalities.Postepy Dermatol Alergol. 2022;39(2):251-257. doi:10.5114/ada.2022.115887
International Hyperhydrosis Society.Diseases and conditions that can cause hyperhydrosis.
International Hyperhidrosis Society.Drugs/medications known to cause hyperhidrosis.
de Groot AC.Fragrances: contact allergy and other adverse effects.Dermatitis. 2020;31(1):13-35. doi:10.1097/DER.0000000000000463
Teerasumran P, Velliou E, Bai S, Cai Q.Deodorants and antiperspirants: new trends in their active agents and testing methods.Intern J of Cosmetic Sci. 2023:ics.12852. doi:10.1111/ics.12852
Kinsey, Brian.Human Body from A to Z. Marshall Cavendish Reference, 2011.
Yayla EM, Yavuz E, Bilge U, Keskin A, Binen E.Drugs with anticholinergic side-effects in primary care.Niger J Clin Pract. 2015;18(1):18-21. doi:10.4103/1119-3077.146969
U.S. Food and Drug Administration.QBREXZA™.
International Hyperhydrosis Society.OnabotulinumtoxinA injections (Botox®).
International Hyperhydrosis Society.Iontophoresis.
Loizzi D, Mongiello D, Bevilacqua MT, et al.Surgical management of compensatory sweating: a systematic review.Front Surg. 2023;10:1160827. doi:10.3389/fsurg.2023.1160827
Toussaint L, Nguyen QA, Roettger C, et al.Effectiveness of progressive muscle relaxation, deep breathing, and guided imagery in promoting psychological and physiological states of relaxation.Evid Based Complement Alternat Med. 2021;2021:5924040. doi:10.1155/2021/5924040
Benson, R.; Palin, R.; and Holt, P.Diagnosis and management of hyperhidrosis.BMJ.2013;347:f6800. doi:10.1136/bmj.f6800
Gross, K.; Schote, A.; Schneider, K. et al.Elevated Social Stress Levels and Depressive Symptoms in Primary Hyperhidrosis.PLoS One.2014;9(3):e92412. doi:10.1371/journal.pone.0092412
Lakraj, A.; Moghimi, N.; and Jabbari, B. Hyperhidrosis:Anatomy, Pathophysiology and Treatment with Emphasis on the Role of Botulinum Toxins.Toxins (Basel).2013;5(4):821-40. doi:10.3390/toxins5040821
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