Hyperhidrosis is excessive sweating. It can be an embarrassing and serious problem. It can affect social, professional, and intimate relationships.
The sweating may be in just one area. It is most common in the palms of the hands, soles of the feet, or armpits. In some cases the sweating can also affect the entire body. Hyperhidrosis is divided into two categories:
- Primary hyperhidrosis—has no known cause
- Secondary hyperhidrosis—caused by an underlying condition
Primary hyperhidrosis may be triggered by:
- High emotional states (eg, intense sadness, fear, anger, stress)
- Spicy foods
- Hot climates
- Certain medications:
Secondary hyperhidrosis may be caused by conditions such as:
- Cancer, such as ]]>lymphoma]]>
- Thyroid disease
- ]]>Acromegaly]]> or anterior pituitary tumor
- Hypothalamic disorders
- Adrenal tumor
- ]]>Parkinson's disease]]>
- Nervous system disorders
- Drug withdrawal
- Fever-lowering medicines
- Emetics (vomit-inducing medicines)
Factors that increase your chance of secondary hyperhidrosis are the conditions that cause it (listed above).
- Sweaty palms of the hands and/or soles of the feet
- Sweaty armpits
- Change in amount of sweating
- Change in pattern of sweating
- Change in the odor associated with sweating
- Stained clothing
The doctor will ask about your symptoms and medical history. A physical exam will be done. There are no specific tests for this condition.
A starch-iodine test is often used on armpits. It may be used to determine the areas of the most active sweat glands. Tests may be ordered if your doctor is concerned that you may have a specific medical condition.
To help decrease the uncomfortable feeling and odor associated with sweating try:
- Frequent clothing changes
- Careful washing
A number of treatments can be applied to decrease sweating in a particular area. These include:
- Aluminum chloride hexahydrate
- Aluminum tetrachloride
- Formalin compresses
- Glutaraldehyde compresses
- Iontophoresis (stimulation with electrical current)—needs to be repeated on a daily or weekly basis, eventually tapering off to every 1-2 weeks; may be used if prescription antiperspirants don't work
These are very rarely used due to their side effects, but may include:
]]>Botulinum A Neurotoxin]]>
This is the poison produced by the bacteria that cause botulism. Injections of this poison can decrease sweating in certain areas. It is often used on the palms of the hands and soles of the feet. The effect of one cycle of injections may last for 6-8 months for most patients.
- Endoscopic thoracic sympathectomy—the destruction of nerves that stimulate sweating
- Curettage—local removal of sweat glands via surgical scraping
- Liposuction techniques
International Hyperhidrosis Society
Canadian Institute for Health Information
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Cecil Textbook of Medicine . 21st ed. WB Saunders Company; 2000.
Kasper DL et al. Harrison's Principles of Internal Medicine . 16th ed. McGraw-Hill Professional; 2004.
Local injection of botulinum toxin A for palmar hyperhidrosis: usefulness and efficacy in relation to severity. Yamashita N, Shimizu H, Kawada M, Yanagishita T, Watanabe D, Tamada Y, Matsumoto Y. J Dermatol . 2008;35(6):325-9.
Primary Care Medicine . 4th ed. Lippincott Williams & Wilkins; 2000.
Baumgartner FJ. Surgical approaches and techniques in the management of severe hyperhidrosis. Thorac Surg Clin . 2008;18(2):167-81.
Commons GW, Lim AF. Treatment of Axillary Hyperhidrosis/Bromidrosis Using VASER Ultrasound. Aesthetic Plast Surg . 2009 Jan 3.
Treatment of hyperhidrosis. Dermatologic Clinics . 1998 Oct.
Last reviewed January 2009 by ]]>Ross Zeltser, MD]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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