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Hyperhidrosis can be an embarrassing condition and affects countless numbers of people of all different ages. Approximately 0.6-1.6% of the population in the US experience excessive sweating and have to seek medical intervention and seek treatment.

What is Hyperhidrosis?

The reason people sweat is to lower the temperature of the body through cooling the skin surface by evaporation and to secrete toxic substances.  Sweating can be called perspiration or transpiration, in hot weather the muscles of the body will warm up and through exertion, sweat is produced.  A person will sweat more when nervous, nauseous or anxious and perspiration decreases when a person is cold or the body is inactive.  Sweat is mostly composed of water, minerals, urea, lactate, calcium, magnesium, zinc, copper, nickel, lead and chromium.

Hyperhidrosis is a condition in which a person will experience abnormal perspiration, beyond what is normal for the regulation of body temperature.  The condition is usually localized to one specific portion of the body and the most common areas are the armpits, hands, feet and groin.  Primary hyperhidrosis normally begins during adolescence or possibly before and is believed to be an autosomal dominant gene trait, while secondary hyperhidrosis can begin at any point in life.  Secondary hyperhidrosis may be due to a pituitary or thyroid disorder, tumors, gout, menopause, diabetes mellitus or mercury poisoning.

What Causes Hyperhidrosis?

There are many different causes of hyperhidrosis; conditions which can lead to secondary hyperhidrosis can include the following:

  • Acromegaly:  a metabolic disorder in which there is an excess production of the growth hormone.
  • Anxiety disorders
  • Cancer
  • Carcinoid syndrome
  • Parkinson’s disease
  • Hyperthyroidism
  • Heart disease
  • Certain prescription drugs and substance abuse
  • Glucose control disorder
  • Lung disease
  • Menopause
  • Stroke
  • Spinal cord injury
  • Tuberculosis or another type of infection
  • Pheochromocytoma: a rare tumor of the adrenal gland which causes abnormal release of norepinephrine and epinephrine

(There is also a condition called idiopathic hyperhidrosis for which the cause is unknown.)

Signs, Symptoms and Diagnosis of Hyperhidrosis

Though there are visible signs which present with hyperhidrosis, the primary symptom is excessive body wetness.  Hyperhidrosis is unlike normal sweating and can happen suddenly and without any particular cause or reason.  The condition is usually aggravated by emotional stress, gustatory stimuli or a high ambient temperature, but usually improves during the cooler months and usually ceases when a person sleeps.

How is Hyperhidrosis Diagnosed?

There are visible outward signs that will occur when a person has hyperhidrosis, but there are also a number of diagnostic tests which can be performed to make a definitive diagnosis.  Such medical tests include the following:

  1. Paper test:  a special type of paper is placed on the affected area of the body to absorb sweat.  Once the test is complete, the piece of paper is weighed, the heavier the paper weighs the more sweat that has been absorbed.
  2. Starch-iodine test:  an iodine solution is applied to the sweaty body area and once it dries it is sprinkled with starch.  The starch-iodine solution turns dark blue in color in places that experience excessive sweating.

When to Contact a Physician?

If a person experiences excessive sweating, it might be necessary to contact a medical professional if any of the following are experienced:

  • Sweating which is accompanied by a fever, weight loss, shortness of breath, chest pain, rapid heartbeat all of which could indicate a disease which needs to be treated by a physician.
  • Prolonged, excessive and unexplainable sweating for no valid reason.
  • Sweating that happens often during sleep.
  • Sweating which is followed by chest pain or feelings of pressure.
  • Sweating which causes weight loss.

How is Hyperhidrosis Treated?

There are a variety of different treatments for hyperhidrosis, which treatment will work best for a person can only be determined after an examination by a medical professional.  Treatments for the hyperhidrosis can include:

Antiperspirants:  the condition can sometimes be controlled by a prescription strength anti-perspirant which will plug up the sweat glands.  Products which contain 10-15% aluminum chloride provide the best results for controlling excessive underarm sweating. 

Prescription medications:  anticholingeric medications can be used to prevent sweat gland stimulation and though the drugs can be effective for some people, there are no definitive medical studies which highlight efficacy.  Side effects with these drugs are also possible and can include nausea, urination problems, dizziness and dry mouth.

Botox injections:  the Food and Drug Administration has approved Botox for the treatment of severe underarm sweating.  Small doses of Botox are injected into the underarm sweat glands to block the nerves which stimulate excessive sweating.  Only a medical doctor can determine if this treatment will be effective for a person.

Ionthophoresis:  the Food and Drug Administration approves the use of electricity to turn off the sweat glands which can cause hyperhidrosis.  The procedure is most effective on the glands of the feet and hands.  A person places the hands or feet in water and a small electrical current is increased until the extremity feels a light tingling sensation.  Ionthophoresis therapy lasts for about 10-20 minutes and requires several sessions in order to reach the desired effects.

Endoscopic thoracic sympathectomy (ETS):  for severe cases of hyperhidrosis.  The procedure is recommended when all else fails and turns off the signal to the body to sweat excessively.  ETS can be used to treat facial and palmer sweating and does not seem to work very well for severe sweating of the armpits.


Hyperhidrosis can be an embarrassing condition and affects countless numbers of people of all different ages.  Approximately 0.6-1.6% of the population in the United States experience excessive sweating and have to seek medical intervention and seek treatment to alleviate the condition.  With proper treatment and medical help a person can experience relief from the symptoms of hyperhidrosis and go on to live a comfortable quality of life.


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