Excessive Sweating (Hyperhidrosis)

Sweating is a natural body cooling process, activated by the nervous system when body temperature rises (Mayo Clinic, 2024). Under normal circumstances, sweat glands are stimulated by physical activity, external environmental factors, and emotional factors (BelMedic, n.d.). Excessive sweating or hyperhidrosis is a condition that occurs when the body sweats more than necessary to regulate its temperature. Individuals with hyperhidrosis may experience sweating at unexpected times, such as in cold temperatures or during rest (Cleveland Clinic, 2023). This condition can lead to embarrassment and social isolation, and in more severe cases, it can make daily activities, such as holding a pen, driving, or shaking hands, more difficult (Powell, 2024). Additionally, people with hyperhidrosis are more prone to skin infections (Mayo Clinic, 2024).

Types of Hyperhidrosis

Depending on the cause, hyperhidrosis can be divided into two types: primary and secondary hyperhidrosis.

• Primary hyperhidrosis: Excessive sweating that usually occurs during adolescence or even earlier. It affects the hands, feet, face, and armpits. The cause of this condition is unknown.
• Secondary hyperhidrosis: This type of hyperhidrosis starts in adulthood and has a medical cause, such as hormonal disorders, infections, or neurological diseases. Certain medications can also trigger this condition (Powell, 2024).

Depending on the areas of the body affected by sweating, several types of hyperhidrosis are also recognized:

• Focal hyperhidrosis: When excessive sweating affects specific body parts, it is called focal hyperhidrosis. It typically affects the palms, soles, armpits, and forehead.
• Generalized hyperhidrosis: This condition involves sweating of the entire body, usually including the head, chest, abdomen, back, arms, legs, groin, and buttocks.
• Axillary hyperhidrosis: This type of hyperhidrosis affects the armpits. Problems with the armpits typically start in late adolescence.
• Palmoplantar hyperhidrosis: This refers to excessive sweating on the palms and soles, usually starting around the age of 13 (Powell, 2024).

Causes of Hyperhidrosis

Primary hyperhidrosis occurs due to incorrect nerve signals that excessively activate sweat glands, usually on the palms, soles, armpits, and face. There is no known medical cause, but it may be hereditary (Mayo Clinic, 2024). Genetic predisposition increases the risk of developing excessive sweating by 50% (BelMedic, n.d.).

Secondary hyperhidrosis is a result of other medical conditions or medications, such as pain relievers, antidepressants, or medications for diabetes and hormones. It can cause sweating of the entire body and can be associated with conditions such as diabetes, menopause, thyroid problems, certain types of cancer, neurological disorders, and infections (Mayo Clinic, 2024).

Symptoms of Hyperhidrosis

The main symptom of hyperhidrosis is excessive sweating, which can cause a feeling of moisture on the skin, wet clothing, or even droplets falling from the skin (e.g., from the forehead). Over time, this condition can lead to other unpleasant symptoms, such as itching and inflammation due to skin irritation from sweat, unpleasant body odor caused by the mixture of sweat and bacteria on the skin, or even cracking and peeling of the skin on the feet (Cleveland Clinic, 2023).

Symptoms of hyperhidrosis can be mild and occasional, or persistent and severely affect daily life. In addition to physical symptoms, this condition can have an emotional impact. Many people feel embarrassed by sweating or avoid social situations. If hyperhidrosis affects your mental health, it is important to consult a doctor who can help control the symptoms, as well as a mental health professional who can help you cope with the emotions caused by this condition (Cleveland Clinic, 2023). Additionally, excessive sweating can sometimes indicate a serious condition, so it is crucial to seek immediate medical attention if it occurs with symptoms such as dizziness, chest pain, or a rapid pulse. Also, see a doctor if sweating interferes with your daily life, causes emotional stress, leads to social withdrawal, or if you notice a sudden increase in sweating or night sweats without explanation (Mayo Clinic, 2024).

Diagnosis of Hyperhidrosis

The diagnosis of hyperhidrosis is made based on a physical examination, symptoms, and medical history. If you sweat in specific body areas, on both sides of the body, and this has been occurring for at least six months, and the symptoms interfere with your daily life and there is a family history of hyperhidrosis, it may indicate hyperhidrosis. To determine the cause of hyperhidrosis, the doctor may use several tests:

• Starch and iodine test: The doctor applies an iodine solution to the sweaty area, then sprinkles starch. The areas where sweating is excessive turn dark blue.
• Paper test: A special paper is placed on the affected area to absorb sweat, and the amount of sweat absorbed is measured, determining the intensity of sweating.
• Blood tests or imaging: These tests may take a blood sample or scan the area beneath the skin, providing the doctor with additional information about the cause of your symptoms (Cleveland Clinic, 2023).

If excessive sweating becomes a serious problem, causes discomfort in social situations, or worsens over time, it is important to see a doctor. It is always essential to act promptly, especially if sweating is accompanied by symptoms such as chest pain, nausea, or dizziness. In cases where this condition negatively affects mental health, it is recommended to speak with a healthcare provider or mental health professional (Ibid).

Treatment of Hyperhidrosis

Hyperhidrosis is not life-threatening, but it can seriously impact daily life, causing discomfort, embarrassment, or gradual withdrawal from activities that you normally enjoy. Although there is no cure for hyperhidrosis, various treatments can significantly improve the quality of life and help reduce symptoms (Cleveland Clinic, 2023). Treatment, regular visits to the doctor, and lifestyle changes, such as wearing breathable clothing, can help keep symptoms under control (Powell, 2024).

Treatment of hyperhidrosis depends on the affected body part, the severity of the symptoms, and the appropriate treatment. A healthcare provider or dermatologist will help you find the most effective options, which may include:

• Home treatment, such as using antiperspirants (preferably aluminum-based), more frequent showers, and wearing breathable clothing like cotton;
• Medications, including anticholinergic drugs, antidepressants, beta-blockers, medical wipes, or aluminum chloride gel; If symptoms do not improve, specialized therapies may be recommended, such as:
• Iontophoresis: A special device emits a low electric current through water, gradually blocking sweat glands. Each therapy lasts 10 to 20 minutes, and repeated treatments may be required. This therapy can also be done at home;
• Botulinum toxin injection (Botox®): A botulinum toxin injection into an overactive nerve can stop sweating production for several months, after which the treatment needs to be repeated;
• Microwave therapy: A high-tech device (miraDry®) emits heat to the affected skin area, permanently destroying overactive sweat glands. The procedure lasts about an hour and is performed in a healthcare professional’s office.
• If these methods are not effective, surgery may be an option, including minimally invasive procedures or removal of sweat glands (Cleveland Clinic, 2023).

Each therapy can have side effects, such as skin irritation and color changes, pain, discomfort, scarring, or damage to clothing, so it is important to discuss potential risks with your doctor before deciding on a treatment (Ibid).

Conclusion

Hyperhidrosis, although not life-threatening, can severely affect daily life, causing physical and emotional discomfort. Excessive sweating can lead to social isolation, embarrassment, and even physical issues like skin irritation and infections. While there is no cure for this condition, there are numerous treatments available that can significantly improve the quality of life for those affected. From lifestyle changes, such as wearing breathable clothing, to therapies like iontophoresis, Botox, or microwave treatments, there are various options for controlling symptoms. It is important to consult a doctor to obtain an accurate diagnosis and choose the most appropriate treatment, significantly reducing the impact of this condition on physical and mental health. Speaking with mental health professionals is also recommended to cope with the emotional challenges that hyperhidrosis can cause.

*This text is intended for informational purposes only. If you experience any symptoms, it is recommended that you seek advice from your doctor or a qualified healthcare professional.

Reference

• BelMedic. (n.d.). Excessive sweating (hyperhidrosis). BelMedic. Retrieved February 9, 2025, from https://www.belmedic.rs/bolesti-od-a-do-s/prekomerno-znojenje-hiperhidroza
• Cleveland Clinic. (2023, July 1). Hyperhidrosis. Retrieved from https://my.clevelandclinic.org/health/diseases/17113-hyperhidrosis
• Powell, A. (2024, September 2). Hyperhidrosis. WebMD. Medically reviewed by Stephanie S. Gardner, MD. Retrieved from https://www.webmd.com/skin-problems-and-treatments/hyperhidrosis2
• Mayo Clinic. (2024, October 25). Hyperhidrosis: Symptoms and causes. Mayo Clinic. Retrieved from https://www.mayoclinic.org/diseases-conditions/hyperhidrosis/symptoms-causes/syc-20367152
• Dumlao, N. (2020, October 21). Man in white shirt sitting on black chair [Photograph]. Unsplash. Retrieved from https://unsplash.com/photos/man-in-white-shirt-sitting-on-black-chair-RJp0YdjgK_E