Hyperhidrosis is a medical condition characterized by excessive sweating
that far exceeds what the body needs for temperature regulation. While sweating is a natural process, those with hyperhidrosis produce an abnormally high amount of sweat, even in situations where it’s not expected—such as while resting or in cool environments. This condition can significantly affect daily activities and social interactions, leading to discomfort and self-consciousness.
Types of Hyperhidrosis (Primary vs. Secondary)
Hyperhidrosis is generally divided into two categories: primary and secondary hyperhidrosis.
- Primary (Focal) Hyperhidrosis: This form usually affects specific areas of the body, such as the underarms, hands, feet, or face. It often starts in childhood or adolescence and tends to have a genetic link, meaning it can run in families. Primary hyperhidrosis is not caused by an underlying medical condition or medications, and the excessive sweating is typically triggered by emotional, psychological, or unknown factors.
- Secondary (Generalized) Hyperhidrosis: Unlike primary hyperhidrosis, secondary hyperhidrosis is often the result of an underlying medical condition or the side effect of a medication. Conditions like hyperthyroidism, diabetes, or menopause can lead to excessive sweating across larger areas of the body. Secondary hyperhidrosis typically appears later in life and may require treatment of the underlying condition to reduce the sweating.
Symptoms and Diagnosis
The primary symptom of hyperhidrosis is excessive sweating, but how it manifests can differ depending on the type. In primary hyperhidrosis, sweating is usually limited to specific areas of the body, such as the underarms (axillary hyperhidrosis), palms (palmar hyperhidrosis), or soles of the feet (plantar hyperhidrosis). In secondary hyperhidrosis, however, sweating tends to occur across larger areas or the entire body.
Doctors typically diagnose hyperhidrosis based on a patient’s medical history and symptoms. Common diagnostic criteria include:
- Excessive sweating that persists for at least six months without an apparent cause.
- Sweating that affects specific areas of the body on both sides (symmetrically).
- Episodes of sweating occurring at least once per week.
- Symptoms starting before the age of 25 (in the case of primary hyperhidrosis).
- No sweating while sleeping (for primary hyperhidrosis).
- Sweating that interferes with daily activities or social interactions.
Your doctor may also conduct tests such as the starch-iodine test or thermoregulatory sweat test to determine the extent of excessive sweating.
Causes of Excessive Sweating
The causes of hyperhidrosis depend on whether it’s primary or secondary.
- Primary Hyperhidrosis: The exact cause of primary hyperhidrosis isn’t well understood, but it is believed to involve overactivity of the nerves that signal the sweat glands. These overactive nerves send signals even when the body doesn’t need to cool down, leading to excessive sweating. Genetics may also play a role, as primary hyperhidrosis tends to run in families.
- Secondary Hyperhidrosis: This form is often linked to medical conditions or medication use. Some of the common causes include:
- Hyperthyroidism (an overactive thyroid)
- Diabetes
- Menopause
- Infections like tuberculosis
- Neurological conditions
- Certain medications, including antidepressants and blood pressure medications
In secondary hyperhidrosis, treating the underlying condition or adjusting medications may help alleviate the excessive sweating.
Who is Affected? (Statistics and Demographics)
Hyperhidrosis affects people of all ages, genders, and backgrounds, though it typically starts during childhood or adolescence in the case of primary hyperhidrosis. According to studies, about 4.8% of the U.S. population (approximately 15 million people) suffer from hyperhidrosis. However, experts believe the condition is underreported, and the actual number of individuals affected may be much higher.
- Gender: Hyperhidrosis affects both males and females equally. However, men tend to experience more sweating on the palms and feet, while women report more underarm sweating.
- Age: Primary hyperhidrosis often begins in childhood or adolescence, with many people noticing symptoms before the age of 25. Secondary hyperhidrosis can occur at any age, particularly if related to an underlying condition such as menopause or a thyroid disorder.
Living with Hyperhidrosis: Psychological and Social Impacts
The constant worry about sweat marks, damp clothes, and handshakes can take a psychological toll on those with hyperhidrosis. Many people report feeling embarrassed, anxious, or socially isolated due to their condition. The fear of excessive sweating can lead to avoidance behaviors, such as skipping social events or wearing only dark clothing to hide sweat stains. Over time, this can severely impact mental health, contributing to low self-esteem, anxiety, and even depression.
Hyperhidrosis also poses practical challenges in the workplace, school, and daily life. Simple tasks like holding a pen, using a touchscreen, or shaking hands can become uncomfortable and embarrassing. Those with hyperhidrosis may also struggle with skin infections, irritation, and body odor due to constant moisture on the skin.
However, with the right management strategies—such as finding the right antiperspirant or pursuing medical treatments—many people with hyperhidrosis can regain confidence and lead fulfilling lives.