Doctor's Notes on Hyperhidrosis (Excessive Sweating)
Hyperhidrosis is a term for excessive sweating, and may be generalized over the entire body or localized to certain areas. Hyperhidrosis can be considered primary, without any underlying associated medical conditions, or it can be secondary (acquired) to other medical conditions:
- Primary hyperhidrosis can run in families and usually becomes considerable at or before puberty.
- Secondary hyperhidrosis can occur at any age.
Symptoms of primary hyperhidrosis include:
- excessive sweating of the palms, soles, and armpits that starts with the first social exposure of the day,
- often reduced at night and dry when a person is relaxed and ready for bed.
Symptoms of secondary hyperhidrosis may occur:
- throughout the day, in unpredictable paroxysms such as in adrenal gland tumors (pheochromocytoma),
- timed with the peak blood levels of certain medications, or
- as "night sweats" in patients with tuberculosis.
Anxiety and depression may be associated with hyperhidrosis due to its impact on quality of life.
What Is the Treatment for Hyperhidrosis?
Treatments for hyperhidrosis are aimed at controlling the rate of sweating and may include one or more of the following measures:
- Prescription antiperspirants containing aluminum chloride
- Anticholinergic medications, which can block certain nerve signaling pathways and help reduce sweating
- Botulinum toxin injections (Botox), which may decrease excessive underarm sweating
- Microwave, laser, or ultrasound destruction of the sweat glands
- Antidepressant medications may reduce sweating in some people
- Surgical procedures may be used as a last resort for severe cases
Sweating (Perspiration) : Test Your IQ Quiz

Sweat is odorless.
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REFERENCE:
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.