What is Hyperhidrosis?

Hyperhidrosis - Excessive Sweating

Hyperhidrosis refers to excessive sweat production that occurs persistently or repeatedly. It can be localized to specific body areas or affect the entire body. In most cases, excessive sweating is limited to daytime. Nighttime excessive sweating (night sweats) is referred to as nocturnal hyperhidrosis. Although precise data is lacking, it's estimated that about 1-3% of the Western population suffers from hyperhidrosis.

Sweating has a physiological and life-sustaining function in thermoregulation. Conversely, generalized anhidrosis (severely reduced or absent sweat secretion) can lead to hyperthermia and heatstroke. However, excessive sweating is considered a medical condition. It recurrently and significantly exceeds the amount necessary for temperature regulation. Dripping sweat, soaked clothing, and constantly moist skin trigger psychological or physical symptoms that significantly impair those affected in their social and professional activities. In a society that doesn't tolerate natural odors and perceives sweating as unhygienic, people with hyperhidrosis feel socially stigmatized. Psychological issues are almost always a consequence of this condition, often leading to social isolation. Additionally, there are secondary conditions like fungal skin infections, bacterial skin infections, and eczema, as well as practical everyday problems like paper becoming soaked with just a touch. Sweat attacks in hyperhidrosis can be triggered by minor thermal, emotional, or gustatory stimuli, or often occur without any apparent trigger. If hyperhidrosis is limited to certain body areas, it's called focal hyperhidrosis; otherwise, it's generalized hyperhidrosis. Hyperhidrosis can occur as a symptom or side effect of an illness, a health disorder, or medication use (secondary hyperhidrosis) or arise without a discernible cause (primary hyperhidrosis).

Classification and Causes of Hyperhidrosis

1. Hyperhidrosis as a Symptom of an Illness (Secondary Hyperhidrosis)

Secondary hyperhidrosis refers to excessive sweating as a accompanying symptom of an underlying disease, disorder, or external influences. Generally, secondary hyperhidrosis affects the entire body (generalized hyperhidrosis). Some of the possible causes: Some of the medical conditions:

• Hyperthyroidism or similar hormonal imbalances
• Severe psychiatric disorders
• Obesity
• Hot flashes during menopause
• Medication side effects
• Alcohol abuse
• Acute medical emergencies like heart attacks

In the case of secondary hyperhidrosis, the goal should be to treat the underlying condition. This will, as a side effect, treat the hyperhidrosis.

2. Hyperhidrosis Without Known Causes (Primary Hyperhidrosis)

This is a very common form of hyperhidrosis. It generally begins in puberty but can also start in childhood or later in life and persist throughout one's life. The sweat outbreaks occur either due to very minor stimuli or entirely without being attributable to specific physical exertion, high ambient temperatures, stress, or other triggers. They usually occur in episodes, often multiple times a day, and significantly disrupt daily life. Typically, they occur in localized areas, such as the soles of the feet, palms of the hands, underarms, or face. Nervousness and excitement can be triggering factors, which can lead to a vicious cycle. The sweat outbreaks then lead to shame and excitement, which in turn leads to the next sweat outbreak. However, this is not a mental illness. Hyperhidrosis can, however, exacerbate psychological problems in patients with psychiatric disorders. Due to familial clustering, a hereditary component is suspected. Experts believe that the sympathetic nervous system, which controls sweat production, is overactive in these cases. The symptoms improve for many patients in winter, while they worsen in summer.

Manifestations of Primary Hyperhidrosis:

Hyperhidrosis Axillaris (Underarm Sweating)

This form of hyperhidrosis, often combined with hand sweating, can be very uncomfortable due to the formation of large wet patches in clothing or even ring-shaped salt deposits. Because apocrine sweat glands are involved in hyperhidrosis axillaris, the problem of odor caused by the decomposition of sweat is intensified. Underarm sweat is particularly noticeable in people who have to wear shirts for work. However, there are numerous aids such as underarm pads or antiperspirants that can help.

Hyperhidrosis Manuum (Hand Sweating)

Excessive hand sweating is by far the most unpleasant and consequential form of hyperhidrosis. The hands are essential for important functions in daily life, both socially and professionally, and are more exposed to the environment than other body parts. Many people with this condition have severely limited career choices because they have difficulty handling moisture-sensitive materials like paper or electrical components. Many patients are reluctant to shake hands when greeting. Some patients even avoid all personal contact with others for fear of rejection. The severity of excessive sweat secretion varies from patient to patient and in the same patient depending on the situation. It can range from uncomfortable moisture to profuse (extremely heavy) dripping of the hands. In most patients, the hands not only become wet during sweat attacks but also cool, in extreme cases with a white-bluish discoloration. Due to the constant moisture, fungal skin infections or bacterial infections can easily occur in the spaces between the fingers. Iontophoresis often provides relief for hyperhidrosis manuum, and special antiperspirants for the hands are also available.

Hyperhidrosis Pedum (Foot Sweating)

Foot sweating is a widespread problem. However, it's relatively often due to footwear made of non-breathable materials. In contrast, hyperhidrosis is not triggered by footwear but is only exacerbated by poorly ventilated shoes. Therefore, only those forms of excessive foot sweating should be referred to as hyperhidrosis where the sweat is pronounced even without footwear or where shoes are soaked or even destroyed by the amount of sweat within a short time. Hyperhidrosis pedum is often characterized by strong odor formation. Because the skin of the feet is often exposed to prolonged moisture in the case of hyperhidrosis, fungal foot infections or bacterial infections are common consequences. To provide relief from excessive foot sweating, iontophoresis, various antiperspirants, foot powder, and special insoles are available. Additionally, attention should be paid to well-ventilated footwear made of breathable materials and suitable socks.

Other Localizations

Less common than the previously mentioned manifestations of hyperhidrosis is isolated hyperhidrosis of the trunk or thighs. In hyperhidrosis of the trunk, itchy and weeping eczema can form in skin folds, for example, under the breasts in female patients. Some patients complain of excessive sweat production on the face, especially the forehead, which many of those affected find particularly embarrassing.

• Many patients also suffer from a combination of several of the manifestations described above.
• Sweat secretions can occur suddenly or continuously.
• Sweat attacks can be triggered by high ambient temperatures or emotional factors (excitement, stress) or occur without a discernible cause.
• Generally, the condition worsens in summer and improves in the cold season.

You can find more tips in our "Sweating Guide". Learn how to control excessive sweating and cope with it better.

Erstmals publiziert am: 12.05.2011

Aktualisiert: 27.05.2025