Hyperhidrosis: What It Is and Why Excessive Sweating Occurs

You step out of the shower — and soon your T-shirt is wet under the arms again. Or your palm slips on the handrail in the subway, even though the car is cool. Let's figure out where ordinary sweating ends and hyperhidrosis begins.

What is hyperhidrosis

Hyperhidrosis is a dysfunction of the sweating system in which a person sweats excessively. External triggers and internal diseases can set the process in motion.

Sweat is a fluid from the sweat glands that contains salt. This is how the body cools down. The process is controlled by the autonomic nervous system, which works without our will.

Sweating in normal conditions and in hyperhidrosis

Sweating is normal. You sweat in the heat, during exercise, with agitation, anger, fear, or embarrassment.

Intensity depends on the number of glands. A person is born with approximately 2–4 million sweat glands, and they become fully active during puberty. In men, the glands are on average more active.

The boundary of normal is simple. Sweating is excessive when you sweat but the body does not need to cool down.

Types: focal and generalized hyperhidrosis

The focal form affects specific areas. Most often these are the armpits, palms, face, soles, and large skin folds.

The generalized form covers all areas where sweat glands are present. It can be physiological — in heat, during physical or emotional stress. And it can be secondary, that is, a consequence of another condition.

The focal form is aggravated by tight shoes, rubber soles, and synthetic clothing. Excess sweat softens the skin and changes its acidity. This creates conditions for fungal and pyogenic flora. Sweat can cause an unpleasant odor and stain fabric.

Causes of excessive sweating

The causes fall into two groups. External stimuli — heat, exertion, stress. Internal — diseases, medications, hormonal shifts.

• Emotional and stressful situations, anxiety: gland activity reflects the level of mental tension.
• Heat, physical exertion, alcohol, caffeine, spicy food. The reaction to spices is called gustatory sweating.
• Medications: thyroid hormones, antipyretics, morphine-based analgesics, medications for treating mental disorders. Sweating occurs with withdrawal from alcohol, sedatives, and narcotic analgesics.
• Diseases: infection with fever, a sharp drop in blood glucose, tuberculosis, nervous system lesions, thyrotoxicosis, diabetic neuropathy, chronic heart failure, rheumatoid arthritis, Alzheimer's disease.
• Hormonal conditions: menopause with hot flashes.

A separate story is essential hyperhidrosis. In it, there are more glands, and they respond more strongly to ordinary stimuli.

How a doctor assesses sweating

The diagnosis is based on complaints and examination. Often this is enough.

If another disease is suspected, the doctor refers the patient for tests. Sweat gland activity is assessed using dynamic infrared thermography.

The doctor clarifies how long the problem has existed, the frequency of episodes, night sweats, family history, and medication use. These details distinguish the primary form from the secondary one.

When excessive sweating requires a visit to the doctor

See a doctor if sweating has lasted six months or more. Or occurs at least once a week. Or interferes with work, study, and communication.

A reason for a visit is night sweats, fever, weight loss, hyperhidrosis in relatives, or medication use for another disease. And also a situation where your own measures do not help.

Sweating together with weight loss should be alarming. This occurs with increased thyroid function and with infection.

Excessive sweating by itself is not a reason to call an ambulance. Call 103 or 112 if sweating occurs together with pain or pressure in the chest, a rapid and noticeable heartbeat, or shortness of breath.

This material is for reference: it does not replace a doctor's consultation and does not take your history into account.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer