Key Takeaways

  • Hyperhidrosis causes excessive sweating beyond what your body needs for temperature regulation. Treatment usually starts with topical antiperspirants and may also include oral medications, Botox, and surgery.
  • Primary (focal) hyperhidrosis affects specific areas, such as the hands, feet, and underarms. Secondary (generalized) hyperhidrosis causes you to sweat all over the body.
  • Focal hyperhidrosis is linked to overactive cholinergic receptors in sweat glands. Generalized hyperhidrosis is associated with conditions like diabetes, hyperthyroidism, substance use, and Parkinson’s disease.

Hyperhidrosis disorder is a condition that results in excessive sweating.

Sweating is your body’s natural cooling mechanism to help regulate its temperature. It’s a natural response to certain conditions, such as warm weather, physical activity, stress, and feelings of fear or anger.

With hyperhidrosis, however, you sweat more than usual and often for no apparent reason. This occurs even when your body doesn’t need to cool down, such as in cool weather.

Keep reading to learn more about the types and symptoms of hyperhidrosis and how to manage the condition.

What are the types of hyperhidrosis?

There are two types of hyperhidrosis:

  • Primary (focal) hyperhidrosis: This is the most common type of hyperhidrosis. It usually affects one or two areas, including the hands, feet, face, scalp, and underarms. It tends to affect people ages 24 years or younger.
  • Secondary (generalized) hyperhidrosis: This type is caused by a medical condition or as a side effect of certain medications. You might sweat all over your body or in just one area.

The underlying cause of hyperhidrosis may depend on the type you have. This will also dictate where you experience symptoms of excessive sweating.

Primary focal hyperhidrosis

Primary focal hyperhidrosis occurs when the cholinergic receptors on your eccrine glands become overactivated. These receptors are part of your sympathetic nervous system.

Sweating from primary hyperhidrosis occurs where these glands are located. It usually affects one or two specific areas, such as the underarms, hands, feet, or face. This is why it’s labeled “focal.”

The exact cause of hyperhidrosis is unknown, but it may be passed down in families.

Secondary generalized hyperhidrosis

Secondary generalized hyperhidrosis is excessive sweating caused by a medical condition or as a side effect of certain medications.

Conditions that may cause this type include:

Several types of prescription and over-the-counter (OTC) medications can cause hyperhidrosis as well. This may include some types of:

If you experience excessive sweating and are taking any of these medications, speak with a healthcare professional. They could help review your treatment plan.

The most common symptom of hyperhidrosis is excessive sweating in one or two body parts. If you have secondary hyperhidrosis, you may experience sweating all over your body.

According to the American Academy of Dermatology Association (AAD), sweating usually stops at night in primary hyperhidrosis, but it’s possible to experience night sweats with secondary hyperhidrosis.

Other symptoms of hyperhidrosis that may affect the areas where you sweat include:

  • body odor
  • chaffing skin
  • skin infections

Hyperhidrosis may also affect your quality of life, leading to feelings of stress, anxiety, and depression. For instance, if hyperhidrosis affects your hands, you may be nervous to shake hands with others or find it more difficult to use a computer.

A healthcare professional could provide a proper diagnosis and develop a treatment plan that’s right for you.

Excessive sweating can be a symptom of other, more serious conditions. Speak with a healthcare professional if you experience excessive sweating and:

It’s also important to see a doctor if you experience frequent night sweats or unexplained, prolonged sweating.

A healthcare professional will perform a physical examination and medical history. This will include questions about:

  • your symptoms, such as when and where they occur
  • any medications you may be taking
  • any health conditions you may have

According to the AAD, a doctor can diagnose primary focal hyperhidrosis if you experience two or more of the following:

  • excessive sweating that’s occurred for at least 6 months without an apparent reason
  • incidents of excessive sweating at least once a week
  • sweating that interferes with your daily activities, such as work or relationships
  • excessive sweating that began when you were younger than 24 years old
  • not sweating in your sleep
  • a family history of hyperhidrosis

If a doctor thinks you may have secondary hyperhidrosis, they may order several tests to help determine the underlying cause of your excessive sweating. These may include:

A doctor may perform three tests to help determine the severity of your sweating:

  • Starch-iodine test: This involves putting iodine on the sweaty area. When the iodine dries, starch is sprinkled on this area. If the starch turns dark blue, you have excess sweating.
  • Paper test: This involves putting a special kind of paper on the sweaty area. After it absorbs your sweat, the paper is weighed. A heavier weight means you’ve sweated excessively.
  • Thermoregulatory test: Similar to the starch-iodine test, this test uses a special powder that’s sensitive to moisture. The powder changes color in areas where there’s excessive sweating.

Your treatment plan for hyperhidrosis will aim to help reduce your symptoms and increase your quality of life.

There are several treatment options for excessive sweating.

Topical treatments are the first-line approach for primary hyperhidrosis. These are medications applied to the skin and may include:

  • an antiperspirant that contains aluminum chloride
  • prescription cloth wipes (glycopyrronium tosylate)

Other treatments for hyperhidrosis may include:

If you have secondary hyperhidrosis, a healthcare professional could help modify your treatment plan for the underlying cause. This may include alternating the dosage, stopping to take the drug, or suggesting an alternative.

Does ADHD cause excessive sweating?

The relationship between ADHD and hyperhidrosis is not well studied.

A 2020 study involving 96 participants found no difference between the ADHD and control groups in hyperhidrosis of the palms and soles. However, a 2014 review suggested that some antidepressant medications used to treat ADHD may cause hyperhidrosis.

How rare is hyperhidrosis?

It’s estimated that almost 5 in 100 people have hyperhidrosis in the United States, but this figure may be underreported.

What triggers hyperhidrosis?

Some triggers of hyperhidrosis may include:

  • exercise
  • anxiety or stress
  • hot weather
  • humidity
  • caffeine

Hyperhidrosis is a condition in which you experience excessive sweating.

Primary focal hyperhidrosis occurs when you sweat excessively in areas like your armpits, feet, and hands. It often happens for no apparent reason.

Secondary generalized hyperhidrosis occurs due to certain medical conditions and medications.

Speak with a doctor if you have excessive sweating. They could provide a proper diagnosis and develop a treatment plan for you.