Hyperhidrosis is a medical condition in which a person sweats excessively. This sweating is also unpredictable since the person can sweat when they are resting and when it is cold.


The cause of primary hyperhidrosis which affects the hands, feet and armpits is unknown though genetic factors are suspected to play a role since it seems to run in families. Overactive sweat glands also contribute to the condition since they produce sweat even without the normal triggers of exercise, warm temperature or situations that make a person stressed, nervous, angry, anxious, embarrassed or afraid.

Secondary hyperhidrosis is excessive sweating that is caused by another medical condition like acromegaly, alcoholism, anxiety, cancer, carcinoid syndrome, congestive heart disease, hyperthyroidism, lung disease, lymphoma, pheochromocytoma, rheumatoid arthritis, spinal cord injury, stroke and tuberculosis.

Medications like pilocarpine, iron and zinc supplements as well as street drugs can also cause secondary hyperhidrosis. This sweating can affect the entire body or just a single part like the face.


The main symptom of hyperhidrosis is wetness from the excessive sweating. In addition, secondary hyperhidrosis is usually associated with symptoms of the underlying condition which can range from weight loss to cough and fever.


The evaluation of hyperhidrosis includes Minor’s starch iodine test in which an iodine solution is applied to the sweating area. Starch is sprinkled after it dries and the combination of starch and iodine turns blue when there is excess sweat.

The paper test is also done to help make a diagnosis of hyperhidrosis. In this test a paper with special characteristics is placed on the sweaty areas and weighed after some time. The heavier the paper, the more sweat it has accumulated.


The treatment of hyperhidrosis includes the use of strong antiperspirants which plug the sweat ducts. These usually contain 10% to 20% of aluminum chloride hexahydrate and they are applied nightly to dry skin over the affected areas. Side effects include skin irritation and damage to clothing.

Medications known as anticholinergics are also prescribed to treat excessive sweating. Examples include Robinul whose side effects include a dry mouth.

Iontophoresis is a procedure that uses electricity to temporarily turn off the sweat glands. It is most effective for the palms and soles. In this procedure the hands and feet are placed in water and a mild electric current is passed through it. The electricity is gradually increased until the patient feels a mild tingling sensation. Sessions usually last for 10 to 20 minutes and several sessions are required to complete treatment. Iontophoresis has a high success rate of 83% in persons with sweaty palms and feet. Side effects include cracking of the skin and development of blisters.

Botulinum toxin type A, which is commonly known as Botox, is also used to treat severe sweating. This medication is injected into the affected areas to temporarily block the nerves that stimulate sweating. Its effects last for several months. Side effects include pain at the injection site, weakness and flu-like symptoms.

The miraDry Procedure has also received FDA approval for the treatment of hyperhidrosis. In this procedure, the sweat glands in the underarm area are safely eliminated by using microwave energy.

Endoscopic thoracic sympathectomy (ETS) is a surgical operation that is used for severe cases of hyperhidrosis that have failed to respond to other treatment options. In this procedure, the nerves that send signals to the body to sweat excessively are cut off. Side effects include compensatory sweating which is irreversible excessive sweating on large areas of the body.

Dietary measures that can reduce sweating include avoiding foods with caffeine and spices since they can stimulate the sweat glands to produce sweat.

Treatment of hyperhidrosis is important because without treatment it can have profound effects on a person’s quality of life by causing physical discomfort and social embarrassment. This can lead to social withdrawal and other emotional effects.


The latest research on hyperhidrosis focusses on the use of micro-needling to treat it. Micro-needling is a technique that uses a device with many fine needles to stimulate local blood circulation and collagen production in the skin.


Support groups for persons with excessive sweating include the International Hyperhidrosis Society whose executive director is Lisa J. Pieretti. She can be contacted via email at or by phone at 610 346 6008. The organization’s website is  and their address is 2560 Township Road, Suite B, Quakertown, PA, 18951. They can also be emailed at or faxed at 610 346 6004.