What are the types and causes of excessive sweating?
Primary (idiopathic) focal hyperhidrosis
This type of excessive sweating tends to affect both sides of your body - that is, the palms of both hands, soles of both feet or both armpits. On the rest of the body, you sweat normally.
The exact cause is not known and it is not associated with any other conditions. (The word idiopathic means of unknown cause.) It just seems that the sweat glands in these areas are more active or more sensitive than normal. In some people, it may run in the family so there may be some genetic factor involved in causing it. It usually first develops under the age of 25 years, but it can develop at any age. Men and women are equally affected. It is common and affects about 3 in 100 people.
The severity can vary from time to time. It may come and go and can be made worse by triggers such as anxiety, emotion, spicy foods or heat. Excessive sweating on the forehead, face, scalp and neck soon after eating is called gustatory sweating.
Anxiety about the sweating itself may make it worse. Excessive sweating tends to be a long-term condition but symptoms sometimes improve over time.
If you have the typical symptoms of primary focal hyperhidrosis, you usually do not need any tests. Your doctor may suggest one or more treatments (see below) if normal antiperspirants do not work well.
Secondary focal hyperhidrosis
This is uncommon. It means that the excessive sweating occurs in one particular part of your body because of a known or likely cause. For example, a spinal disease or injury may cause sweating in one leg. Your doctor may suggest some tests to look for an underlying cause.
This means that you sweat more than normal all over your body. This is less common than primary focal hyperhidrosis. However, it is usually caused by an underlying medical condition. A whole range of conditions can cause a generalised increased sweating. For example:
- Anxiety disorders.
- Various heart problems.
- Damage to nerves in the spinal cord.
- Side-effects to certain medicines.
- Various hormone problems (including an overactive thyroid gland).
- Certain cancers.
If you have generalised hyperhidrosis your doctor is likely to examine you and do some tests to find out the cause. The treatment depends on the cause.
Did you find this information useful?
- Grabell DA, Hebert AA; Current and Emerging Medical Therapies for Primary Hyperhidrosis. Dermatol Ther (Heidelb). 2017 Mar 7(1):25-36. doi: 10.1007/s13555-016-0148-z. Epub 2016 Oct 27.
- Hyperhidrosis; NICE CKS, July 2013 (UK access only)
- Endoscopic thoracic sympathectomy for primary hyperhidrosis of the upper limb; NICE Interventional Procedure Guidance, May 2014
- Benson RA, Palin R, Holt PJ, et al; Diagnosis and management of hyperhidrosis. BMJ. 2013 Nov 25 347:f6800. doi: 10.1136/bmj.f6800.
- Ibrahim O, Kakar R, Bolotin D, et al; The comparative effectiveness of suction-curettage and onabotulinumtoxin-A injections for the treatment of primary focal axillary hyperhidrosis: a randomized control trial. J Am Acad Dermatol. 2013 Jul 69(1):88-95. doi: 10.1016/j.jaad.2013.02.013. Epub 2013 Apr 13.
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