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Hyperhidrosis

Last reviewed: 30 Sep 2024
Last updated: 18 Jan 2024

Summary

Definition

History and exam

Key diagnostic factors

  • excessive palmar sweating
  • excessive plantar sweating
  • onset in early childhood or puberty
  • exacerbation of palmar sweating with use of hand lotion
  • severe facial sweating
  • severe axillary sweating
  • generalized sweating
Full details

Risk factors

  • family history
  • spicy foods
  • medications
  • endocrine disorders
  • cardiovascular diseases
  • hypoglycemia
  • menopause
  • infectious diseases
  • sepsis
  • neoplastic diseases
  • carcinoid tumors
  • neurologic injuries
  • obesity
Full details

Diagnostic tests

Tests to consider

  • starch-iodine test
  • gravimetry
  • thyroid function test
  • metabolic panel
  • 24-hour urine collection for catecholamines, metanephrines, normetanephrines
  • serum free metanephrines, normetanephrines
  • urine 5-hydroxyindoleacetic acid
  • chest x-ray
  • CT scans
Full details

Treatment algorithm

ACUTE

primary: axillary hyperhidrosis

primary: palmar hyperhidrosis

primary: plantar hyperhidrosis

primary: craniofacial hyperhidrosis

secondary hyperhidrosis

Contributors

Authors

Fritz J. Baumgartner, MD
Fritz J. Baumgartner

Surgery Associates

Long Beach

Clinical Assistant Professor of Surgery

Division of Cardiothoracic Surgery

Harbor-UCLA Medical Center

Torrance

CA

Disclosures

FJB is author of a number of references cited in this topic.

Peer reviewers

Jane S. Bellet, MD

Professor of Pediatrics and Dermatology

Duke University School of Medicine

Durham

NC

Disclosures

JSB declares that he has no competing interests.

Jonathan Villena-Vargas, MD

Assistant Professor of Cardiothoracic Surgery

Cardiothoracic Surgery Department

New York-Presbyterian/Weill Cornell Medical Center

NY

Disclosures

JVV declares that he has no competing interests.

Alan Cameron, MA, MCh, FRCS

Consultant Surgeon

Ipswich Hospital NHS Trust

Ipswich

UK

Disclosures

AC declares that he has no competing interests.

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