Hyperhidrosis

Last reviewed: 23 Aug 2023
Last updated: 08 Sep 2020

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
More key diagnostic factors

Risk factors

  • family history
  • high emotional states
  • spicy foods
  • hot or humid climates
  • medications
  • substance abuse
  • endocrine disorders
  • cardiovascular diseases
  • hypoglycemia
  • menopause
  • infectious diseases
  • sepsis
  • neoplastic diseases
  • carcinoid tumors
  • neurologic injuries
  • obesity
More risk factors

Diagnostic investigations

Investigations 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
  • urine drug screen
  • chest x-ray
  • CT scans
More investigations to consider

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

Paul S. Yamauchi, MD, PhD

Dermatology Institute and Skin Care Center

Clinical Science Institute

Santa Monica

CA

Disclosures

PSY declares that he has no competing interests.

Jeffrey Milliken, MD

Clinical Professor and Chief

Division of Cardiothoracic Surgery

UC Irvine School of Medicine

Orange

CA

Disclosures

JM 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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