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

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.
Guidelines
- About hyperhidrosis: clinical guidelines
- Hyperhidrosis: management options
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