Blog Details

Hyperhidrosis (HPH)

Hyperhidrosis (HPH): Symptoms, Causes, and Treatment

What is Hyperhidrosis?

Hyperhidrosis (HPH) is a condition characterized by excessive sweating beyond what is necessary for normal body temperature regulation. It often affects areas rich in eccrine sweat glands such as the underarms, palms, soles, and face, creating social and emotional distress.

Symptoms

• Excessive sweating that soaks through clothes or drips from hands and feet.
• Sweating episodes occur at least once weekly, usually on both sides of the body.
• Sweating unrelated to heat, exercise, or anxiety (primary hyperhidrosis).
• Can lead to skin infections, embarrassment, social withdrawal, and occupational impairment.

Causes

• Primary hyperhidrosis: Idiopathic, possibly due to overstimulation of cholinergic receptors on sweat glands.
• Secondary hyperhidrosis: Due to underlying conditions like infections, hyperthyroidism, diabetes, neurologic diseases, medications, or systemic illnesses.
• Impairment in acetylcholine negative feedback loops may contribute to excessive sweat gland activation.

Diagnosis

• Primarily clinical based on history and physical examination.
• Severity scales and tests like the starch-iodine test may be used.
• Laboratory testing to rule out secondary causes if indicated.

Treatment

• Topical therapies: Aluminum chloride hexahydrate antiperspirants are first-line for mild-to-moderate cases but may cause skin irritation. Recently, topical glycopyrronium cloths were approved for hyperhidrosis.
• Oral medications: Anticholinergics such as oxybutynin and glycopyrrolate reduce sweating but have systemic side effects.
• Iontophoresis: Electrical treatment used mainly for palms and soles, requiring multiple sessions.
• Botulinum toxin injections (Botox): Block acetylcholine release at nerve terminals supplying sweat glands, effective for axillary, palmar, plantar, and facial hyperhidrosis. Effects last several months but require repeat injections.
• Surgical options: Sympathectomy to cut sympathetic nerves controlling sweat glands or excision/liposuction of sweat glands may be considered in refractory cases. Surgery carries risk of compensatory sweating and other complications.

Key Points

• Hyperhidrosis is excessive sweating causing significant social and functional impairment.
• It can be primary (idiopathic) or secondary to other medical conditions.
• Treatment ranges from topical and oral agents to injections and surgery depending on severity.
• Early consultation improves management and quality of life.

Consult with Our Team of Experts Now!

For thorough diagnosis and individualized hyperhidrosis treatment plans including the latest therapies, consult our dermatology and surgical specialists dedicated to effective care.

References:

1. Maazi H, Leung AKC, Lam JM. Primary Hyperhidrosis: An Updated Review. Cureus. 2025 Jun 15;17(6):e40573. doi:10.7759/cureus.40573. Available at: https://pubmed.ncbi.nlm.nih.gov/40575073/​
2. Hyperhidrosis. StatPearls. 2022 Oct 2. Available at: https://www.ncbi.nlm.nih.gov/books/NBK459227/​
3. Baumann L. Hyperhidrosis: Management Options. Am Fam Physician. 2018 May 31;97(12):729-736. Available at: https://www.aafp.org/pubs/afp/issues/2018/0601/p729.html​
4. Hyperhidrosis – Mayo Clinic. Symptoms, causes & treatment. 2024 Oct 24. Available at: https://www.mayoclinic.org/diseases-conditions/hyperhidrosis/symptoms-causes/syc-20367152​
5. Hyperhidrosis: Types, Causes & Treatment. Cleveland Clinic. 2025 Aug 25. Available at: https://my.clevelandclinic.org/health/diseases/17113-hyperhidrosis