Hyperhidrosis (Excessive Sweating): Causes and Treatments

Table of Contents

1. Primary and Secondary Hyperhidrosis Are Two Different Situations
2. How Often It Occurs and What It Does to Daily Life
3. Sweat Glands and Nerves in Plain Words
4. Causes of Secondary Sweating
5. How Hyperhidrosis Is Measured
6. Aluminum Chloride
7. Topical Anticholinergics: Glycopyrronium and Sofpironium
8. Oral Oxybutynin and Glycopyrrolate
9. Botulinum Toxin Injections
10. Iontophoresis
11. Microwave Thermolysis
12. Endoscopic Thoracic Sympathectomy and Compensatory Sweating
13. Traditional and Dietary Reports
14. Key Research Papers
15. Connections
16. Featured Videos

Primary and Secondary Hyperhidrosis Are Two Different Situations

Hyperhidrosis is sweating beyond what the body needs to control its temperature. Researchers split it into two kinds. Primary hyperhidrosis, also called focal or idiopathic, has no underlying disease behind it and appears in otherwise healthy people, most often on the palms, armpits, soles or face (Haider 2005). Secondary hyperhidrosis comes from another illness or from a medicine, and it is often spread over the whole body (Maazi 2025; Behinaein 2025).

The split matters because the secondary form is a symptom of something else. Reviews state that primary hyperhidrosis accounts for 93% of all cases (Maazi 2025). That matches a 13-year chart review of 415 people at one university dermatology department, where 387 (93.3%) had the primary form and 28 (6.7%) the secondary form (Walling 2011). A dermatology clinic is a selected group, however. A general-population survey in Sweden found secondary hyperhidrosis in 14.8% of those who answered (Shayesteh 2016).

Features that separated the two in the chart review

• People with the secondary form were older on average, 39.0 years against 27.3 years. Onset after age 25 occurred in 55% of them against 12.1% of those with the primary form.
• Sweating on one side or unevenly was far more common in the secondary form (odds ratio 51), as was sweating over the whole body (odds ratio 18) and sweating at night (odds ratio 23.2).

From those data the same study tested a set of criteria for the primary form: excessive sweating for 6 months or more, plus 4 or more of these features: mainly on the armpits, palms, soles or head and face; on both sides and even; absent at night; episodes at least weekly; onset at age 25 or younger; a family history; and interference with daily activities. In that single-center group the criteria identified 99% of primary cases and correctly excluded 82% of secondary ones (Walling 2011).

Sweating at night is covered on the separate Night Sweats page.

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How Often It Occurs and What It Does to Daily Life

Estimates vary widely because surveys ask the question differently. One review gives a global range for the primary form of 0.072% to 9% (Maazi 2025), another gives 2–5% (Schreiner 2026), and a 2026 review attributes the spread to differences in method and in how well the condition is recognized (Shayesteh 2026).

• United States, 2004: a mailed survey of 150,000 households projected a prevalence of 2.8%, about 7.8 million people. Just over half of them (50.8%) reported underarm sweating (Strutton 2004).
• United States, 2016: an online panel of 8,160 people gave 4.8%, about 15.3 million people, and 70% of them reported severe sweating in at least one body area (Doolittle 2016).
• Sweden, 2016: of 1,353 people who answered, 5.5% had the primary form and 1.4% had it severely (Shayesteh 2016).
• Australia, 2026: of 3,000 adults surveyed, 156 reported excessive or abnormal sweating and 65% of those reported severe disease (Farrell 2026).

Many people never raise it with a health professional: 38% had done so in the 2004 US survey, 51% in the 2016 US survey and 49% in the Australian one, where 27% had a formal diagnosis. In the 2016 US survey the main reasons given were a belief that it is not a medical condition and a belief that no treatment exists (Strutton 2004; Doolittle 2016; Farrell 2026).

About one third of people with underarm hyperhidrosis in the 2004 survey said their sweating was barely tolerable and frequently interfered with daily activities, or was intolerable and always did (Strutton 2004). The review literature also describes cold, clammy skin and softened, damaged skin that is more prone to infection (Maazi 2025).

Anxiety and depression

Among 2,017 dermatology outpatients in Vancouver and Shanghai, anxiety was present in 21.3% of those with hyperhidrosis against 7.5% of those without it, and depression in 27.2% against 9.7%. Both rose with severity (Bahar 2016). A meta-analysis of 15 studies reported an odds ratio of 3.5 for anxiety, with a wide confidence interval of 1.0 to 11.8, and 2.4 for depression (Henning 2025). Another pooled 18 studies and 47,053 participants and put depression at 18.0%, while noting that the figure changed with the questionnaire used (Wang 2026). These are associations. They do not show which comes first. Stress and anxiety are also described as triggers that worsen sweating in the primary form (Maazi 2025), and they were the most commonly named trigger in a retrospective group of 69 patients, named by 15 of them (Patra 2020). More on the anxiety side is on the Anxiety and Social Anxiety Disorder pages.

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Sweat Glands and Nerves in Plain Words

The skin has two main kinds of sweat gland. Eccrine glands are spread over the whole body and make watery, odorless sweat for cooling. Apocrine glands sit at hair follicles and contribute to body odor. They are not the glands involved in primary hyperhidrosis. Eccrine glands are densest on the palms, soles and armpits, which are the places primary hyperhidrosis usually affects (Maazi 2025). The sweat animation shows how cooling normally works.

These glands take their orders from the sympathetic nerves, and the chemical signal at the gland is acetylcholine (Heckmann 2001). This one fact explains most of the treatments on this page. Anticholinergic medicines block that signal at its receptor, and botulinum toxin stops the nerve from releasing it. It also explains the commonest side effect: the same receptor type, called M3, dominates in both sweat glands and salivary glands, so a medicine that dries one tends to dry the other (Cheshire 2008).

The glands themselves are not the obvious fault. Under the microscope, eccrine glands in people with primary hyperhidrosis look the same as in other people and are not more numerous. The leading explanation is overactivity of the sympathetic nerves, though the review literature states that the exact mechanism remains unclear (Maazi 2025). A 2026 review adds that molecular changes found in the glands may be an adaptation to long-term nerve stimulation rather than the original cause (Shayesteh 2026).

Genes

Across 20 studies, between 5.7% and 65% of people with primary hyperhidrosis reported a family history. Studies have pointed to regions on chromosomes 2, 14 and 16, the evidence is described as limited, and the authors conclude that it is probably inherited through several genes (Henning 2019). In 2026, DNA sequencing of affected families linked one subset to rare changes in sodium channel genes, most strongly SCN10A. Mice engineered to carry one of those changes sweated excessively, and in mice the sweating reversed with sodium channel blockers (Yamauchi 2026). That abstract reports no treatment trial in people.

Sweat and the rest of the body

A comprehensive physiology review describes sweat as a minor route for removing waste and toxic substances compared with the kidneys and gut. It finds minimal risk of losing trace minerals and vitamins through sweat, and a raised risk of salt imbalance during long, heavy sweating in people with very salty sweat, such as those with cystic fibrosis (Baker 2019).

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Causes of Secondary Sweating

One large review lists conditions across more than a dozen categories (Maazi 2025). A hospital study of 420 adults with recurrent generalized sweating identified over 130 different causes, and 16.7% stayed without a diagnosis (Collercandy 2022). The groups named most often are below.

• Thyroid and other hormone disease. In the dermatology chart review, endocrine disease accounted for 57% of secondary cases, including 11 people with diabetes and 4 with hyperthyroidism (Walling 2011). Review lists also name acromegaly, pituitary tumors and adrenal insufficiency (Maazi 2025). The wider group of conditions is on the Thyroid Disorders page.
• Medicines. Drug classes reported to induce excess sweating include cholinesterase inhibitors, selective serotonin reuptake inhibitors, opioids and tricyclic antidepressants (Cheshire 2008). Venlafaxine is also reported. In one case report a 59-year-old woman's sweating on the head and neck resolved 5 weeks after paroxetine was withdrawn, and the authors rated the link as probable (Marcy 2005). Review lists add aromatase inhibitors, gonadotropin-releasing hormone agonists, antiandrogens and oral contraceptives (Maazi 2025).
• Infection. Infectious diseases made up 10.5% of the hospital group, including 13 people with tuberculosis (Collercandy 2022). Review lists also include bacterial endocarditis, HIV and malaria (Maazi 2025).
• Menopause. Menopause is listed among the physiological causes, alongside pregnancy, and ovarian insufficiency among the endocrine ones (Maazi 2025). Hot flushes are grouped with thermoregulatory disorders (Lu 2026); see Hot Flashes and Night Sweats and Menopause.
• Low blood sugar. Adults with type 1 diabetes who phoned in low-blood-sugar episodes (a reading under 4.0 mmol/L) most often reported hunger, sweating, trembling and weakness (Amin 2014).
• Tumors and blood cancers. In the hospital group, solid cancers made up 14.3%, including 13 lung cancers, and blood cancers 14.0%, including 35 non-Hodgkin lymphomas (Collercandy 2022). Review lists also name pheochromocytoma and carcinoid tumors (Maazi 2025). That study came from a tertiary hospital, so its mix does not describe sweating in the general public.
• Nerve disease. Neurologic disease accounted for 32% of secondary cases in the chart review, including peripheral nerve injury and Parkinson's disease. Uneven sweating pointed toward this group (Walling 2011).

Features linked to a serious cause

In the hospital study, fever, impaired general condition and a raised C-reactive protein blood test helped separate inflammatory, infectious and cancer causes from the others. Sweating lasting over 1 year counted against infection or cancer, with 94% specificity (Collercandy 2022). Review authors list weight loss, fever and swollen lymph nodes among the symptoms checked for a secondary cause (Maazi 2025).

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How Hyperhidrosis Is Measured

Diagnosis rests mostly on the history and examination. Three measures appear throughout the trials below (Schreiner 2026; Maazi 2025).

The Hyperhidrosis Disease Severity Scale (HDSS)

This is a single question scored from 1 to 4 (Solish 2007; Doolittle 2016):

1. Sweating is never noticeable and never interferes with daily activities.
2. Sweating is tolerable but sometimes interferes with daily activities.
3. Sweating is barely tolerable and frequently interferes with daily activities.
4. Sweating is intolerable and always interferes with daily activities.

Scores of 3 or 4 count as severe (Shayesteh 2016), and a Canadian expert committee built its 2007 treatment algorithm around this score and the body site (Solish 2007). Trials commonly count a “responder” as someone improving by at least 1 or 2 points. A Portuguese translation tested in 290 Brazilian patients proved reproducible and tracked changes with treatment (Varella 2016).

The starch-iodine test

Also called the Minor test, this one shows where sweat is coming from. An iodine solution is wiped on the skin and starch is dusted over it, and any sweat that appears turns black (Hong 2012). Clinicians use it to map the area before treatment; one large trial placed its injections inside the area this test defined (Naumann 2001). It shows location more than amount.

Gravimetry

Filter paper is weighed, held against the skin for a set time, then weighed again. Trials report the result in milligrams. Several trial authors acknowledge that this measure is hard to do reliably (Glaser 2019; Grove 2024).

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Aluminum Chloride

Aluminum chloride (also spelled aluminium chloride) is an aluminum salt from the antiperspirant family, described in trial reports as the established topical treatment (El-Samadony 2023). The 2007 Canadian committee placed it first for mild underarm, palm and sole sweating and among first choices in severe cases (Solish 2007). Review tables list skin irritation, heat rash and dermatitis as its common side effects (Maazi 2025). Trials comparing it with other treatments often favored the comparator, though most were small:

• In 40 patients randomized to oxybutynin 3% gel or aluminum chloride 15% lotion, the two were similar at 2 weeks and the gel was better at 4 weeks, with lower recurrence a month later (El-Samadony 2023).
• In palm sweating, a randomized trial found oral oxybutynin better than aluminum chloride. Itching occurred in 65.0% of the aluminum chloride group, and symptoms returned in both groups one week after treatment ended (Attallah 2022).
• In a three-arm trial of 66 patients, 81.8% of the botulinum toxin group had an excellent response, significantly more than with a 25% aluminum chloride lotion or oral oxybutynin (ElKholy 2025).
• In a retrospective series of 69 patients, around 15.3% responded adequately to the 20% lotion alone (Patra 2020).

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Topical Anticholinergics: Glycopyrronium and Sofpironium

These creams and gels apply a blocker of the sweat signal directly to the skin. Most trials studied underarm sweating and ran for only a few weeks.

• Glycopyrronium tosylate 3.75%. Two replicate phase 3 trials ran for 4 weeks. Pooled, 59.5% responded on a sweating diary against 27.6% on the inactive base, and sweat fell by 107.6 mg against 92.1 mg per 5 minutes. Both differences were statistically significant, and the inactive base also lowered sweat considerably (Glaser 2019).
• Glycopyrronium bromide 1% cream. In 171 patients over 4 weeks, sweat fell by 197.08 mg against 83.49 mg, while the severity scale response was 23% against 12%. Dry mouth occurred in 16% (Abels 2021). A meta-analysis of 4 trials and 1,401 patients found 2.33 times as many severity scale responders as placebo (Elrosasy 2024).
• Sofpironium 12.45% gel. Two phase 3 trials of 701 people in all (353 treated, 348 on the inactive gel) ran for 6 weeks. Both the severity measure and weighed sweat favored the drug, and the authors list the short treatment and follow-up as limits (Pariser 2025). A meta-analysis of 3 trials and 1,209 patients confirmed the benefit and found anticholinergic and application-site side effects statistically more common on sofpironium (Oshima 2026).

A 2026 meta-analysis of 8 trials and 1,921 patients found these agents as a group 2.40 times as likely as placebo to produce a 2-point severity scale improvement. Side effects of any kind were 1.43 times as likely. Sofpironium carried the highest risk of dry mouth, and glycopyrronium the highest for widened pupils and constipation. The authors note few trials and short follow-up (Kim 2026).

The drug can also reach other parts of the body. One case report describes a 22-year-old woman who made one emergency visit and several urgent care visits for difficulty urinating and blurred vision while using topical glycopyrronium together with cetirizine; the effects were reversible (Green 2023).

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Oral Oxybutynin and Glycopyrrolate

Tablets reach sweat glands all over the body and have been studied in widespread as well as focal sweating. The same reach explains side effects elsewhere. Oxybutynin is also used as a bladder medicine.

Oxybutynin

• In a placebo-controlled trial of 62 patients, most with generalized sweating, the dose rose from 2.5 mg to 7.5 mg per day. At least a 1-point severity scale improvement occurred in 60% against 27% on placebo. Dry mouth occurred in 43% against 11% (Schollhammer 2015).
• In a trial of 50 patients with palm sweating, given up to 5 mg twice daily for 6 weeks, palm and underarm sweating improved in more than 70%. Dry mouth occurred in 47.8%. The trial was placebo-controlled, but its abstract gives no separate placebo figures (Wolosker 2012).
• A meta-analysis of 6 trials and 293 patients found a risk ratio of 1.68 for severity scale improvement (El-Samahy 2023).
• A systematic review of palm sweating reports relief in 60%–97%, with frequent anticholinergic side effects (Moniati 2025).

Glycopyrrolate

The evidence here is mostly retrospective. In a review of case notes, 15 of 19 evaluable patients (79%) responded, but side effects limited treatment in around one third (Bajaj 2007). Among 31 children and teenagers at a mean dose of 2 mg daily, 90% improved and 29% had side effects, most often dry mouth (26%) and dry eyes (10%). Improvement came within hours and disappeared within a day of the last dose (Paller 2012). In the stepwise series above, the cumulative response rose from 15.3% with aluminum chloride alone to 45.8% with 1 mg twice daily added, and 55.9% with 2 mg twice daily (Patra 2020).

Concerns the research raises

Medicines that block sweating can raise the risk of heat exhaustion or heat stroke, because the body loses a way to cool itself (Cheshire 2008). Separately, a nested case-control study in England of 58,769 people with dementia and 225,574 controls, aged 55 or older, linked more than 1,095 standard daily doses of bladder antimuscarinic drugs to higher odds of dementia, with an adjusted odds ratio of 1.65 (Coupland 2019). That study was observational, was not about hyperhidrosis, and its participants averaged 82.2 years old. It raises a concern for long use later in life and does not show that these drugs cause dementia.

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Botulinum Toxin Injections

Botulinum toxin is given as many small injections spread evenly over the sweating area, where it blocks acetylcholine release from the nerve endings. Its underarm use rests on large placebo-controlled trials.

• In 145 patients in a within-person trial, sweat at 2 weeks was 24 mg per minute on the toxin side and 144 on the placebo side, from a starting average of 192. At 24 weeks it was still below the starting level (Heckmann 2001).
• In 320 randomized patients receiving 50 units per underarm or placebo, 94% against 36% responded at 4 weeks, and 82% against 21% at 16 weeks. Adverse events occurred in 11% against 5% (Naumann 2001).
• In a 52-week trial of 322 people, a 2-point severity scale improvement occurred in 75% of those on either dose against 25% on placebo. Median duration of effect was 197 and 205 days against 96 days on placebo (Lowe 2007).
• A meta-analysis of 12 trials and 904 patients confirmed the advantage over placebo, found no significant difference in sweat reduction compared with other treatments, and reported fewer side effects than those treatments (Sun 2025).

Palms have been studied less. In a small placebo-controlled trial of 19 patients, sweat fell and grip strength did not change (Lowe 2002). A 2026 review of 19 palm studies found effects lasting 3 to 12 months, with botulinum toxin type A averaging 4.9–9.5 months, and satisfaction of 65–100% that faded over time (Eze 2026). Local reactions such as pain and itch are reported, and the 2025 three-arm trial named pain and high cost as limiting factors (Schreiner 2026; ElKholy 2025). The effect wears off, so treatment is repeated.

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Iontophoresis

In iontophoresis the hands or feet sit in shallow water while a mild electric current passes through. The 2007 Canadian committee named it for palms and soles (Solish 2007).

• In a randomized trial of 70 patients with palm and sole sweating, tap water iontophoresis three times a week for 4 weeks lowered the mean severity score from 3.40 to 1.48, against 3.28 to 2.14 with 20% aluminum chloride (Rahim 2022).
• In 80 patients, both 10 and 20 sessions reduced sweating. The authors judged 10 sessions in two weeks adequate, while patients were more satisfied with 20 (Vural 2022).
• In a retrospective series of 92 patients, 65.2% responded, and the number of sessions completed tracked with the response. Among responders 85% relapsed within six months, and logistical difficulties were the commonest reason for stopping (17.5%). No severe adverse events or compensatory sweating were seen (Gülmez 2026).

A systematic review of palm sweating describes the effect as moderate with few side effects, and as requiring ongoing sessions to hold (Moniati 2025). Review authors list pregnancy, substantial metal implants, heart conditions, epilepsy and implanted electronic devices as contraindications (Maazi 2025).

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Microwave Thermolysis

A handheld device heats the layer between the skin and the fat underneath, where the sweat glands sit (Hong 2012). The studies here all concern the underarms.

• In the randomized sham-controlled device study, 89% responded at 30 days against 54% with the sham. In the active group the response was 74% at 3 months and 69% at 12 months (Glaser 2012).
• In 31 adults followed for 12 months, 90.3% had severity scores of 1 or 2. All had temporary swelling, discomfort and numbness, and 12 had altered sensation in the arm that resolved (Hong 2012).
• In a within-patient trial treating one underarm with botulinum toxin and the other with microwaves, sweat reduction was greater with the toxin at 6 months and equal at 1 year. Odor reduction lasted at 1 year only with microwaves, hair loss followed only microwaves, and 76% preferred them (Grove 2024).
• Of 103 people with severe underarm sweating, 88.2% reached a severity score of 2 or less at 1 year, along with better anxiety and depression scores, in a study with no control group (Pissa 2024). In a 3-year follow-up of 103 treated people at a Swedish clinic, 45 of the 87 contacted replied, and their median severity score was 2 against 3 at the start (Micu 2026).

A systematic review counted only 5 trials and 189 patients and called for further study of long-term efficacy and safety (Hsu 2017). A 2026 case report describes new excessive sweating on the lower back about 12 days after treatment, little change in the armpits, and persistence through 30 months of follow-up (Lim 2026).

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Endoscopic Thoracic Sympathectomy and Compensatory Sweating

In this operation a surgeon uses a camera through small chest incisions to cut or remove part of the sympathetic nerve chain that runs beside the spine, cutting the signal to the hands and armpits. The 2007 Canadian committee placed it only after all other options had failed (Solish 2007), and a 2026 review places thoracic sympathectomy among further options for palm sweating (Schreiner 2026).

How well it works

Palm results are the strongest. In 406 consecutive patients followed for a year, success at 12 months was 97.8% for palms alone and 96.5% for palms with armpits, but 71.4% for armpits alone (Rodríguez 2008). A meta-analysis of 13 observational studies and 1,463 underarm patients reported 92% satisfaction and 96% symptom control while rating the quality of evidence as extremely low (Felisberto 2021). Nine trials of 895 palm patients showed improved quality of life after surgery (Wei 2020).

Compensatory sweating

The main drawback is new heavy sweating elsewhere, usually the back and abdomen, called compensatory sweating. In 50 patients, all 39 who developed it reported the back and abdomen, 28.2% the groin and thighs (Masarwa 2024). Published rates vary considerably:

• A meta-analysis of 10 studies and 3,117 patients put the overall incidence at 62%, and severe compensatory sweating at 23% in the 4 studies that reported it (Lin 2025).
• Of 406 patients, 55% developed it, and 6% regretted the surgery because of severe compensatory sweating (Rodríguez 2008).
• Of 138 palm patients followed for 5 years, 78.9% developed it, 23.8% of them severely, and scores rose gradually over the 5 years (Wu 2025).
• Of 152 palm patients followed for a median of 3.1 years, 74.3% developed it, 33.6% of them severely, and here scores stayed stable over time (Xu 2024). The two long-term studies disagree on whether it worsens.
• Of 820 patients, the degree was rated minimal in 63.4%–74.9% of the palm and underarm groups (Santos 2025).

Studies also disagree on who is at risk. The meta-analysis links it to older age, higher body mass index and smoking (Lin 2025). One series found women more prone (Rodríguez 2008), and the 820-patient series also found sex, body mass index and body site significant (Santos 2025). On the level of the cut, one series found no link with how extensive the surgery was (Rodríguez 2008), while a 2026 meta-analysis of 11 studies and 3,090 patients found lower odds when the second thoracic level was spared: odds ratio 0.38 overall and 0.43 for severe cases (Delgado 2026).

Other complications

Among 940 procedures in 467 patients there were no deaths and three major complications: one torn subclavian artery and two leaks of lymph fluid into the chest. Bleeding from a vein occurred in 5.3%, collapsed lung in 1.3%, and partial Horner syndrome, an eyelid and pupil change, in 0.4%. The authors concluded that the operation is not as minor as usually asserted (Gossot 2001). In the 406-patient series complications arose in 5.6%, most often collapsed lung, and excessive dryness appeared in 9% (Rodríguez 2008).

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Traditional and Dietary Reports

The sources below are labelled by type, because none of them is a controlled trial of a traditional remedy for hyperhidrosis.

• Traditional herbal formula (single case report). A 66-year-old man with long-standing head and face sweating took Samhwangsasim-tang extract granules alone. After about 42 days, his severity score went from 4 to 1 (Lee 2026).
• Acupuncture (narrative review). Evidence in primary, emotional and cancer-related hyperhidrosis is limited to small, often uncontrolled studies and is called weak and inconclusive. Evidence is stronger for hot flushes in menopause and breast cancer, with short-term improvement that generally fades after three months (Lu 2026).
• Food and drink (case-control survey, Sweden). Of 171 people with primary hyperhidrosis and 165 without, those with it had higher caffeine intake, and 57% against 39.5% drank energy drinks weekly. Participants reported that spicy foods, fatty foods, fast foods and sweets set off sweating. The authors state that causality cannot be inferred (Glas 2025).

Sage is studied for menopausal hot flashes on the Sage: Menopause and Hot Flashes page. The searches for this page found no hyperhidrosis trial of sage.

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Key Research Papers

1. Haider A, Solish N. Focal hyperhidrosis: diagnosis and management. CMAJ. 2005;172(1):69-75. PubMed PMID: 15632408
2. Maazi M, Leung AK, Lam JM. Primary hyperhidrosis: an updated review. Drugs Context. 2025;14. PubMed PMID: 40575073
3. Schreiner W, Rapprich S, Rzany B, Wiegering A. Hyperhidrosis: Prevalence, Diagnosis, and Stepwise Treatment. Dtsch Arztebl Int. 2026;123(9):253-260. PubMed PMID: 41572865
4. Shayesteh A. Primary Hyperhidrosis: A Review of Epidemiology, Pathophysiology and Management. Acta Derm Venereol. 2026;106. PubMed PMID: 42747166
5. Walling HW. Clinical differentiation of primary from secondary hyperhidrosis. J Am Acad Dermatol. 2011;64(4):690-5. PubMed PMID: 21334095
6. Behinaein P, Gavagan K, Waitzman J, Pourang A, Potts G. A Review of the Etiologies and Key Clinical Features of Secondary Hyperhidrosis. Am J Clin Dermatol. 2025;26(1):97-108. PubMed PMID: 39604775
7. Strutton DR, Kowalski JW, Glaser DA, Stang PE. US prevalence of hyperhidrosis and impact on individuals with axillary hyperhidrosis: results from a national survey. J Am Acad Dermatol. 2004;51(2):241-8. PubMed PMID: 15280843
8. Doolittle J, Walker P, Mills T, Thurston J. Hyperhidrosis: an update on prevalence and severity in the United States. Arch Dermatol Res. 2016;308(10):743-749. PubMed PMID: 27744497
9. Shayesteh A, Janlert U, Brulin C, Boman J, Nylander E. Prevalence and Characteristics of Hyperhidrosis in Sweden: A Cross-Sectional Study in the General Population. Dermatology. 2016;232(5):586-591. PubMed PMID: 27576462
10. Farrell J, Stewart T. Prevalence of Hyperhidrosis: An Australian Population Study. Australas J Dermatol. 2026. PubMed PMID: 42960527
11. Bahar R, Zhou P, Liu Y, Huang Y, Phillips A, Lee TK, et al. The prevalence of anxiety and depression in patients with or without hyperhidrosis (HH). J Am Acad Dermatol. 2016;75(6):1126-1133. PubMed PMID: 27567033
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13. Wang X, Xie L, Wang S, Meng S, Huang Y. The prevalence of depression among patients with primary hyperhidrosis: a systematic review and meta-analysis. BMC Psychol. 2026;14(1). PubMed PMID: 42458641
14. Henning MA, Pedersen OB, Jemec GB. Genetic disposition to primary hyperhidrosis: a review of literature. Arch Dermatol Res. 2019;311(10):735-740. PubMed PMID: 31435740
15. Yamauchi S, Vander Cruyssen J, Cervellera M, Wohler E, De Waele J, Lammens M, et al. A neurocutaneous Na(V)1.8 channelopathy underlies a genetic subtype of primary idiopathic hyperhidrosis. Sci Adv. 2026;12(29):eaed3221. PubMed PMID: 42467787
16. Cheshire WP, Fealey RD. Drug-induced hyperhidrosis and hypohidrosis: incidence, prevention and management. Drug Saf. 2008;31(2):109-26. PubMed PMID: 18217788
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18. Collercandy N, Thorey C, Diot E, Grammatico-Guillon L, Thillard EM, Bernard L, et al. When to investigate for secondary hyperhidrosis: data from a retrospective cohort of all causes of recurrent sweating. Ann Med. 2022;54(1):2089-2101. PubMed PMID: 35903938
19. Marcy TR, Britton ML. Antidepressant-induced sweating. Ann Pharmacother. 2005;39(4):748-52. PubMed PMID: 15728327
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21. Solish N, Bertucci V, Dansereau A, Hong HC, Lynde C, Lupin M, et al. A comprehensive approach to the recognition, diagnosis, and severity-based treatment of focal hyperhidrosis: recommendations of the Canadian Hyperhidrosis Advisory Committee. Dermatol Surg. 2007;33(8):908-23. PubMed PMID: 17661933
22. Varella AY, Fukuda JM, Teivelis MP, Campos JR, Kauffman P, Cucato GG, et al. Translation and validation of Hyperhidrosis Disease Severity Scale. Rev Assoc Med Bras. 2016;62(9):843-847. PubMed PMID: 28001258
23. Rahim M, Ahmed N, Naz Khan K, Memon S, Naveed T, Shah SA, et al. Comparison of the Efficacy of Tap Water Iontophoresis Versus Aluminum Chloride Hexahydrate in the Treatment of Palmoplantar Hyperhidrosis. Cureus. 2022;14(12):e32367. PubMed PMID: 36627989
24. El-Agamy El-Samadony A, Hegab DS, El Maghraby GM, El-Maadawy IH. Topical Oxybutynin 3% Gel Versus Aluminum Chloride 15% Lotion in Treatment of Primary Focal Hyperhidrosis. Dermatol Pract Concept. 2023;13(3). PubMed PMID: 37557105
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PubMed Topic Searches

1. PubMed: primary hyperhidrosis randomized trials
2. PubMed: causes of secondary hyperhidrosis
3. PubMed: compensatory sweating after sympathectomy
4. PubMed: topical anticholinergics for underarm hyperhidrosis

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Connections

• Dermatology — the skin conditions section
• Night Sweats — sweating during sleep and its causes
• Hyperthyroidism — an overactive thyroid, a named cause of generalized sweating
• Thyroid Disorders — the wider group of thyroid conditions
• Menopause — the transition and its symptoms
• Hot Flashes and Night Sweats — vasomotor symptoms of menopause
• Anxiety — reported more often in people with hyperhidrosis
• Social Anxiety Disorder — the social side of visible sweating
• Sweat: How Your Body Cools Itself — an animation of normal sweating

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