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The Daily Drip

Sweat Assessment: Understanding the Different Types of Hyperhidrosis

Hyperhidrosis is a medical condition characterized by excessive sweating. Depending on the cause, hyperhidrosis can be categorized as primary or secondary. It can also be generalized or focal, meaning it can affect the whole body or just some regions.

 

Before commencing treatment, you must first determine the cause, or lack thereof, of your excessive sweating. Read on to find out more!

 

Secondary Hyperhidrosis

 

 

Excessive sweating can be attributed to an underlying medical condition or can be a side effect of a medication. If that is the case, then it is referred to as secondary hyperhidrosis, as it is secondary to another condition.

 

Generalized Hyperhidrosis

Secondary hyperhidrosis is typically generalized, meaning it affects large sections of the body. This type of sweating will usually have an abrupt onset in relation to another condition’s development, and most commonly affects those aged 25 and older.

 

Generalized hyperhidrosis is usually the result of an infectious, endocrine or neurological disorder. Some conditions that are associated with secondary generalized hyperhidrosis include anxiety, diabetes, cancer, heart disease, hyperthyroidism, menopause, and obesity, among others.

 

Many drugs used to treat a variety of medical conditions have excessive sweating listed as a side effect. Some of these medications include antidepressants, migraine medications, pain relieve, diabetes medications, asthma inhalers, heartburn medications, and cancer medications.

 

In these cases, the best course of treatment is to first identify the underlying cause of the sweating by consulting a medical professional. Since the cause of the excessive sweating can be a serious condition, it is important to never self-diagnose and always consult a doctor. Once the primary cause is identified and treated, then the sweating could subside.

 

Focal Secondary Hyperhidrosis

 

Secondary focalized hyperhidrosis can be the result of neurologic injury and dermatologic syndromes. While secondary hyperhidrosis usually affects the entire body, if you’ve been subject to an injury, focal hyperhidrosis could develop in that specific region. The most common cause of focal secondary hyperhidrosis is central nervous system injuries.

 

Compensatory Hyperhidrosis

 

Compensatory hyperhidrosis can occur following a major injury, and is seen in diabetic neuropathy, in Ross syndrome, and following endoscopic thoracic sympathectomy (ETS). If you’re subject to an injury that affects a large portion of the sympathetic chain, then you may suffer from anhidrosis (absence of sweating) in certain areas, generally below the site of the injury. If the area affected by anhidrosis is significant, then compensatory hyperhidrosis can occur in other areas. As the name suggests, it’s compensating for the absence of sweat in other areas and is sometimes called reflex or rebound hyperhidrosis.

 

ETS is a high-risk operation for severe cases of hyperhidrosis, which is strongly advised against by many physicians, due to its many side effects. Those who have undergone it often suffer from compensatory hyperhidrosis, and they often end up sweating more in places they were not even sweating before. Before considering ETS surgery, we urge you to research other non-invasive treatment options.

 

Primary Hyperhidrosis

 

 

Focal Hyperhidrosis

 

If your hyperhidrosis is not associated with an underlying condition nor is considered a side-effect of a medication you are taking, then it is of primary origin. Unfortunately, the causes of primary hyperhidrosis are not as clear, and its pathophysiology is poorly understood.

 

As we explored in last week’s blog, the hyperfunction of sweat glands generally has a trigger, such as exercise and stress. However, those suffering from primary hyperhidrosis produce excessive amounts of sweat that is beyond what is needed for thermoregulation needs of the body. It is the more common type of hyperhidrosis.


While there is no satisfactory explanation for this type of hyperhidrosis, it is believed that there is a hereditary component to it. In fact, about 30 to 50 percent of people with this type have a family history of excessive sweating. It is also believed that heightened stimulation of the sympathetic nervous system, possibly at the central level, is responsible for the excessive sweating. Primary hyperhidrosis is generally present and diagnosed in childhood, and almost always before young adulthood.

 

Primary hyperhidrosis is most commonly localized, meaning it affects one or more specific areas of the body.  The most commonly affected areas are the hands, feet, underarms, and face/head. When more than one area is affected, it is referred to as multifocal hyperhidrosis. According to a study, more than 81% of patients reported 3 or more focal hyperhidrotic sites.

 

No matter the cause of the sweating, it can have serious impacts on the quality of life of its sufferer. A great resource for those suffering from hyperhidrosis is the International Hyperhidrosis Society. While there is no cure for hyperhidrosis, highly effective treatment is available. To learn more about iontophoresis as a non-invasive, drug-free, and needle-free treatment option, click here!