The Etiology, Diagnosis and Management of Hyperhidrosis: A Comprehensive Review. Part I. Etiology and Clinical Work-Up

Publication date: Available online 31 January 2019

Source: Journal of the American Academy of Dermatology

Author(s): Shiri Nawrocki, Jisun Cha

Abstract

Hyperhidrosis (HH) is a dermatologic disorder defined by sweat production beyond the thermoregulatory requirements. Clinically, HH is diagnosed when excess sweating creates significant emotional, physical, or social discomfort, causing negative impact on the patient's quality of life. Existing data imply that this condition may affect at least 4.8% of the US population. The etiology of HH may stem from autonomic nervous system complex dysfunction, resulting in neurogenic overactivity of otherwise normal eccrine sweat glands. Alternatively, HH may be a result of aberrant central control of emotions. This condition is categorized as primary or secondary HH. Approximately 93% of patients with HH have primary HH, of whom >90% have a typical focal and bilateral distribution affecting the axillae, palms, soles, and craniofacial areas. Secondary HH presents in a more generalized and asymmetric distribution and is generated by various underlying diseases or medications. Secondary causes of HH need to be excluded prior to diagnosing primary HH.

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