What is Hyperhidrosis?
Hyperhidrosis is a disorder of excessive sweating that exceeds what is necessary for thermoregulation and environmental conditions, affecting approximately 3% of the population and causing significant medical and psychosocial impairment. 1
Clinical Definition and Characteristics
Hyperhidrosis presents as pathologically excessive focal or generalized sweating that is uncontrollable, excessive, and unpredictable beyond normal thermoregulatory needs. 2, 3 The condition manifests in two distinct forms:
Primary Hyperhidrosis
- Bilaterally symmetric, focal excessive sweating affecting specific body regions including axillae (underarms), palms, soles, or craniofacial areas without an underlying medical cause 4
- Most commonly involves areas of high eccrine gland density 1
- Estimated prevalence of nearly 3% in the general population 1
Secondary Hyperhidrosis
- May be focal or generalized sweating caused by an underlying medical condition or medication use 4
- Can result from certain anticancer agents, presenting as palmar-plantar erythrodysesthesia syndrome 5
- Requires identification and treatment of the underlying pathology, which may sometimes be malignant 3
Clinical Impact and Consequences
The condition carries substantial burden beyond the physical symptom:
- Significant negative impact on quality of life, causing social and work impairment, emotional distress, embarrassment, and apprehension 1, 4
- Can lead to isolation and depression in severe cases 3
- May increase risk of developing psychiatric and somatic comorbidities 2
- The stigmatizing nature causes patients to experience decreased well-being 2
Common Pitfalls
Hyperhidrosis is likely underdiagnosed and undertreated despite being a relatively frequent reason for consultation. 3 Clinicians should maintain awareness that this "ostensibly benign symptom" can have major consequences and warrants systematic evaluation and treatment. 3