From the Research
Hyperhidrosis is a disorder of excessive sweating beyond what is expected for thermoregulatory needs and environmental conditions, with primary hyperhidrosis having no identifiable underlying cause but involving overactivity of the sympathetic nervous system that innervates eccrine sweat glands. The etiology of hyperhidrosis can be classified into primary and secondary hyperhidrosis. Primary hyperhidrosis, which accounts for most cases, typically begins in childhood or adolescence and affects focal areas like the palms, soles, axillae, or face. There is often a genetic component, with 30-50% of patients reporting a family history 1. Secondary hyperhidrosis results from an underlying medical condition or medication use, with potential causes including endocrine disorders, neurological conditions, infections, malignancies, and medications 2.
Some key points to consider in the etiology of hyperhidrosis include:
- Primary hyperhidrosis has an estimated prevalence of nearly 3% and is associated with significant medical and psychosocial consequences 3
- The condition carries a substantial psychological and social burden, since it interferes with daily activities 4
- Physiologically, hyperhidrosis involves normal sweat glands that receive excessive stimulation from acetylcholine released by sympathetic nerves, explaining why anticholinergic medications can be effective treatments 5
- Treatment options are tailored to the specific patient needs, characteristics, and goals, and may include topical preparations, iontophoresis, botulinum toxin, and anticholinergic medications 1, 2
In terms of the most recent and highest quality study, the 2019 study published in the Journal of the American Academy of Dermatology provides a comprehensive review of the etiology, diagnosis, and management of hyperhidrosis, and is considered the most up-to-date and authoritative source on the topic 1. This study highlights the importance of considering the underlying cause of hyperhidrosis, whether primary or secondary, in determining the most effective treatment approach.