How to treat hypohidrosis (reduced sweating) or anhidrosis (absence of sweating)?

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Last updated: April 17, 2025View editorial policy

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From the Guidelines

To manage anhidrosis, it is crucial to avoid extreme temperatures and outdoor activities during the hottest periods of the day, and instead, use methods like regular topical skincare and cooling devices to help regulate body temperature. When considering how to train the body to sweat in cases of anhidrosis, the focus should be on gradual and safe methods to stimulate sweat glands without causing overheating or dehydration.

  • Avoiding extreme temperatures is key, as recommended by the European guidelines of care for congenital ichthyoses 1.
  • Wearing adequate clothing and using cooling devices such as air conditioning or fans can help in managing body temperature.
  • In cases of severe thermoregulation issues, oral retinoids may be considered as a treatment option, as they have shown a positive effect in a case report 1.
  • While there is limited direct evidence on training the body to sweat in anhidrosis, the principle of avoiding extreme temperatures and using topical skincare (as recommended for managing sweat glands in congenital ichthyoses) can be applied to help manage anhidrosis symptoms.
  • It's essential to consult a healthcare provider before starting any new regimen, especially if anhidrosis is caused by an underlying medical condition, to ensure the safest and most effective approach.

From the Research

Understanding Anhidrosis

Anhidrosis is a condition characterized by the inability to sweat, which can lead to heat intolerance and other thermoregulatory issues. The condition can result from various factors, including intrinsic abnormalities of sweat glands or postganglionic sympathetic cholinergic nerve dysfunction 2.

Causes of Anhidrosis

Research suggests that anhidrosis can occur due to central or peripheral damage to the autonomic nervous system 3. The thermoregulatory control of sweating involves central pathways from the hypothalamus to the brainstem and then spinal cord, as well as projections to peripheral structures, including the sympathetic chain ganglia, peripheral nerves, and eccrine sweat glands. Disruption at any point of this pathway may lead to impaired sweating.

Diagnosis and Treatment

Diagnosing the underlying cause of anhidrosis is crucial for guiding treatment. Characterization of sweating dysfunction can help localize different autonomic disorders and may allow for evaluation of treatment effect 3. Some studies suggest that anhidrosis may result from sweat gland dysfunction rather than decreased sympathetic outflow to the skin 4.

Potential Mechanisms

Some research suggests that ion channels and cellular damage may play a role in sweat response, correlating anhidrosis as a possible effect of congenital channelopathy 5. Additionally, studies have shown that anhidrosis in certain conditions, such as Fabry's disease, may result from sweat gland dysfunction as well as abnormal skin sympathetic nerve activity 6.

Training the Body to Sweat

While there is limited research on training the body to sweat in individuals with anhidrosis, some studies suggest that increasing skin sympathetic nerve activity may help improve sweat response. However, this would depend on the underlying cause of the anhidrosis and may require further investigation. Some possible approaches may include:

  • Gradual exposure to heat to stimulate sweat glands
  • Exercise or physical activity to increase skin sympathetic nerve activity
  • Certain medications or treatments that target the underlying cause of anhidrosis

Key findings:

  • Anhidrosis can result from central or peripheral damage to the autonomic nervous system 3
  • Sweat gland dysfunction may be a primary cause of anhidrosis 2, 4
  • Ion channels and cellular damage may play a role in sweat response 5
  • Increasing skin sympathetic nerve activity may help improve sweat response 4, 6

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Sweating Disorders.

Continuum (Minneapolis, Minn.), 2020

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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