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Hyperhidrosis is the production of sweat which is in excess of that needed for normal thermoregulation (1).

  • the condition, although it often goes unreported, can have a negative effect on quality of life
  • it may be associated with an unpleasant odour (bromhidrosis) caused by by-products of bacteria that colonise sweaty areas (1)

Hyperhydrosis can be primary (idiopathic hyperhidrosis) and secondary hyperhidrosis. Furthermore, excessive sweating in patients can be either in a localized area (focal) or over the entire body (generalized) (2)

  • primary disease is usually focal and may affect
    • axillae (73%)
    • hands (45.9%)
    • feet (41.1%)
    • scalp (22.8%)
    • groin (9.3%)
  • secondary hyperhidrosis can be generalized or focal (1,2)

Primary hyperhidrosis commonly starts during childhood or adolescence (3):

  • believed to be caused by overactive hypothalamic thermoregulation
  • commonly focal, and in 30% to 50% of cases a family history is reported
  • people with primary hyperhidrosis may find that the disease persists or improves as they age
  • is a clinical diagnosis where sweating is visible, excessive, focal, and has no apparent cause
    • further diagnostic criteria include:
      • a duration of more than 6 months and/or occurrence in at least one focal area;
      • bilateral and approximately symmetrical sweat pattern;
      • positive family history;
      • frequency of at least twice a week; interference with daily activities;
      • onset before the age of 25; and
      • cessation during sleep (unlike secondary hyperhidrosis)

Secondary hyperhidrosis can start at any age (3)


  • palmar hydrosis can affect manual tasks, such as writing, using tools, and playing instruments
  • plantar hyperhidrosis can ruin footwear and make the feet more prone to pompholyx or secondary bacterial or fungal infection


  1. Benson RA, Palin R, Holt PJ, Loftus IM. Diagnosis and management of hyperhidrosis. BMJ. 2013;347:f6800
  2. Perera E, Sinclair R.Hyperhidrosis and bromhidrosis - a guide to assessment and management. Aust Fam Physician. 2013;42(5):266-9
  3. Ashton S et al. Hyperhidrosis: assessment and management in general practice. British Journal of General Practice 2024; 74 (742): 236-238. DOI: 10.3399/bjgp24X737361

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