Excessive Sweating

Overview

Excessive sweating (hyperhidrosis) is sweating more than the body needs for temperature control. It can be a long-standing, harmless tendency (primary focal hyperhidrosis), or it can be a symptom of an underlying medical condition (secondary, generalised). Distinguishing the two is important, because secondary causes need investigation and treatment while primary hyperhidrosis is managed with symptom-control measures.

Primary versus secondary

• Primary focal hyperhidrosis — sweating of the palms, soles, underarms or face, both sides, since adolescence, with no underlying cause; often runs in families.
• Secondary generalised sweating — widespread sweating, often new in onset, with an identifiable cause.

Common secondary causes

• An overactive thyroid (hyperthyroidism) — see Thyroid Disorders.
• Diabetes — including low blood sugar reactions (see Diabetes & Metabolic Health).
• Infections, including night sweats (see Fever & Infectious Diseases).
• Anxiety and stress.
• Certain medicines.
• Hormonal changes, such as menopause.
• Other internal conditions, occasionally.

Evaluation and investigations

Evaluation considers the pattern (focal vs generalised, both sides vs one side, day vs night), onset, and accompanying symptoms (weight change, heat intolerance, palpitations, thirst, fever). Blood tests — thyroid function, blood sugar and HbA1c, complete blood count, inflammatory markers — are arranged when a secondary cause is suspected. See Thyroid Disorders and Abnormal Test Results.

Management overview

Management treats any underlying cause found. For primary focal hyperhidrosis, measures include strong antiperspirants, lifestyle and clothing advice, and, for severe cases, specialist treatments such as iontophoresis, botulinum toxin, or other options arranged via a dermatologist.

Warning signs — seek prompt care

• New, widespread sweating with weight loss, fever or night sweats — needs evaluation.
• Sweating with heat intolerance, palpitations and weight loss — check thyroid.
• Sweating with shakiness, hunger and confusion that eases with food — possible low blood sugar.

How we help

Dr. Nayak distinguishes primary from secondary hyperhidrosis, investigates for underlying causes, treats those found, and advises on symptom control — referring to a dermatologist for severe primary hyperhidrosis. Consultations are available in-clinic in Bhubaneswar and over teleconsultation.

Related conditions and patient concerns

• Thyroid Disorders
• Diabetes & Metabolic Health
• Fever & Infectious Diseases
• Fungal Skin Infection
• Abnormal Test Results