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Hyperhidrosis – Quick review chart

Hyperhidrosis – excessive sweating

Primary- idiopathic ( no underlying cause ) over-activity of sympathetic nerves in body areas as axilla , palms , soles or craniofacial regions pathology is poorly understood focal primary hyperhidrosis is the most common form axilla is the most common site ( up to 79 % )


b/l and symmetrical peaks 2nd or 3rd decade of life (onset puberty ) duration atleast 6 months ( with no obvious cause ) impairs daily activity happens atleast once / week age of onset < 25 positive family history in 30 % to 50 % no sweating during sleep no change in sweat gland morphology


topical aluminium chloride ( 10-20 % ) chloride hexa hydrate
 oral ( anti cholinergics as amitriptyline ) , beta blockers , calcium channel blockers , oral propantheline injectibles ( botulinum toxin for axillary HH ) iontophoresis ( small electrical bath ) microwave thermolysis surgical – endoscopic thoracic sympathectomy axillary curettage , liposuction for axillary hyperhidrosis


  1. Benson R APalin RHolt P J ELoftus I MDiagnosis and management of hyperhidrosis doi:10.1136/bmj.f6800 Diagnosis and management of hyperhidrosis | The BMJ
  2. Lakraj, Amanda-Amrita D et al. “Hyperhidrosis: anatomy, pathophysiology and treatment with emphasis on the role of botulinum toxins.” Toxins vol. 5,4 821-40. 23 Apr. 2013, doi:10.3390/toxins5040821 Hyperhidrosis: Anatomy, Pathophysiology and Treatment with Emphasis on the Role of Botulinum Toxins (
  3. Brackenrich J, Fagg C. Hyperhidrosis. [Updated 2021 Oct 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from:
  4. Schlereth, Tanja et al. “Hyperhidrosis–causes and treatment of enhanced sweating.” Deutsches Arzteblatt international vol. 106,3 (2009): 32-7. doi:10.3238/arztebl.2009.0032 Hyperhidrosis—Causes and Treatment of Enhanced Sweating (


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