Classification and Causes of Hyperhidrosis

Types of Hyperhidrosis

1. Primary Hyperhidrosis: Also known as essential or idiopathic hyperhidrosis, this type has no known cause. It is the most common form and typically affects specific areas such as the hands, feet, armpits, or face.
2. Secondary Hyperhidrosis: This type is caused by underlying conditions or external factors, usually affecting the entire body.

Common Locations

• Palmar Hyperhidrosis: Excessive sweating of the hands
• Axillary Hyperhidrosis: Excessive sweating of the armpits
• Plantar Hyperhidrosis: Excessive sweating of the feet
• Facial Hyperhidrosis: Excessive sweating of the face
• Truncal Hyperhidrosis: Excessive sweating on the chest, abdomen, and back
• Generalized Hyperhidrosis: Excessive sweating affecting the whole body

Secondary Hyperhidrosis

Secondary hyperhidrosis can be triggered by various conditions, including:

• Endocrine disorders (e.g., hyperthyroidism, hypothyroidism)
• Severe psychiatric disorders
• Obesity
• Menopause and pregnancy
• Certain medications (e.g., beta-blockers, antidepressants)
• Infections
• Low blood sugar
• Anxiety
• Lymphoma

Primary Hyperhidrosis

Primary hyperhidrosis is more common than secondary hyperhidrosis. It often affects localized areas such as the hands, feet, and armpits. Like high blood pressure, it results from a sub-optimal setting of the body’s regulatory mechanism for temperature and skin moisture in the hypothalamus, part of the brain stem. Genetic factors frequently play a role in the predisposition to this condition.

Manifestations of Primary Hyperhidrosis

• Palmar Hyperhidrosis (Sweaty Hands): This is the most distressing form, affecting social and professional activities. Severe cases can limit career choices and social interactions. It often has a genetic background and is frequently combined with sweaty feet (palmoplantar hyperhidrosis).
• Axillary Hyperhidrosis (Sweaty Armpits): The most common form, affecting about 2% of the population. It causes noticeable wet marks on clothing, which can be embarrassing.
• Facial Hyperhidrosis: Sweating on the forehead during stressful situations can be particularly embarrassing, as it may be perceived as nervousness or insecurity.
• Plantar Hyperhidrosis (Sweaty Feet): This condition makes walking barefoot difficult and can destroy footwear due to excessive moisture.

Other Locations

Less frequent areas include the trunk, inguinal area, intergluteal fold, thighs, and legs.

Compensatory Sweating

This severe form of sweating can occur in patients who have undergone surgery on the sympathetic nervous system. The intensity and frequency depend on the type of procedure and individual genetic factors.

Common Features

Hyperhidrosis can manifest as sudden, profuse sweating attacks or continuous sweating. It can be triggered by high temperatures, emotional stress, or occur without any apparent reason. Typically, it worsens during warm seasons and improves in winter.