Sweating: Causes, Symptoms and Treatment
Sweating is a natural body function that regulates temperature. Excessive sweating, however, can indicate underlying conditions and significantly affect quality of life.
Things worth knowing about "Sweating"
Sweating is a natural body function that regulates temperature. Excessive sweating, however, can indicate underlying conditions and significantly affect quality of life.
What is Sweating?
Sweating (medically known as diaphoresis or perspiration) is a physiological process in which the sweat glands of the skin secrete fluid. This process is essential for life, as it regulates body temperature and prevents overheating. The human body contains between two and four million sweat glands distributed across the entire skin surface.
Types of Sweating
Normal Sweating
Normal sweating occurs in response to physical exertion, heat, or emotional stress. It is a healthy and important protective mechanism of the body.
Primary Hyperhidrosis
Primary hyperhidrosis is a condition in which a person sweats excessively without any underlying medical condition as the cause. The most commonly affected areas are the hands, feet, armpits, and face.
Secondary Hyperhidrosis
Secondary hyperhidrosis results from another medical condition or medication use. It often affects the entire body rather than specific areas.
Causes
Sweating can be triggered by a wide range of factors:
- Physical causes: Heat, physical activity, exercise
- Emotional causes: Stress, anxiety, excitement
- Hormonal causes: Menopause, hyperthyroidism (overactive thyroid), diabetes mellitus
- Infectious diseases: Fever, tuberculosis, HIV
- Neurological conditions: Parkinson disease, stroke
- Medications: Antidepressants, fever-reducing drugs, certain blood pressure medications
- Malignant conditions: Lymphomas or other cancers (characterized by night sweats as part of so-called B symptoms)
Symptoms and Associated Complaints
Excessive sweating may be accompanied by additional symptoms, including:
- Wet or damp hands and feet
- Soaked clothing without an obvious trigger
- Unpleasant body odor caused by bacterial breakdown of sweat
- Skin irritations or fungal infections in moist body areas
- Psychological distress due to social embarrassment
Diagnosis
To evaluate excessive sweating, the physician begins with a detailed medical history and physical examination. The following diagnostic measures may be used:
- Iodine-starch test (Minor test): Visualizes sweat production on the skin surface
- Blood tests: Thyroid levels, blood glucose, hormone levels
- Sweat measurement (sudometry): Quantification of sweat volume
- Imaging: When a systemic condition is suspected (e.g., X-ray, ultrasound)
Treatment
General Measures
Mild cases can be managed with simple lifestyle adjustments: wearing breathable clothing, avoiding spicy foods and alcohol, and maintaining regular personal hygiene.
Medication-Based Treatment
- Aluminum chloride antiperspirants: Block sweat ducts to reduce secretion
- Anticholinergics: Medications that inhibit sweat gland activity via the nervous system
- Beta-blockers or anxiolytics: Helpful in stress-related sweating
Non-Invasive and Invasive Therapies
- Iontophoresis: Weak electrical currents reduce sweat production, especially on hands and feet
- Botulinum toxin injections: Block nerve signals to sweat glands for several months
- Microwave therapy: Permanently destroys sweat glands in the underarm area
- Surgical procedures: Endoscopic thoracic sympathectomy (ETS) as a last resort for severe primary hyperhidrosis
When to See a Doctor
Medical evaluation is recommended when sweating occurs without an obvious trigger, significantly interferes with daily life, is associated with night sweats, is accompanied by additional symptoms such as weight loss, fever, or rapid heartbeat, or appears suddenly and without explanation.
References
- Schlereth T, Dieterich M, Birklein F. Hyperhidrosis – Causes and Treatment of Enhanced Sweating. Deutsches Ärzteblatt International. 2009;106(3):32–37.
- Hornberger J, Grimes K, Naumann M, et al. Recognition, diagnosis, and treatment of primary focal hyperhidrosis. Journal of the American Academy of Dermatology. 2004;51(2):274–286.
- International Hyperhidrosis Society. Clinical Overview of Hyperhidrosis. Available at: www.sweathelp.org. Accessed 2024.
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