Hyperhidrosis is a medical condition in which a person exhibits excessive sweating,[1][2] more than is required for the regulation of body temperature.

[3] Although it is primarily a physical burden, hyperhidrosis can deteriorate the quality of life of the people who are affected from a psychological, emotional, and social perspective.

[5] People suffering from it present difficulties in professional fields, more than 80% experiencing a moderate to severe emotional impact from the disease[6] and half are subject to depression.

This excess of sweat happens even if the person is not engaging in tasks that require muscular effort, and it does not depend on the exposure to heat.

[7] Common places to sweat can include underarms, face, neck, back, groin, feet, and hands.

Primary or focal hyperhidrosis usually starts during adolescence or even earlier and seems to be inherited as an autosomal dominant genetic trait.

Secondary hyperhidrosis commonly accompanies conditions such as diabetes mellitus, Parkinson's disease, hyperthyroidism, hyperpituitarism, anxiety disorder, pheochromocytoma, and menopause.

[citation needed] Similarly, secondary (generalized) hyperhidrosis has many causes including certain types of cancer, disturbances of the endocrine system, infections, and medications.

[4] Certain endocrine conditions are also known to cause secondary hyperhidrosis including diabetes mellitus (especially when blood sugars are low), acromegaly, hyperpituitarism, pheochromocytoma (tumor of the adrenal glands, present in 71% of patients) and various forms of thyroid disease.

[citation needed] Excessive sweating affecting only one side of the body is more suggestive of secondary hyperhidrosis and further investigation for a neurologic cause is recommended.

For severe cases of plantar and palmar hyperhidrosis, there has been some success with conservative measures such as higher strength aluminium chloride antiperspirants.

Use of these drugs can be limited, however, by side-effects, including dry mouth, urinary retention, constipation, and visual disturbances such as mydriasis and cycloplegia.

For people who find their hyperhidrosis is made worse by anxiety-provoking situations (public speaking, stage performances, special events such as weddings, etc.

[19] In 2018, the U.S. Food and Drug Administration (FDA) approved the topical anticholinergic glycopyrronium tosylate for the treatment of primary axillary hyperhidrosis.

[26] BTX-A has since been approved for the treatment of severe primary axillary hyperhidrosis (excessive underarm sweating of unknown cause), which cannot be managed by topical agents.[when?

[29] With this device, rare but serious side effects exist and are reported in the literature, such as paralysis of the upper limbs and brachial plexus.

[33] Sweat gland removal or destruction is one surgical option available for axillary hyperhidrosis (excessive underarm perspiration).

[41][42][45] Other possible side-effects include Horner's Syndrome (about 1%), gustatory sweating (less than 25%) and excessive dryness of the palms (sandpaper hands).

[47] Percutaneous sympathectomy is a minimally invasive procedure similar to the botulinum method, in which nerves are blocked by an injection of phenol.

[50] Excessive sweating or focal hyperhidrosis of the hands interferes with many routine activities,[51] such as securely grasping objects.

Some people with focal hyperhidrosis sufferers avoid situations where they will come into physical contact with others, such as greeting a person with a handshake.

Hiding embarrassing sweat spots under the armpits limits the affected person's arm movements and pose.