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Causes of Hyperhidrosis

The cause of hyperhidrosis is based upon the origin of the stimulus causing the sweating response.

These triggers may come from the;

Cortex: (Brain)
  • Emotional response
  • Mental
  • Sensory
Hypothalamic Area (area of the brain that controls temperature, hunger and thirst)
  • Exercise,
  • Thermoregulation,
  • Systemic diseases - infections, etc
Medullary Area (area of the brain that controls involuntary functions, like breathing)
  • Chiari malformations (malformation of the brain) can cause localized hyperhidrosis
  • Infarction (stroke)
Spinal Cord
  • Syringomyelia is a disease of the spinal cord that can also cause rare hyperhidrosis,
  • Spinal cord mass lesions (such as tumors) can cause it
Axon reflex: (local nerve reflexes)
  • Hyperhidrosis can occur bordering painful skin lesions such as venous ulcers
Compensatory Mechanism:
  • Post-sympathectomy (surgical interruption of nerves)
  • Ross syndrome
Endocrine System: (Hormonal)
  • Hyperthyroidism - excessive activity of the thyroid
  • Hyperpituitarism - excessive secretion of the pituitary gland
  • Increased release of catecholamine (shock, fight-or flight response)
Primary or Idiopathic Hyperhidrosis - Cause unknown, usually appears in localized areas:
  • Axilla - underarms
  • Palms of hand
  • Soles of feet

Common sites of excessive sweating and their impact on Quality of Life (QOL)

Palms and Plantar (soles of feet)
  • Sweaty palms and feet have a higher QOL impact than axillary sweating
  • QOL impact can be significant - embarrassing, sweat stains, odor
Face and scalp
  • Highly visible, highest QOL impact (more than hands & feet, and more than axillary)
  • Generalized (QOL impact is higher than isolated localized hyperhidrosis)

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