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Hyperhidrosis Overview

Hyperhidrosis, also called over-perspiration, occurs when the sweat glands in the face, hands, and underarms produce excessive sweat secretions.

People with hyperhidrosis sweat excessively — above and beyond their physiologic needs. The excessive sweating can occur without warning — even when resting or under cool temperature conditions.

Hyperhidrosis affects a small, but statistically significant, portion of young people globally. It affects their lives and social activities considerably, causing debilitating physical and emotional symptoms.

People living with the disorder suffer social embarrassment at school or work due to excessive sweating. Even simple activities — shaking hands, reading a book, or wearing certain fabrics (i.e. silks and linens) — can cause intense shame.

Experts believe over-stimulation of the sympathetic nerves that trigger the sweat glands of the face, hands, and underarms cause the excessive sweating.

Types of hyperhidrosis

Doctors divide hyperhidrosis into two categories: primary and secondary.

Researchers do not understand what causes primary hyperhidrosis. They do believe that lesions on the central nervous system or the presence of other systemic diseases may cause secondary hyperhidrosis.

Primary hyperhidrosis

  • Involves excessive sweating of the hands, feet, face, or armpits (axillae).
  • Affects about 3 percent of the population globally; yet, less than 40 percent seek help for their condition.
  • Seems to run in families, indicating a genetic component, but experts have not identified a cause.

Secondary hyperhidrosis

  • Involves sweating in either one area of the body or all over.
  • Occurs as a result of an underlying medical condition, such as:
    • Anxiety
    • Stroke
    • Menopause
    • Tuberculosis
    • Acromegaly
    • Cancer
    • Carcinoid syndrome
    • Medications and substance abuse
    • Diabetes
    • Heart disease
    • Lung disease
    • Hyperthyroidism
    • Parkinson’s disease
    • Pheochromocytoma
    • Other infections

Contact Us

Contact the UPMC Esophageal and Lung Surgery Institute with questions or for more information.
Or, call the Thoracic and Foregut Surgery Division at 412-647-7555.

Hyperhidrosis Diagnosis

Doctors in UPMC's Division of Thoracic and Foregut Surgery can diagnose hyperhidrosis by observing the visible signs of unprovoked and excessive sweating.

They may ask you details about your sweating, such as:

  • Location on body
  • Time of occurrence
  • Onset (i.e. with or without warning)
  • Triggers (i.e. thought process when sweating occurs)
  • Other noticeable symptoms (i.e. heart pounding or weight loss)

Contact Us

Contact the UPMC Esophageal and Lung Surgery Institute with questions or for more information.
Or, call the Thoracic and Foregut Surgery Division at 412-647-7555.

Hyperhidrosis Treatment

Experts in UPMC's Division of Thoracic and Foregut Surgery offer surgical and non-surgical treatment options for hyperhidrosis.

Thoracoscopic sympathectomy surgery

Thoracoscopic sympathectomy is the preferred surgical treatment for correcting hyperhidrosis.

Advances in surgical techniques and instrumentation have simplified the operation. It's now done as an outpatient procedure, using minimally invasive methods with significant success.

What to expect during thoracoscopic sympathectomy

  • People undergoing the procedure receive a short general anesthetic.
  • The surgeon makes two tiny incisions in the area just below the armpits.
  • The operation gives the best results for those with palmar hyperhidrosis, but also works well for people with armpit (axillary) and facial hyperhidrosis.
  • Typically, people can go home the same day, with dry hands and armpits for the first time since the onset of the disorder.

Non-surgical treatments for hyperhidrosis

Non-surgical treatments for hyperhidrosis represent a way to temporarily reduce and manage excessive sweating and don’t work as a permanent cure.

Topical agents

Topical agents to manage sweating associated with hyperhidrosis include:

  • Prescription strength aluminum chloride antiperspirant
  • Anesthetic agents
  • Astringents

Disadvantages of these treatments are:

  • The short duration of efficacy
  • Possible skin irritation, causing discomfort leading to discontinuation of use

Anticholinergic drugs

Anticholinergic agents, such as glycopyrrolate:

  • Help prevent the stimulation of sweat glands.
  • Seem effective for some people, but researchers haven’t studied their long-term effects or implications as well as they have for other non-surgical therapies.


This procedure:

  • Involves temporarily deactivating the sweat gland by passing an electrical current through intact skin while submerged in water.
  • Works best for those with hyperhidrosis of the hands or feet.
  • Takes about 10 to 20 minutes per session and requires several sessions.

Botox® injections

This treatment:

  • Uses Botox brand botulinum toxin injections.
  • Is FDA-approved for treating armpit (axillary) hyperhidrosis.
  • Seems effective as a temporary hyperhidrosis management protocol.

Disadvantages of Botox injections include:

  • High cost
  • Need for repeated treatments
  • Pain of injections

Contact Us

Contact the UPMC Esophageal and Lung Surgery Institute with questions or for more information.
Or, call the Thoracic and Foregut Surgery Division at 412-647-7555.

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