Excessive sweating due to hyperhidrosis can arise as a stand-alone condition or be related to a secondary medical condition, such as thyroid disease, cardiovascular conditions, or menopause.
Read on to learn about causes of hyperhidrosis.
Common Causes
Hyperhidrosis is classified as either primary focal hyperhidrosis or secondary generalized hyperhidrosis, both of which have numerous individual possible causes.
Primary Focal Hyperhidrosis
Primary focal hyperhidrosis involves sweating in one or more “focal” areas of the body, usually on the palms of the hands, under the arms, or the soles of the feet. Focal hyperhidrosis may also affect the face and/or scalp.
There are several causes of primary focal hyperhidrosis, including:
Primary idiopathic hyperhidrosis: Idiopathic means the disease has an unknown cause or mechanism of origin. Most cases of primary hyperhidrosis are idiopathic. Frey’s syndrome: A rare neurological disorder also called gustatory sweatingOther neurologic conditions: Examples include spinal injuries and miscellaneous conditions of the nervous system.
Secondary Generalized Hyperhidrosis
Secondary generalized hyperhidrosis refers to sweating that occurs all over the body and may include night sweats (sweating while asleep). It usually develops in adulthood and is caused by a secondary or underlying disorder affecting any of several systems in the body or by other factors:
Endocrine
Hyperthyroidism Diabetes Hyperpituitarism Menopause (hot flashes) Pregnancy Pheochromocytoma (a small tumor of the adrenal gland) Carcinoid syndrome (a rare disorder triggered by an altered immune system response) Acromegaly (an abnormality of the pituitary gland, which produces too much growth hormone and is characterized by the development of an oversized face, hands, and feet)
Neurological
Parkinson’s disease Stroke (cerebral vascular accident) Spinal cord injury
Malignancy
Hodgkin’s disease Myeloproliferative disorders (a group of slow-growing blood cancers)
Cardiovascular-Related
Shock Heart failure Stroke
Side Effects of Medications
Anticholinesterases used to treat Alzheimer’s disease Antidepressants including Prozac (fluoxetine), Sinequan (doxepin), Norpramin (desipramine), Pamelor (nortriptyline), and Effexor (venlafaxine) Anxiolytic drugs used to treat anxiety Asthma inhalers such as albuterol Depo-Provera birth control pills Insulin used to manage diabetes Methadone used to treat heroin addiction Migraine medications such as Triptan (rizatriptan) and sumatriptan Non-steroidal anti-inflammatory drugs like Celebrex (celecoxib) Opioids like Vicodin (hydrocodone) and Oxycontin (oxycodone) Salagen (pilocarpine) used to treat glaucoma Propranolol used to treat angina and hypertension Testosterone Thyroid-regulating drugs
Other Factors
Alcohol withdrawal Fever Infection (such as malaria, HIV, or tuberculosis) Obesity Opiate withdrawal Respiratory failure Toxicity from alcoholism or substance abuse
Genetics
In primary focal hyperhidrosis, sweating usually starts during childhood, which suggests it may be genetic. A 2019 review of 20 published studies found a wide range of positive family history—from 5.7% to 65%.
The study authors noted primary focal hyperhidrosis appears to have an autosomal dominant pattern, meaning only one copy of the gene for the disease is required for it to manifest. In addition, the gene can be passed along by either the male or female parent, and both sexes are at equal risk of inheriting hyperhidrosis.
Weight
A common cause of secondary hyperhidrosis is extra body weight and obesity. This is likely due to body heat becoming trapped by adipose tissue, kicking off the body’s natural cooling response, and causing excessive perspiration.
A 2019 study published in the Journal of the American Academy of Dermatology assessed the link between body mass index (BMI) and hyperhidrosis. The study included nearly 2.8 million teenagers. It found higher rates of hyperhidrosis in obese individuals than in those who were underweight. In addition, the study authors noted the risk of hyperhidrosis increased for each BMI unit above the normal weight threshold.
Cardiovascular
Several factors related to normal cardiovascular function overlap with hyperhidrosis. The same mechanism that triggers sweating in hyperhidrosis causes an increase in heart rate and blood pressure.
The sympathetic nervous system, which activates the fight-or-flight response, plays a role in hyperhidrosis. The fight-or-flight response causes an increase in heart rate and blood pressure, which leads to excessive sweating.
In addition, a 2016 study assessed post-exercise blood pressure and recovery heart rate in people with hyperhidrosis and those without and found people with secondary generalized hyperhidrosis of unknown origin had a significantly impaired blood pressure recovery and decreased heart rate recovery after exercise.
A Word From Verywell
There are many factors involved in the cause of the different forms of hyperhidrosis, however, perhaps the most important thing to keep in mind is that the condition is treatable. You can explore resources that provide education and support to those who have hyperhidrosis. While hyperhidrosis can be an embarrassing condition, it doesn’t have to be one that takes over a person’s life.
