Causes of Hyperhidrosis

In This Article

Hyperhidrosis is a condition involving excessive sweating that occurs frequently and is difficult to control. It is often so severe that sweating is visible to others; some people have even reported sweating while swimming in a pool. There are two types of hyperhidrosis, including primary focal hyperhidrosis, for which there often is no known cause, and generalized secondary hyperhidrosis which can be triggered by many different conditions.

Sweating is the body’s normal way of cooling itself off. The normal physiological process of sweating involves the nervous system (which triggers the sweat glands when the body’s temperature rises). Sweating can also occur when a person gets nervous or anxious (nervous sweating usually involves sweating on the palm of the hands).

Common Causes

There are several potential causes for each type of hyperhidrosis.

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 and the soles of the feet. Focal hyperhidrosis may also involve facial or head sweating.

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 (also called gustatory sweating, a condition that originates from a rare neurological disorder)
  • Other neurologic conditions (including spinal injuries, and miscellaneous conditions of the nervous system)

Secondary Generalized Hyperhidrosis

Secondary generalized hyperhidrosis involves sweating that occurs all over the body; it is not localized as primary focal hyperhidrosis is. This type of sweating usually doesn’t begin until adulthood. Generalized hyperhidrosis may involve night sweats (sweating while asleep). Generalized hyperhidrosis is caused by a secondary or underlying disorder. Many conditions can cause secondary generalized hyperhidrosis, including:


  • Hyperthyroidism
  • Diabetes
  • Hyperpituitarism
  • Menopause
  • 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; the condition is characterized by growth of oversized face, hands, and feet)


  • Parkinson’s disease
  • Stroke (cerebral vascular accident)
  • Spinal cord injury


  • Hodgkin’s disease
  • Myeloproliferative disorders (a group of slow-growing blood cancers)


  • Shock
  • Heart failure
  • Stroke

Side Effects of Medications

Medications for depression that may cause generalized hyperhidrosis include:

  • Prozac (fluoxetine)
  • Sinequan (doxepin)
  • Norpramin (desipramine)
  • Pamelor (nortriptyline)
  • Effexor (venlafaxine)

Other Factors

  • Infection (such as malaria, HIV, or tuberculosis)
  • Respiratory failure
  • Alcohol withdrawal
  • Opiate withdrawal
  • Toxicity from alcoholism or substance abuse


When a person has primary focal hyperhidrosis, sweating usually starts during childhood. It’s thought that primary focal hyperhidrosis may be genetic. A review of the literature found a wide range of positive family history in studies, from 5.7% to 65%. It seems often to have an autosomal dominant pattern, with equal risk for males and females and being passed along by either the male or female parent.


Although cardiovascular disease does not cause an increased risk for primary focal hyperhidrosis, some cardiac conditions can result in secondary generalized hyperhidrosis. The cardiovascular-related causes of excessive sweating may include:

  • Heart failure
  • Stroke
  • Shock (which could result from a lack of circulating oxygen-rich blood, secondary to a heart condition)

Hyperhidrosis and Normal Cardiovascular Function

There are several factors related to normal cardiovascular (heart and blood vessel) function, and hyperhidrosis, these include:

  • Overactivity of the sympathetic nervous system causes hyperhidrosis. The sympathetic nervous system is responsible for activating a person's fight or flight response. An increase in heart rate, increase in blood pressure and sweating results.
  • In a study published by the journal European Neurology, the study authors discovered that 63 people with focal hyperhidrosis also had abnormal heart rate patterns as compared to healthy control subjects.
  • A 2016 study vaulted the blood pressure and heart rate recovery rate, after exercise, and compared the findings between normal people (control) and those with hyperhidrosis. The study discovered that people with hyperhydrosis of unknown origin (secondary generalized hyperhidrosis) had a significantly impaired blood pressure recovery and decreased heart rate recovery rate, after exercise.

The takeaway, when it comes to heart health, cardiovascular disease, and the causes of hyperhidrosis, is to be aware that the same mechanism that causes sweating in hyperhidrosis also causes an increase in heart rate and blood pressure. In addition, some heart conditions (such as heart failure) may be underlying factors in secondary generalized hyperhidrosis.

Lifestyle Factors

Lifestyle factors related to hyperhidrosis depend largely on the type of hyperhidrosis, as well as the underlying cause. 

For example, a rare disease called Frey’s syndrome is a disorder that causes a person to sweat excessively while eating. The condition is usually a result of a complication of surgery (such as a facelift or neck dissection) which caused an injury near the parotid glands (major salivary glands located just below the ear). This injury causes symptoms of flushing and/or sweating on the cheek, temple or behind the ear on one side of the face. The symptoms can worsen when eating hot, spicy, or very acidic foods. Therefore, adjusting the diet to eliminate spicy and highly acidic foods is important, but only for those who have general hyperhidrosis caused by Frey’s syndrome.

Additionally, those who have focal hyperhidrosis and also have heart disease should follow the recommendations of their primary healthcare provider regarding exercise and other lifestyle factors that could impact their heart rate and blood pressure. This is because studies have discovered there may be an alteration of how the body controls the heart rate and blood pressure for those with focal hyperhidrosis.

For people diagnosed with diabetes (an underlying factor in secondary generalized hyperhidrosis), managing the blood sugar/diet is important. Low blood sugar can cause excessive sweating. 

Additionally, women going through menopause may want to consult with a dietitian or other health care provider to establish a diet program. Some foods (such as flax seeds and soy products) are thought to regulate hormone levels. Low estrogen levels during menopause can cause secondary hyperhidrosis, particularly symptoms of severe night sweats.

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.

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