Question · Answered

How Do I Know If My Sweating Is Considered Hyperhidrosis?

Sweating is a normal and essential function of the body, but hyperhidrosis occurs when sweating exceeds what is needed for temperature regulation. Because there is no single test that measures hyperhidrosis severity, diagnosis is based largely on how symptoms affect daily life, social interactions, and routine activities. When excessive sweating consistently interferes with normal function, it may be a sign of hyperhidrosis.
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Answered by

Dr. Eraj Basseri, M.D.

Excessive sweating, also known as hyperhidrosis, is described and defined as sweating above and beyond the physiological needs of the body. A certain amount of sweat is normal and a compulsory part of our ability to regulate our body temperature. It gives us the ability to secrete certain chemicals which have no more use in our bodies.

This site deals specifically with local / focal hyperhidrosis in which the hands and or feet are sweating excessively beyond normal levels. Total body sweating, however, is a separate issue that is beyond the framework of this segment. Total body hyperhidrosis is not cured or treated with surgery. As a rule a thumb total body hyperhidrosis appears later in life (middle age and up) compared to focal hyperhidrosis that starts at a very young age.

Hyperhidrosis Diagnosis

Excessive sweating as felt and experienced by the patient is a very subjective matter. To measure this sweating in terms of quantity is a difficult task. It is very easy to talk with a patient who says that their hands are dripping wet, and make a determination because his/her symptoms are clearly defined. Dripping sweat is a physical statement that clearly describes a severe case palmar or plantar hyperhidrosis.

In cases where the description doesn’t describe dripping hands or feet, it ultimately comes down to how much discomfort the patient feels as a result of the symptoms. If the excessive sweating bothers the patient in both a significant social and functional way, then the patient should first start using conservative treatment methods to see if they alleviate the problem. If conservative treatment measures are unsuccessful, then a careful evaluation by an experienced surgeon is mandatory to consider surgery. It is our policy that every patient should try some conservative treatment modalities given by a doctor. It also shows the insurance company that honest attempts were carried out by the patient to help him or her with this problem.

To summarize the above mentioned comments, hyperhidrosis cannot be measured by certain numbers. It is mainly the subjective findings by the patient that should be confirmed with a doctor who is familiar with this subject. It is always recommended for the patient, or his or her parents, to discuss it with a doctor and verify the symptoms and presentation of hyperhidrosis which are very unique. The uniqueness is that the excessive sweating, in the case of palmar hyperhidrosis, appears below the wrist and in the case of plantar hyperhidrosis it is the sweat that appears below the ankle. This simple presentation is the hallmark of the diagnosis. Unfortunately this simple and basic fact is not really understood nor known to many physicians.

The surgeries available now (ETS and ELS), have a proven track record of safety, and high success rates. That being said, evaluation and discussion with an experienced surgeon is a very crucial step.

Excessive

Sweating occurs beyond what is needed for normal body function.

Subjective

The impact on daily life is an important part of diagnosis.

Distinctive

Palmar and plantar hyperhidrosis typically affect areas below the wrists and ankles.

If sweating interferes with everyday activities, social situations, or confidence, it may be more than normal perspiration.

Dr. Eraj Basseri

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