Excessive Sweating – Systemic Causes and Treatment Options

Excessive sweating is a condition in which sweat production exceeds the physiological needs of the body’s thermoregulation. It can be primary (hyperhidrosis) or secondary, associated with diseases such as hyperthyroidism, diabetes, or hematological cancers.

• It is most often characterized by primary hyperhidrosis.
• It can be a symptom of endocrine and metabolic diseases.
• Night sweats require the exclusion of hematological diseases.
• Treatment includes topical preparations, iontophoresis, and botulinum toxin.
• In severe cases, sympathectomy is considered.

See also: Feeling cold – can it indicate thyroid problems?

Is hyperhidrosis the most common cause of excessive sweating?

Excessive sweating most often results from primary hyperhidrosis, which is not associated with another systemic disease.

Primary hyperhidrosis usually affects the hands, feet, armpits, or face and is based on the hyperactivity of the sympathetic nervous system. Symptoms often appear at a young age and are symmetrical in nature.

Diagnosis is clinical and is based on the exclusion of secondary causes.

Can hyperthyroidism and diabetes cause increased sweating?

Excessive sweating can be a symptom of endocrine diseases, especially hyperthyroidism.

In the course of hyperthyroidism, accelerated metabolism and increased heat production lead to heightened activity of the sweat glands. Symptoms are often accompanied by tachycardia and weight loss.

Diabetes can also cause hyperhidrosis, particularly during episodes of hypoglycemia. Fluctuations in blood sugar activate the sympathetic nervous system and intensify sweating.

Can excessive sweating be a symptom of cancer?

Excessive sweating, especially at night, can accompany cancer diseases such as lymphomas or leukemia.

In these cases, the symptom often coexists with weight loss and a low-grade fever. Similar symptoms can also occur in tuberculosis.

In the case of persistent, intensified night sweats, laboratory and imaging diagnostics are necessary.

What are the methods for treating hyperhidrosis?

Excessive sweating can be treated with both topical and procedural methods.

The basis of therapy is preparations containing aluminum chloride, which reduce sweat secretion by blocking the ducts of the sweat glands.

In cases where topical treatment is ineffective, the following are used:

• Iontophoresis.
• Botulinum toxin injections.
• Surgical treatment in the form of sympathectomy.

Herbal methods, such as sage or lemon balm, have limited confirmation in clinical studies and may only support therapy.

Q&A

Does excessive sweating always indicate a disease?
No, it often has a primary nature and is not associated with systemic pathology.

When should tests be performed?
When sweating is accompanied by other general symptoms, such as weight loss or fever.

Is botulinum toxin effective?
Yes, many studies have shown its high effectiveness in treating focal hyperhidrosis.

Does obesity increase sweating?
Yes, greater body mass is associated with increased heat and sweat production.

Sources:

1. Hornberger J et al. Recognition, diagnosis, and treatment of primary hyperhidrosis. Journal of the American Academy of Dermatology.
2. NICE Guidelines. Hyperhidrosis management.
3. Bahn RS et al. Hyperthyroidism guidelines. Thyroid.
4. NCCN Guidelines. Hodgkin and non-Hodgkin lymphoma.
5. American Diabetes Association Standards of Care.