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Hyperhidrosis and Stress

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Stress and Skin Disorders


Hyperhidrosis is a psychological skin condition characterized by uncontrollable, excessive amounts of sweat in specific body locations. Although not a physically debilitating condition, those individuals affected with this condition commonly experience psychosocial stress during regular social encounters and exhibit low self-confidence, thus drastically decreasing the quality of life of these individuals (Coutinho dos Santos et al. Pediatr Dermatol 26(4):439–444, 2009; Glogau, Dermatol Surg 24(8):817–819, 1998; Kouris et al. Pediatr Dermatol 32(2):226–230, 2015). Hyperhidrosis is often diagnosed in patients suffering from psychosocial disorders such as social anxiety, suggesting a psychological factor may influence it’s onset. Various management options exist for the treatment of hyperhidrosis including fractionated microneedle radio (FMR) treatment, botulinum toxin type A (BTXA), surgery, oral administration of the anticholinergic drug glycopyrronium bromide (glycopyrrolate), aluminum chloride antiperspirants, iontophoresis, and endoscopic thoracic sympathectomy (Glogau, Dermatol Surg 24(8):817–819, 1998; Kouris et al. Pediatr Dermatol 32(2):226–230, 2015; Bajaj and Langtry, Br J Dermatol 157(1):118–121, 2007; Fatemi Naeini et al. Australas J Dermatol 56(4):279–284, 2015; Kobayashi et al. J Dermatol 21(8):575–581, 1994; Rompel and Scholz, J Eur Acad Dermatol Venereol 15(3):207–211, 2001). Currently, endoscopic thoracic sympathectomy is the only current, permanent treatment option. However, new therapeutic options on the horizon such as lasers and microwave thermolysis demonstrate promising results.

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Adrenocorticotropic hormone


Botulinum toxin type A


Corticotrophin-releasing hormone


Dermatology Life Quality Index


Hospital Anxiety and Depression Scale


Hyperhidrosis Disease Severity Scale




Minnesota Multiphasic Personality Inventory-2


Obsessive-compulsive disorder


Olfactory reference syndrome


Primary axillary hyperhidrosis


Subjective evaluation scale


Visual Analogue Scale


  1. Coutinho dos Santos LH, Gomes AM, Giraldi S, Abagge KT, Marinoni LP. Palmar hyperhidrosis: long-term follow-up of nine children and adolescents treated with botulinum toxin type A. Pediatr Dermatol. 2009;26(4):439–44.

    Article  PubMed  Google Scholar 

  2. Glogau RG. Botulinum A neurotoxin for axillary hyperhidrosis. Dermatol Surg. 1998;24(8):817–9.

    Article  CAS  PubMed  Google Scholar 

  3. Kouris A, Armyra K, Stefanaki C, Christodoulou C, Karimali P, Kontochristopoulos G. Quality of life and social isolation in Greek adolescents with primary focal hyperhidrosis treated with botulinum toxin type A: a case series. Pediatr Dermatol. 2015;32(2):226–30.

    Article  PubMed  Google Scholar 

  4. Bajaj V, Langtry JA. Use of oral glycopyrronium bromide in hyperhidrosis. Br J Dermatol. 2007;157(1):118–21.

    Article  CAS  PubMed  Google Scholar 

  5. Fatemi Naeini F, Abtahi-Naeini B, Pourazizi M, Nilforoushzadeh MA, Mirmohammadkhani M. Fractionated microneedle radiofrequency for treatment of primary axillary hyperhidrosis: a sham control study. Australas J Dermatol. 2015;56(4):279–84.

    Article  PubMed  Google Scholar 

  6. Kobayashi K, Omote K, Homma E, Abe T, Iitoyo M. Sympathetic ganglion blockade for the management of hyperhidrosis. J Dermatol. 1994;21(8):575–81.

    Article  CAS  PubMed  Google Scholar 

  7. Rompel R, Scholz S. Subcutaneous curettage vs. injection of botulinum toxin A for treatment of axillary hyperhidrosis. J Eur Acad Dermatol Venereol. 2001;15(3):207–11.

    Article  CAS  PubMed  Google Scholar 

  8. Nordqvist C. What is hyperhidrosis? What caues hyperhidrosis? 2014. Available from:

  9. Tronstad C, Helsing P, Tonseth KA, Grimnes S, Krogstad AL. Tumescent suction curettage vs. curettage only for treatment of axillary hyperhidrosis evaluated by subjective and new objective methods. Acta Derm Venereol. 2014;94(2):215–20.

    Article  PubMed  Google Scholar 

  10. Vary Jr JC. Selected disorders of skin appendages--acne, alopecia, hyperhidrosis. Med Clin North Am. 2015;99(6):1195–211.

    Article  PubMed  Google Scholar 

  11. Hornberger J, Grimes K, Naumann M, Glaser DA, Lowe NJ, Naver H, et al. Recognition, diagnosis, and treatment of primary focal hyperhidrosis. J Am Acad Dermatol. 2004;51(2):274–86.

    Article  PubMed  Google Scholar 

  12. Singh S, Davis H, Wilson P. Axillary hyperhidrosis: a review of the extent of the problem and treatment modalities. Surgeon. 2015;13(5):279–85.

    Article  PubMed  Google Scholar 

  13. Munro DD, Verbov JL, O’Gorman DJ, du Vivier A. Axillary hyperhidrosis. Its quantification and surgical treatment. Br J Dermatol. 1974;90(3):325–9.

    Article  CAS  PubMed  Google Scholar 

  14. Britannica E. Sweat gland Encyclopaedia Britannica; [Updated 8/19/2014; cited 2016 1/26/16]. Available from:

  15. Staff MC. Sweating and body odor Mayoclinic.org2014 [Cited 2016 1/26/16]. Available from:

  16. Ruchinskas RA, Narayan RK, Meagher RJ, Furukawa S. The relationship of psychopathology and hyperhidrosis. Br J Dermatol. 2002;147(4):733–5.

    Article  CAS  PubMed  Google Scholar 

  17. Gross KM, Schote AB, Schneider KK, Schulz A, Meyer J. Elevated social stress levels and depressive symptoms in primary hyperhidrosis. PLoS One. 2014;9(3):e92412.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Bohaty BR, Hebert AA. Special considerations for children with hyperhidrosis. Dermatol Clin. 2014;32(4):477–84.

    Article  CAS  PubMed  Google Scholar 

  19. Lessa Lda R, Luz FB, De Rezende RM, Duraes SM, Harrison BJ, De Menezes GB, et al. The psychiatric facet of hyperhidrosis: demographics, disability, quality of life, and associated psychopathology. J Psychiatr Pract. 2014;20(4):316–23.

    Article  PubMed  Google Scholar 

  20. Weber A, Heger S, Sinkgraven R, Heckmann M, Elsner P, Rzany B. Psychosocial aspects of patients with focal hyperhidrosis. Marked reduction of social phobia, anxiety and depression and increased quality of life after treatment with botulinum toxin A. Br J Dermatol. 2005;152(2):342–5.

    Article  CAS  PubMed  Google Scholar 

  21. Ferrao YA, Shavitt RG, Prado H, Fontenelle LF, Malavazzi DM, de Mathis MA, et al. Sensory phenomena associated with repetitive behaviors in obsessive-compulsive disorder: an exploratory study of 1001 patients. Psychiatry Res. 2012;197(3):253–8.

    Article  PubMed  Google Scholar 

  22. Braganca GM, Lima SO, Pinto Neto AF, Marques LM, Melo EV, Reis FP. Evaluation of anxiety and depression prevalence in patients with primary severe hyperhidrosis. An Bras Dermatol. 2014;89(2):230–5.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Krogstad AL, Mork C, Piechnik SK. Daily pattern of sweating and response to stress and exercise in patients with palmar hyperhidrosis. Br J Dermatol. 2006;154(6):1118–22.

    Article  CAS  PubMed  Google Scholar 

  24. Reisfeld R, Berliner KI. Evidence-based review of the nonsurgical management of hyperhidrosis. Thorac Surg Clin. 2008;18(2):157–66.

    Article  PubMed  Google Scholar 

  25. Pariser DM, Ballard A. Topical therapies in hyperhidrosis care. Dermatol Clin. 2014;32(4):485–90.

    Article  CAS  PubMed  Google Scholar 

  26. Haider A, Solish N. Focal hyperhidrosis: diagnosis and management. CMAJ. 2005;172(1):69–75.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Hoorens I, Ongenae K. Primary focal hyperhidrosis: current treatment options and a step-by-step approach. J Eur Acad Dermatol Venereol. 2012;26(1):1–8.

    Article  CAS  PubMed  Google Scholar 

  28. Brown AL, Gordon J, Hill S. Hyperhidrosis: review of recent advances and new therapeutic options for primary hyperhidrosis. Curr Opin Pediatr. 2014;26(4):460–5.

    Article  PubMed  Google Scholar 

  29. Scuderi S, Manoharan P, Lim D, Manoharan S. A survey of patient satisfaction with use of microwave device for axillary hyperhidrosis. Australas J Dermatol. 2016.

    Google Scholar 

  30. Pariser DM, Ballard A. Iontophoresis for palmar and plantar hyperhidrosis. Dermatol Clin. 2014;32(4):491–4.

    Article  CAS  PubMed  Google Scholar 

  31. Weinberg T, Solish N, Murray C. Botulinum neurotoxin treatment of palmar and plantar hyperhidrosis. Dermatol Clin. 2014;32(4):505–15.

    Article  CAS  PubMed  Google Scholar 

  32. Benohanian A. Needle-free anaesthesia prior to botulinum toxin type A injection treatment of palmar and plantar hyperhidrosis. Br J Dermatol. 2007;156(3):593–6.

    Article  CAS  PubMed  Google Scholar 

  33. Smith KC, Comite SL, Storwick GS. Ice minimizes discomfort associated with injection of botulinum toxin type A for the treatment of palmar and plantar hyperhidrosis. Dermatol Surg. 2007;33(1 Spec No.):S88–91.

    Google Scholar 

  34. de Almeida AR, Montagner S. Botulinum toxin for axillary hyperhidrosis. Dermatol Clin. 2014;32(4):495–504.

    Article  PubMed  Google Scholar 

  35. Karpinski RHS. Surgical treatment of axillary hyperhidrosis treatment & management Medscape2014 [Cited 2016 1/23/16]. Available from: – d13.

  36. Shi Z, Yan X, Ye X. Modified tumescent superficial suction with curettage treatment for axillary bromidrosis: clinical experience of 280 cases. Aesthetic Plast Surg. 2014;38(1):151–5.

    Article  PubMed  Google Scholar 

  37. Solish N, Bertucci V, Dansereau A, Hong HC, Lynde C, Lupin M, et al. A comprehensive approach to the recognition, diagnosis, and severity-based treatment of focal hyperhidrosis: recommendations of the Canadian Hyperhidrosis Advisory Committee. Dermatol Surg. 2007;33(8):908–23.

    CAS  PubMed  Google Scholar 

  38. Johnson JE, O’Shaughnessy KF, Kim S. Microwave thermolysis of sweat glands. Lasers Surg Med. 2012;44(1):20–5.

    Article  PubMed  Google Scholar 

  39. Glaser DA, Galperin TA. Local procedural approaches for axillary hyperhidrosis. Dermatol Clin. 2014;32(4):533–40.

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Keyvan Nouri MD .

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Hsu, V.M., Shah, V.V., Aldahan, A.S., Mlacker, S., Samarkandy, S., Nouri, K. (2017). Hyperhidrosis and Stress. In: França, K., Jafferany, M. (eds) Stress and Skin Disorders. Springer, Cham.

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