Hyperhidrosis: Pathophysiology and Treatment

Hyperhidrosis is the process of dysregulated sweating beyond homeostatic regulation. It is often classified by aetiology (primary or secondary) and location (focal or generalised). Sweating is essential for thermoregulation but it is thought that failure within the negative-feedback loop, driven by acetylcholine, causes disproportionate sweating. Often this impacts patient’s emotional, mental, and physical wellbeing. Personalization of therapy and education is paramount to improving outcomes. Hyperhidrosis can be managed using topical or oral agents, iontophoresis, botulinum toxin injection and with local and endoscopic surgical techniques