Excessive Sweating (Hyperhidrosis)

Hyperhidrosis is a condition characterised by excessive sweating that goes beyond what is needed for normal temperature regulation. Sweating may be localised to specific areas or more widespread.

The condition can have a significant impact on comfort, daily activities, and quality of life.

Primary hyperhidrosis is diagnosed when no underlying medical cause is identified. It often begins earlier in life, commonly affects the hands, feet, underarms, or face, and typically does not occur during sleep.

Secondary hyperhidrosis occurs because of an underlying cause, such as medications, infections, medical illnesses, or hormonal or endocrine disorders. It may be more generalised and can occur during sleep.

Distinguishing between these forms is important for appropriate management.

Medical review may be helpful to:

• Clarify whether sweating is primary or secondary

• Identify contributing triggers or underlying causes

• Guide appropriate investigations where required

• Support stepwise treatment selection

• Assist with long-term symptom management

Assessment includes:

• A detailed medical and medication history

• Review of sweating pattern, distribution, and triggers

• Clinical examination

Where appropriate, blood tests or other investigations may be arranged to exclude underlying medical causes.

Management follows a stepwise treatment approach, tailored to symptom severity and the areas affected.

Initial management may include:

• Practical measures and skincare strategies to reduce irritation and sweating

• Avoidance of known triggers where possible

If symptoms persist, treatment options may be discussed progressively and may include:

• Topical therapies

• Oral medications, with careful discussion of potential side effects

• Physical therapies, such as iontophoresis, particularly for hands and feet

In selected cases, additional targeted treatments may be considered following specialist assessment. Eligibility for subsidised treatment depends on clinical criteria and Medicare requirements.

Hyperhidrosis is often a long-term condition, but symptoms can usually be significantly improved with appropriate management. Ongoing review allows treatment to be adjusted over time to ensure management remains safe, effective, and appropriate.

Dermatologists are trained to assess excessive sweating, distinguish between different causes, and guide stepwise management safely. Specialist review helps ensure appropriate investigations are performed and that treatment is tailored to individual needs.

At Ready Dermatology, North Shore Health Hub, St Leonards, our dermatologist support patients with excessive sweating by helping them understand the cause of their symptoms and guiding safe, individualised management to improve comfort and daily functioning.