Hyperhidrosis Treatment

Hyperhidrosis leads to marked excessive sweating, either generalized or localized in certain parts of the human body

Hyperhidrosis is a pathological phenomenon characterized by the production of sweat in excessive and abnormal amounts compared to the physiological needs of thermoregulation.

Every day our body produces about ½ liter of sweat through sweat glands present everywhere in our body, obviously in different concentrations depending on the area.

As a matter of fact, we have between 2 and 4 million sweat glands with different densities – 700 / cm2 on the hands, 181 / cm2 on the forehead, 64 / cm2 on the back, etc. – but most are located on the palms of the hands and feet, which are often the most affected areas.

Approximately 5% of the population (International Hyperhidrosis Society® data) is affected by hyperhidrosis. It’s impact on daily life can be so significant that it can deter quality of life psychologically, emotionally and socially, so much so that it has been called the “silent handicap”

According to some research, the emotional and psychological effects can lead to low self-esteem, unhappiness, depression and even suicidal thoughts, as well as impaired social and interpersonal relationships. Afflicted individuals will commonly avoid contact with others and recreational activities and this behavior naturally impacts occupational and work productivity performance.


Hyperhidrosis for more than 50% of the affected population is seen as an intrusion on their lives and difficult to tolerate, and they feel emotionally impaired.

From 69-74% report reduced self-confidence;

54-63% report feeling unhappy or depressed;

67-71% complain of feeling severely restricted in social circumstances;

54-63% report spending less time on leisure;

63% are severely limited at work;

22% minimize their working hours.

Coping skills for the condition do not seem to improve with time. In fact, patients with hyperhidrosis have lower coping skills and greater psychological and emotional difficulties than individuals without the condition.


The areas most affected by hyperhidrosis are the face, palms of the hands, soles of the feet and armpits.

The most prominent symptoms occur mainly in the hands.

In general, the degree of sweating can go as far as dripping.

The hands of hyperhidrosis sufferers are often cold, damp, and wet, while the feet, in addition to being damp, may be smelly.

This condition leads individuals not to offer their hand to greet people and they may have problems at work handling objects as they “slip” from their hands, or wet the worksheet.

Armpits, sweating a lot, obviously create visible sweat stains on shirts or shirts, which can then cause embarrassment for the afflicted.

How hyperhidrosis is diagnosed

Hyperhidrosis cannot be diagnosed by objective measurements or blood tests.

Diagnosis therefore relies mainly on the patient’s description and medical history.

In severe and secondary forms, the possible cause must be sought and treated, and the medical history can be crucial.

Only after a thorough study of the patient’s medical history will it be functional to proceed with some blood tests: blood count, renal function and electrolytes, liver function, thyroid function, blood sugar, urinary catecholamines.

For the primary-localized form, a careful examination will be sufficient for diagnosis.

Before proceeding to treatment, however, some tests should be carried out, such as a minor test and a paper test (described below), which can help to monitor the effectiveness of treatment and for the so-called follow-up of the patient.

The Minor Test consists of applying an iodine solution to the area affected by hyperhidrosis followed by the application of starch powder. If the area sweats a lot it will turn dark blue-black, indicative of hyperhidrosis. This test does not help so much to quantify sweat as to identify its location and thus the areas of greatest production.

The Paper Test uses a special absorbent paper applied to the area affected by hyperhidrosis and left there for 5 min, then the paper is weighed to measure the amount of sweat produced after the 5 min of application compared to before application;

“Excessive sweating” is difficult to define; instead of quantifying sweat secretion, one must think of “perceived amount of sweat” as a limiting activity in daily life, causing physical, emotional and social discomfort and affecting quality of life (QoL).

That is why different types of formularies are often used, such as the HDH (hyperhidrosis severity scale) and the Dermatology Quality of Life Index (DLQI).

Types and causes of hyperhidrosis:

We can find two types of hyperhidrosis: primary, when the causes are unidentifiable (idiopathic), or secondary, if other disorders such as obesity, drug use, hormonal imbalances such as menopause, hyperthyroidism, and others are the triggers.

In addition, hyperhidrosis can also be classified according to its distribution:

Primary idiopathic hyperhidrosis typically presents itself with a focal, bilateral, symmetrical distribution, commonly affecting the armpits (73%), hands (45.9%), feet (41.1%), and craniofacial regions (22.8%), and more than one area may be affected.

Instead, secondary hyperhidrosis manifests as generalized exaggerated sweating.

Primary hyperhidrosis accounts for 93% of all cases of hyperhidrosis and can occur in healthy individuals without other health problems.

Statistically, a genetic factor is quite probable as about 50% of Patients report a positive family history of hyperhidrosis.

Hyperhidrosis can have a variable phenotype, partial penetrance, and an autosomal dominant form of transmission. Loci for the condition have been mapped to chromosomes 14q11.2-q13 and 2q31.1.


When dealing with a patient who complains of hyperhidrosis, the history is crucial, especially to identify the cause (if not known) and the form.

After ruling out a secondary form, it will be necessary to assess, on a case-by-case basis, the intensity of the disorder, its location and psychological impact.

During the visit, Dr. Ifrach performs the minor test to best assess the main location of major production before applying her protocol.

Dr. Ifrach has developed a specific Protocol to treat hyperhidrosis using state-of-the-art technology, which turns out to be a non-invasive, painless and fast treatment, so much so that it is performed during the lunch break since it is called “lunch break treatment” by her patients, so it allows the patient to immediately return to the routine of his or her life without side effects.

The doctor is the only one in Italy to have this cutting-edge technology that allows her to treat all areas of the body, from the face to the feet.

Request a visit or appointment now

Click now and book a visit.