A review of hyperhidrosis: pathophysiology, clinical management, and emerging therapies

Abstract

Hyperhidrosis is a chronic disorder characterised by excessive sweating beyond the physiological needs of thermoregulation, significantly affecting patients’ quality of life. This review explores the epidemiology, pathophysiology, and classification of hyperhidrosis, distinguishing between primary focal hyperhidrosis and secondary generalised hyperhidrosis. Current treatment strategies, including topical agents, systemic medications, botulinum toxin injections, iontophoresis, and surgical interventions, are discussed. Emerging therapies, such as microwave thermolysis, laser treatments, and novel pharmacological agents, are evaluated for their efficacy and safety. Advances in understanding the neural regulation of sweat glands and the impact of hyperhidrosis on mental health have opened new avenues for personalised and minimally invasive treatments. Despite the progress, challenges remain in diagnosis, treatment accessibility, and long-term management. This article highlights the importance of multidisciplinary care and future research to improve therapeutic outcomes for individuals with hyperhidrosis.