Causes of Excessive Sweating
The causes of excessive sweating differ depending on whether it is primary or secondary in nature. Excessive sweating may result from overactive sweat glands, medical conditions, or side effects of certain medications. Identifying the cause is key to finding the right treatment.
Primary Hyperhidrosis
This form usually begins in childhood or adolescence and has no underlying medical cause. It typically affects:
Palms
Soles of the feet
Underarms
Forehead or face
The sweating is usually symmetrical (occurs on both sides equally), and may be triggered by stress, anxiety, or no clear cause at all. In many cases, it runs in families, suggesting a genetic component.
Primary hyperhidrosis occurs without sweating during sleep and tends to worsen during social interactions or emotional stress, regardless of temperature.
Secondary Hyperhidrosis
This form is caused by another condition or external factor. It can start at any age and often results in widespread (generalised) sweating. Causes include:
Medical Conditions
Thyroid disorders, especially hyperthyroidism
Diabetes, particularly when blood sugar is low (hypoglycaemia)
Infections, such as tuberculosis or HIV
Menopause, due to hormonal shifts and hot flushes
Certain cancers, including lymphoma or leukaemia
Heart or lung disease
Medications
Antidepressants
Painkillers (opioids)
Diabetes medication
Hormonal treatments
Sweating may improve once the underlying condition is treated or the medication adjusted.
Triggers and Aggravating Factors
Heat and humidity
Emotional stress
Spicy foods or caffeine
Alcohol
Wearing synthetic fabrics
Causes of Excessive Sweating In South Africa
In South Africa, excessive sweating is often linked to infections like TB or untreated thyroid problems. The stigma attached to sweating—especially in professional or social settings—can prevent people from seeking help. Education about hyperhidrosis and better access to diagnosis can improve outcomes.
Understanding the causes of excessive sweating ensures that patients are not misdiagnosed and that appropriate therapies are explored early.
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