How does a doctor diagnose hyperhidrosis?

To diagnose this condition, a doctor will perform a physical exam. This includes looking closely at the areas of the body that sweat excessively. Your primary care doctor may refer you to a dermatologist, the specialists who are most knowledgeable about this condition. The doctor may ask very specific questions, which can help them understand more about your excessive sweating.

Questions may be similar to the ones below:

  • Do you carry items around with you to deal with episodes of excessive sweating (hyperhidrosis), such as napkins, antiperspirants, towels, pads, change of clothes, etc.?
  • Do you find you have to buy new clothes and shoes more often than others do?
  • Does hyperhidrosis affect your behavior or mental state when you are in public?
  • Does the thought of having to touch other people in a social situation make you sweat?
  • Has hyperhidrosis had any effect on your employment?
  • Has hyperhidrosis ever made you alter your social plans?
  • Have you ever lost a friend due to hyperhidrosis?
  • Does your hyperhidrosis mean you have to spend a lot of your day having to deal with it? If so, how much?
  • How often do you change your clothing?
  • How often do you wash and/or have a shower/bath?
  • How often do you think about excessive sweating?
  • When you are in a social situation when you have to touch other people, do you sweat?
  • Would you say you have experienced more skin infections or irritations than other people?

In most cases hyperhidrosis which affects all or most of the body (generalized hyperhidrosis) has an underlying condition, while primary hyperhidrosis tends to affect specific parts of the body (focal hyperhidrosis).

The doctor will probably diagnose primary hyperhidrosis if:

  • Episodes of excessive sweating occur at least once weekly
  • Excessive sweating does not occur during sleep
  • Excessive sweating occurs in both affected parts of the body, e.g. both armpits, both feet, or both hands
  • The patient suffers from focal hyperhidrosis (only limited parts of the body are affected)
  • There appears to be no underlying condition/illness that may be causing it

Sometimes medical testing is necessary. Some patients require a test called the sweat test. This involves coating some of their skin with a powder that turns purple when the skin gets wet. To find an underlying medical condition, other medical tests may be necessary.