Secondary hyperhidrosis is excessive sweating caused by an underlying medical condition or by a medication. This is different from primary hyperhidrosis, which is excessive sweating that occurs on its own without another identifiable cause. If you have secondary hyperhidrosis, finding and treating the root cause is often the most important step.
Quick Summary
- Secondary hyperhidrosis is caused by a medical condition or medication.
- It often begins in adulthood and may involve generalized sweating.
- Unlike primary hyperhidrosis, sweating may continue during sleep.
- Common causes include endocrine conditions, infections, menopause, neurologic disease, and medication side effects.
- Treatment focuses first on the underlying cause, but sweat-control treatments may still help.
What Is Secondary Hyperhidrosis?
Secondary hyperhidrosis is excessive sweating that happens because of another issue, such as an illness, hormone change, infection, neurologic problem, or medication side effect. In contrast, primary hyperhidrosis is usually not caused by another disease or medication.
Because secondary hyperhidrosis can be a symptom of another condition, it should not be ignored—especially if the sweating is new, generalized, or starts later in life.
Common Causes of Secondary Hyperhidrosis
Secondary hyperhidrosis has a root cause. That cause is usually either a medical condition or a medication.
Medical conditions associated with secondary hyperhidrosis
- Diabetes
- Hyperthyroidism
- Infections
- Menopause
- Heart disease
- Parkinson’s disease and other neurologic disorders
- Certain cancers
Medications that can cause secondary hyperhidrosis
- Antidepressants, including some SSRIs and SNRIs
- Antipyretics such as aspirin and acetaminophen
- Certain blood pressure medications
- Hormone therapy
- Other medications such as insulin, some antibiotics, and some antivirals may also contribute in certain cases
Primary vs Secondary Hyperhidrosis
Primary and secondary hyperhidrosis can look very different clinically.
Age of onset
Primary hyperhidrosis often begins earlier in life, sometimes in childhood or adolescence. Secondary hyperhidrosis more often begins in adulthood.
Pattern of sweating
Primary hyperhidrosis is usually focal, meaning it affects specific body areas such as the underarms, hands, feet, or face. Secondary hyperhidrosis is more likely to be generalized, meaning it affects much of the body.
Night sweats
People with primary hyperhidrosis often notice that sweating decreases significantly during sleep. In secondary hyperhidrosis, sweating may continue at night.
Family history
Primary hyperhidrosis often runs in families. Secondary hyperhidrosis is usually related to a cause outside of family pattern, such as disease or medication use.
How Do You Know If Sweating Might Be Secondary?
Secondary hyperhidrosis may be more likely if:
- Your sweating started suddenly or later in adulthood
- You sweat all over rather than only in certain areas
- You sweat during sleep
- You recently started a new medication
- You have other symptoms that suggest an underlying medical problem
How Secondary Hyperhidrosis Is Treated
1. Treat the underlying cause when possible
If the sweating is being caused by a medical condition, treating that condition may significantly reduce or resolve the sweating. For example, if a patient is hyperthyroid, treatment of the thyroid condition may improve the sweating.
If the sweating appears to be caused by a medication, changing the dose or switching medications may help—but this should only be done in consultation with the prescribing healthcare provider.
2. Treat the sweating itself when needed
Sometimes the underlying disease cannot be fully reversed, or the medication causing the sweating is medically necessary. In those situations, controlling the sweating directly may be the best option.
Treatment options may include:
- prescription-strength antiperspirants
- oral anticholinergic medication such as glycopyrrolate
- iontophoresis for the hands, feet, and sometimes underarms
- Botulinum toxin injections in appropriate cases
When to Seek Medical Evaluation
You should seek medical evaluation if excessive sweating is new, worsening, generalized, associated with night sweats, or accompanied by other symptoms such as weight loss, palpitations, fever, or medication changes. Secondary hyperhidrosis can sometimes be a clue that something else needs attention.
What If You Are Not Sure Which Type You Have?
If you are not sure whether your sweating is primary or secondary, getting evaluated is important. The distinction matters because treatment may be different depending on the cause.
You can also explore our hyperhidrosis resources or take our product recommendation quiz to learn more about treatment options for excessive sweating.
Frequently Asked Questions
What is secondary hyperhidrosis?
Secondary hyperhidrosis is excessive sweating caused by an underlying medical condition or by a medication.
What causes secondary hyperhidrosis?
Common causes include diabetes, hyperthyroidism, infections, menopause, neurologic conditions, certain cancers, and medication side effects.
How is secondary hyperhidrosis different from primary hyperhidrosis?
Secondary hyperhidrosis more often begins in adulthood, is more likely to be generalized, and may continue during sleep.
Can medications cause excessive sweating?
Yes. Certain antidepressants, antipyretics, hormone therapies, and other medications can cause excessive sweating in some patients.
How do you treat secondary hyperhidrosis?
The best treatment is to address the underlying cause when possible. If sweating persists, treatments such as antiperspirants, oral medications, iontophoresis, or botulinum toxin may help manage symptoms.
Medical Disclaimer
This content is for informational purposes only and is not medical advice. Patients should follow the recommendations of their healthcare provider. If you have new, generalized, or nighttime sweating, speak with a qualified medical professional for evaluation.
