About Secondary Hyperhidrosis – Symptoms, Causes, Diagnostics and Treatment Possibilities

Secondary hyperhidrosis

According to the International Hyperhidrosis Society, excessive sweating affects about 365 millions of people around the world. There are many ways how people sweat, someone has to change a T-shirt a few times a day because of wet maps in underarms, the other experiences heavy head sweating always during a business meeting or dating. The manifestation of sweat has many shapes, but one thing is common for everybody who sweat too much, it affects daily activities, creates a psychical and physical discomfort and worsens the quality of life.

In this article, we are going to talk about secondary hyperhidrosis, which is the name of the condition typical for night sweats.


The Difference Between Primary and Secondary Hyperhidrosis

Secondary generalised hyperhidrosis

Excessive sweating is also known as hyperhidrosis, and current medicine distinguishes 2 main types of this condition: Primary and secondary hyperhidrosis. The difference lies basically in the character of the sweating. While primary hyperhidrosis is a medical condition itself and is not caused by some other condition (idiopathic), secondary hyperhidrosis is sweating that is affected by another health problem or as a side effect of some medicaments (that’s why it’s secondary – secondary to something else).

Secondary hyperhidrosis is characterised by sweating mostly at night. There are also some other differences between these two types of hyperhidrosis. While the onset of primary hyperhidrosis is in childhood or adolescence, secondary hyperhidrosis mostly occurs after the age of 25 years. We have described primary hyperhidrosis in details in the article Primary focal hyperhidrosis – Symptoms, Causes, and Treatment possibilities. Now, we are going to deep into the second type of hyperhidrosis occurring usually while sleeping.


Two Types of Secondary Hyperhidrosis

We can also split the secondary hyperhidrosis into two categories according to the areas of the body affected by excessive sweating. Focal Secondary Hyperhidrosis is a profuse perspiration caused by another medical issue or medicaments and it occurs only in some areas of the body. While this is quite a rare health problem, we are going to deal more with Secondary Generalised Hyperhidrosis that affects the entire body (that’s why it’s generalised) and it occurs more often.


Secondary Generalised Hyperhidrosis (SGH)

The distinguishing of these two main terms (primary and secondary) helps doctors with finding the underlying cause of the condition and determining the proper treatment. People suffering from Primary hyperhidrosis can only treat sweating, and nowadays there are many possibilities on how to effectively reduce sweat. 

But the patient with Secondary generalised hyperhidrosis experience heavy sweating caused by some other disease, which means the doctor needs to find a real reason, make a diagnose and then suggest a proper treatment. So, If the disease is treated, sweating will stop.

In this chart, you can see the basic characteristics of all the mentioned types of hyperhidrosis.

Types of hyperhidrosis






If you decide to visit a physician because of sweating while sleeping, he/she will ask you some questions related to your sweating, make an examination, have a look in your medical history and make a test to determine the proper diagnostics. These are common tests that should be done for knowing a diagnosis.

  • Laboratory blood tests should be done for a wide range of possible diagnoses (anemia, infections, glycemia, thyroid hormones, and others)
  • X-ray chest imaging can discover pulmonary tuberculosis
  • Psychological examination can help with making a general picture of the condition of the patient related to hyperhidrosis
  • Starch-iodine test
  • Filter paper test


Causes of Secondary Hyperhidrosis

Excessive sweating can be caused by many other conditions, such as:

  • Cancer
  • Alcoholism
  • Obesity
  • Lung disease
  • Stroke
  • Infections 
  • Tuberculosis
  • Spinal cord injuries
  • Parkinson

According to the International Hyperhidrosis Society, the major reasons for secondary causes of abnormal focal sweating are neurologic injury and dermatologic syndromes. Hyperhidrosis in the trunk, face, and neck can occur in patients with cervical spine injury. Injury in cranial part of the sympathetic chain, reflex sympathetic dystrophy, or tumor impinging on the sympathetic trunk can also lead to increased perspiration.

Menopause and pregnancy

Profuse sweating in menopause or pregnancy is caused by hormonal changes and usually occurs at night. Menopausal women experience night sweats differently, some of them sweat more just for a few weeks, others can have them much longer. For pregnant women, night sweats usually disappear after the pregnancy.

Medicaments causing excessive sweating

Medicaments causing hyperhidrosis

Also, some medicaments have excessive sweating as a possible side effect. These are some of the most common:

  • Painkillers (Vicodin, Morphine, Tramadol,…)
  • Psychiatric medications (Antidepressant, antipsychotic)
  • Hormonal medications (Insulin, Evista, Glucotrol,…)
  • Skin medications (Topical steroids, Lidocaine,…)
  • Antibiotics (Zovirax, Avelox, Sustiva,…)

On the International Hyperhidrosis Society website, you can find the complete list of medications affecting excessive sweating.


When to Visit a Doctor? 

If you wake up in the morning regularly with a linen and sleepwear soaked by sweat, you should make an appointment with a physician immediately. Visiting a doctor is the first step because if you want to get rid of sweating at night, you have to find a real underlying reason causing the abnormal perspiration. 

It is also important how often night sweats occur. If it is very occasionally, it should be caused by an outer condition (overheated bedroom), or inner condition (fever, flu, other common disease or anxiety, stress, nightmares). While we suffer from common disease, or we are under permanent stress, our body temperature is increased and the body reacts by producing more sweat to cool down the organism. We discussed this topic in the article How to reduce night sweats? First, identify the cause. If you want to know if you suffer from secondary hyperhidrosis, these symptoms can help you to recognise it:

  • Your sweating start after the age of 25 
  • Other family members don’t suffer from excessive sweating
  • You suffer from some medical condition we mentioned above
  • You take some medicament causing excessive sweating
  • You sweat all around the body
  • You sweat abnormally while sleeping


How to Check Your Condition About Sweating

For helping people to determine if they sweat excessively, what kind of hyperhidrosis they have, we created a tool called SweatChecker. It is a simple questionnaire with 11 questions about your sweating. After you answer all of them, you will be redirected to a result page with a description of your condition and treatment recommendation. It takes only 1 minute to find out how serious your problem is with excessive sweating and what you can do step by step to get rid of it. The questionnaire is completely anonymous and free. Run SweatChecker now.

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