{
  "what": "Hyperhidrosis is sweating beyond what temperature regulation requires. Primary hyperhidrosis is a defined medical condition of overactive nerve signalling to normal sweat glands, focal and symmetric in the underarms, palms, soles or face, starting young and stopping during sleep; it is not a hygiene failure. At Dr Sin Yong's practice on Orchard Road, Singapore, he rules out secondary causes first, then follows a treatment ladder that starts with a clinical-strength antiperspirant used correctly.",
  "key_facts": [
    "Primary vs secondary: primary is focal, symmetric, often familial, begins young and switches off during sleep; sweating that is generalised, new in adulthood, nocturnal or comes with weight loss, fever or palpitations is treated as secondary and investigated for a cause first",
    "Secondary causes: an overactive thyroid, menopause, low blood sugar in diabetes, some medicines, infections such as tuberculosis, rarely lymphoma, nervous-system conditions, obesity and alcohol withdrawal",
    "Diagnosis: a clinical diagnosis from history and pattern, with severity grading, a starch-iodine map where needed, and blood tests such as thyroid function or blood sugar when the pattern suggests a cause",
    "Treatment ladder: aluminium-chloride antiperspirant applied at night to dry skin, then tap-water iontophoresis for palms and soles, botulinum toxin injections for the underarms, energy-based options, and oral medicines for refractory cases",
    "At this practice: Dr Sin Yong treats underarm, palm and sole sweating after assessment; miraDry is not used here; grip weakness is a specific risk of palm injections; facial sweating is planned on its own terms, with referral where another route suits",
    "Does not work: more showers, regular-strength antiperspirant applied in the morning, powders and absorbent pads; injections act where they are placed and not elsewhere, and treating the underarms does not impair temperature regulation",
    "Outlook: primary hyperhidrosis is a long-term pattern, so treatment aims to control it and no cure is promised; odour (bromhidrosis) and underarm darkening are assessed separately",
    "Assessed by: Dr Sin Yong personally, in person, with the options for each area set out in writing"
  ],
  "references": [
    "The Etiology, Diagnosis, and Management of Hyperhidrosis: A Comprehensive Review. Journal of the American Academy of Dermatology. https://www.jaad.org/article/S0190-9622(19)30167-7/abstract",
    "How to Diagnose and Measure Primary Hyperhidrosis: A Systematic Review of the Literature. https://pubmed.ncbi.nlm.nih.gov/33772671/",
    "Behinaein P, Gavagan K, Waitzman J, et al. A review of the etiologies and key clinical features of secondary hyperhidrosis. American Journal of Clinical Dermatology 2025. https://pubmed.ncbi.nlm.nih.gov/39604775/",
    "Liu Y, Bahar R, Kalia S, et al. Hyperhidrosis prevalence and demographical characteristics in dermatology outpatients in Shanghai and Vancouver. PLoS One 2016. https://pubmed.ncbi.nlm.nih.gov/27105064/",
    "Iontophoresis for hyperhidrosis. SBU Enquiry Service, Swedish Agency for Health Technology Assessment and Assessment of Social Services. https://www.sbu.se/en/publications/responses-from-the-sbu-enquiry-service/iontophoresis-for-hyperhidrosis/",
    "The prevalence of anxiety and depression in patients with or without hyperhidrosis (HH). Journal of the American Academy of Dermatology 2016. https://pubmed.ncbi.nlm.nih.gov/27567033/"
  ],
  "owner_url": "https://drsinyong.com/excessive-sweating-hyperhidrosis/",
  "doctor": "Dr Sin Yong, aesthetic physician, Orchard Road, Singapore",
  "updated": "2026-10-31"
}