We at TSC subjectively assess the patient’s history. If patients are complaining of a sudden triggering of sweat in their hands, underarms, or feet, which cannot be controlled, and impacts the quality of their life, they can be diagnosed as having focal hyperhidrosis. It is critical to differentiate focal from generalized hyperhidrosis as the treatment algorithm is very different.

We currently use the Hyperhidrosis Severity Score (Solish et al.) to quantify a patient’s symptoms. This score classifies symptoms into 4 categories:

  1. Never noticeable and never interfering with daily activities
  2. Tolerable, but sometimes interfering
  3. Barely tolerable and frequently interfering
  4. Intolerable and always interfering

Typically, surgical intervention for focal hyperhidrosis is considered only in those with a score of 3 or 4.

Regulation of Body Temperature:

There are two types of sweat glands: apocrine glands that produce the odor, and eccrine which are more common and are responsible for thermal regulation.

Eccrine glands are most dense in the palmar, axillary, and plantar areas. Evaporation from the sweat is the most effective way to dissipate heat produced by the body and is therefore our body’s best way to maintain its temperature.