Focal vs Generalized Hyperhidrosis

Hyperhidrosis is a medical condition characterized by excessive sweating. There are two primary types: focal hyperhidrosis (FHH) and generalized hyperhidrosis (GHH). Focal hyperhidrosis (also called primary hyperhidrosis) involves excessive sweating from specific areas of the body such as the underarms, palms, soles of the feet (palmoplantar hyperhidrosis), groin, scalp, or face. The cause of this condition is unknown and typically occurs in otherwise healthy individuals.

On the other hand, generalized hyperhidrosis affects the entire body and may indicate an underlying medical condition that requires attention. It involves excessive sweating beyond specific areas and warrants medical evaluation.

Helping Create Dryer Lifestyles

Not Sure if You have Focal Hyperhidrosis?

Determining whether you have focal hyperhidrosis usually involves the presence of regionalized or site-specific excessive sweating for at least 6 months. You should also have at least two of the following factors*:

• Sweating occurs on both sides of the body (e.g., both hands, both feet, both sides of the face). In other words, sweating is bilateral

• You have at least one sweating episode per week.

• You have some degree of impairment of daily activities.

• The onset of your excessive sweating was less than 25 years old.

• You have some family history of the condition.

• Your sweating tends to cease during sleep.

Factors Associated with Focal Hyperhidrosis

Diagnosing focal hyperhidrosis typically involves identifying regionalized or site-specific excessive sweating persisting for at least 6 months, along with meeting at least two of the following criteria*:

1. Sweating occurs bilaterally on both sides of the body (e.g., both hands, both feet, both sides of the face).

2. Experiencing sweating episodes at least once per week.

3. Experiencing impairment in daily activities due to sweating.

4. Onset of excessive sweating before the age of 25.

5. Family history of hyperhidrosis.

6. Sweating ceases during sleep.

Facts & Figures

In a study** of over four hundred individuals with hyperhidrosis from an outpatient clinic, the following patterns were observed:

*Haider A, Solish N. Can Med Assoc J. 2005; 174(1): 69-75 **Walling HW. J Am Acad Dermatol. 2011; 64(4): 690-5

• Focal hyperhidrosis (FHH) was much more prevalent, with the majority (93%) experiencing palmoplantar hyperhidrosis, compared to only 7% who had generalized hyperhidrosis (GHH).

• Individuals with GHH were older on average, with a mean age of 39 years, while those with FHH had a younger mean age of 27 years.

• FHH typically had a younger onset, commonly occurring between 14 and 25 years of age. Only 12% of individuals with FHH experienced onset after the age of 25. In contrast, more than half (55%) of those with GHH reported onset after 25 years of age.

• Asymmetric sweating (one-sided sweating) was 51 times more likely in individuals with GHH compared to those with FHH.

• Sweating during sleep was 23 times more likely to occur in individuals with GHH compared to those with FHH.