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Hello. I am Dr. Hwang Sang-cheol, a specialist in the study and treatment of the autonomic nervous system.
When treating patients who visit our clinic for hyperhidrosis, I frequently hear the same questions over and over again.
“Why do I sweat so much more than other people?”
“The tests say there’s nothing wrong, so why is this happening?”
“Do I need surgery?”
As you can see, many people share this concern.
Today, I’ll focus on the five most common questions asked by patients with hyperhidrosis in my clinic
and provide a clear summary of the key points.
1. I sweat more than other people, but when I get checked, they say everything is normal. Why is that?
This is the question I hear most often in my clinic. To put it simply, this is because hyperhidrosis is often a “functional issue” rather than a structural abnormality of the body. It is normal for general blood tests or comprehensive health screenings to reveal no specific abnormalities. However, even if the numbers don’t show it, the autonomic nervous systemmay actually be overreacting, causing the sweat glands to become overly active. In particular, many people experience sudden, profuse sweating on their hands, feet, armpits, and face when they feel nervous or stressed. This can be attributed to the sympathetic nervous system—which regulates body temperature— being in a state of excessive arousal. In other words, even if test results are normal, symptoms of hyperhidrosis can still manifest if the balance of the autonomic nervous system is disrupted.
2. Is hyperhidrosis hereditary?
It is not uncommon for this condition to run in families. In fact, when I consult with patients, I often find that many of them have parents or siblings who suffer from hyperhidrosis. However, genetic factors alone do not determine the condition 100%. Even within the same family, some individuals may experience severe symptoms, while others may hardly notice them at all. This is because, in addition to one’s innate constitution, factors such as sleep patterns, stress, lifestyle habits, and the current state of the autonomic nervous system all interact to influence the condition.
Therefore, you shouldn’t be discouraged just because there is a family history; the severity of your symptoms can vary significantly depending on your overall health and how well you manage your autonomic nervous system.
3. Will hyperhidrosis surgery completely resolve the problem?
Many people are considering surgical treatment. The commonly known “sympathectomy” is a standard procedure primarily used to treat hyperhidrosis of the hands, armpits, and face. After surgery, patients often experience a noticeable reduction in sweating in the treated areas.
However, there is an important concept you must understand before deciding to undergo surgery. It is called “compensatory hyperhidrosis.”
Although sweating on the hands and face has decreased, this condition is characterized by increased sweating in other areas—such as the back, chest, abdomen, and thighs—where sweat cannot be properly released. Compensatory hyperhidrosis is more common than one might think, and some patients actually report feeling even more discomfort than before. Ultimately, surgery may simply shift the location of sweating, so this decision must be made very carefully after thorough consultation with a specialist.
4. Why do I sweat more when I’m stressed?
This is a common experience for many people with hyperhidrosis. When facing an important presentation, meeting someone who makes you nervous, or finding yourself in an anxious situation, your hands and feet may suddenly become clammy, and your face may flush. This happens because when we experience stress, the sympathetic nervous system—which causes the body to tense up—becomes activated, and this system strongly stimulates the sweat glands. In particular, people with a naturally sensitive autonomic nervous systemtend to react much more strongly than others to even minor stress or stimuli. This is precisely why we say that hyperhidrosis is not simply a problem with the skin or sweat glands themselves, but is closely related to “autonomic nervous system disorders.” It is for this same reason that symptoms worsen as chronic stress and fatigue become more frequent.
5. Do daily habits also have an impact?
Yes, it has a greater impact than you might expect. In my clinical practice, I’ve found that patients with irregular sleep patterns or chronic fatigue tend to report much more severe symptoms of hyperhidrosis. Irregular sleep is one of the main causes of an imbalance in the autonomic nervous system. Additionally, your daily posture and body shapecan also have an indirect impact. When forward head posture or rounded shoulders become severe, the chest cavity is compressed and breathing tends to become shallow. During this process, the body unconsciously remains in a state of tension, which can continuously stimulate the sympathetic nervous system.Therefore, the key to managing hyperhidrosis lies not merely in suppressing visible sweat, but in restoring the balance of the autonomic nervous system across all aspects of daily life—including sleep, stress, and proper posture.
Let me summarize it for you.
Hyperhidrosis cannot simply be dismissed as a matter of having a “sweaty constitution.” If you experience symptoms that disrupt your daily life even though medical tests show no abnormalities, it may be a sign of an imbalance in the autonomic nervous system or heightened nervous system sensitivity.
Therefore, rather than simplytreating the sweating itself, it’s important to examine the underlying cause of why your body’s autonomic nervous system has become unbalanced. If any of the questions above resonate with you, I recommend that you look beyond a simple issue with your sweat glands and assess the overall balance of your autonomic nervous system.
