Procedures
Injections of botulinum toxin type A can be used to block neural control of sweat glands. The effect can last from 3–9 months depending on the site of injections. This use has been approved by the U.S. Food and Drug Administration (FDA). The duration of the beneficial effect in primary palmar hyperhidrosis has been found to increase with repetition of the injections. The Botox injections tend to be painful. Various measures have been tried to minimize the pain, one of which is the application of ice. This was first demonstrated by Khalaf Bushara and colleagues as the first nonmuscular use of BTX-A in 1993. BTX-A has since been approved for the treatment of severe primary axillary hyperhidrosis (excessive underarm sweating of unknown cause), which cannot be managed by topical agents.A microwave-based device has been tried for excessive underarm perspiration and appears to show promise.Tap water iontophoresis as a treatment for palmoplantar hyperhidrosis was originally described in the 1950s. Studies showed positive results and good safety with tap water iontophoresis. One trial found it decreased sweating by about 80%. Surgery
Sweat gland removal or destruction is one surgical option available for axillary hyperhidrosis (excessive underarm perspiration). There are multiple methods for sweat gland removal or destruction, such as sweat gland suction, retrodermal curettage, and axillary liposuction, Vaser, or Laser Sweat Ablation. Sweat gland suction is a technique adapted for liposuction.The other main surgical option is endoscopic thoracic sympathectomy (ETS), which cuts, burns, or clamps the thoracic ganglion on the main sympathetic chain that runs alongside the spine.
Idiopathic unilateral circumscribed hyperhidrosis
Reported association with:
Blue rubber bleb nevus
Glomus tumor
POEMS syndrome
Burning feet syndrome (Gopalans)
Trench foot
Causalgia
Pachydermoperiostosis
Pretibial myxedema
Gustatory sweating associated with:
Encephalitis
Syringomyelia
Diabetic neuropathies
Herpes zoster (shingles)
Parotitis
Parotid abscesses
Thoracic sympathectomy
Auriculotemporal or Freys syndrome
Miscellaneous
Lacrimal sweating (due to postganglionic sympathetic deficit, often seen in Raeders syndrome)
Harlequin syndrome
Emotional hyperhidrosis

Cancer
A variety of cancers have been associated with the development of secondary hyperhidrosis including lymphoma, pheochromocytoma, carcinoid tumors (resulting in carcinoid syndrome), and tumors within the thoracic cavity. Endocrine
Certain endocrine conditions are also known to cause secondary hyperhidrosis including diabetes mellitus (especially when blood sugars are low), acromegaly, hyperpituitarism, pheochromocytoma (tumor of the adrenal glands, present in 71% of patients) and various forms of thyroid disease. Medications
Use of selective serotonin reuptake inhibitors (e.g., sertraline) is a common cause of medication-induced secondary hyperhidrosis. Other medications associated with secondary hyperhidrosis include tricyclic antidepressants, stimulants, opioids, nonsteroidal anti-inflammatory drugs (NSAIDs), glyburide, insulin,  anxiolytic agents, adrenergic agonists, and cholinergic agonists. Miscellaneous
In people with a history of spinal cord injuries
Autonomic dysreflexia
Orthostatic hypotension
Posttraumatic syringomyelia
Associated with peripheral neuropathies
Familial dysautonomia (Riley-Day syndrome)
Congenital autonomic dysfunction with universal pain loss
Exposure to cold, notably associated with cold-induced sweating syndrome
Associated with probable brain lesions
Episodic with hypothermia (Hines and Bannick syndrome)
Episodic without hypothermia
Olfactory
Associated with systemic medical problems
Parkinsons disease
Fibromyalgia
Congestive heart failure
Anxiety
Obesity
Menopausal state
Night sweats
Compensatory
Infantile acrodynia induced by chronic low-dose mercury exposure, leading to elevated catecholamine accumulation and resulting in a clinical picture resembling pheochromocytoma. Febrile diseases
Vigorous exercise
A hot, humid environment

Diagnosis
Symmetry of excessive sweating in hyperhidrosis is most consistent with primary hyperhidrosis. To diagnose this condition, a dermatologist gives the patient a physical exam.