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Tests for Hyperhidrosis


Tests for hyperhidrosis are split into two main sort of tests

Firstly, there are the tests to check that there is not an underlying cause for hyperhidrosis.

Secondly, there are the tests to check the severity of the hyperhidrosis itself.

Tests for underlying causes of hyperhidrosis

Most of the underlying causes of hyperhidrosis can be determined by talking to the patient (medically called “taking a history”) and performing a careful examination. Provided the patient is honest and answers all of the doctors questions truthfully, most underlying causes can be determined simply by this interview.

Occasionally tests are needed but usually only two are used:

  • Thyroid function test – this is a simple blood test, where a syringe of blood is taken from the arm and sent to a special laboratory. The laboratory measures the level of thyroid hormone and also the level of the hormone that controls the thyroid hormone. By looking at these blood levels, it can be determined whether the patient has an overactive thyroid gland causing the hyperhidrosis.
  • 24 hours urine test – very uncommonly, if after talking to the patient and examining them the doctor feels that is a risk of a problem called phaeochromocytoma or even a carcinoid syndrome, then a 24 hour urine test can be performed. This test measures for the breakdown products of excessive adrenaline a noradrenaline if a phaeochromocytoma is suspected, or the breakdown products of a chemical produced by carcinoid if that is suspected. Urine tests can be influenced by what we eat and so if this is ordered, a special dietary sheet is also issued.

Tests for hyperhidrosis

Most hyperhidrosis is diagnosed by speaking to the patient alone and seeing whether hyperhidrosis is present.

However, with armpit sweating (axillary hyperhidrosis), Prof Mark Whiteley of The Whiteley Clinic developed the Laser Sweat Ablation (LSA) operation from the subdermal laser ablation (SDLA) procedure that was performed widely elsewhere (including “Axillase” performed in the USA), putting science to these procedures and in particular developing the Whiteley Laser Sweat Ablation (LSA) cannula.

As such, we use two different sweat tests for axillary hyperhidrosis to enable us firstly to diagnose who needs the Laser Sweat Ablation (LSA) procedure and secondly, exactly where the heaviest sweating is coming from in the armpit.

1 – Volumetric test: outpatients are asked to attend The Whiteley Clinic for an appointment having observed a special regime before they come. They are told not to wear any deodorants or antiperspirants for a period of time before the test and also not to drink any caffeinated drinks before the test.

During the test, cotton wool balls are placed under the armpits for one hour. Measuring the weight of the cotton wool balls at the beginning of the hour and at the end of the hour allows us to calculate exactly how much sweat has been produced.

2 – Minor’s starch and iodine test: alcoholic iodine solution is placed upon the skin of the under arms and then starch is sprinkled onto the area. In areas where the skin is dry, the starch stays white. In areas that sweat is being produced, the starch turns black. In this way, we are able to identify exactly the distribution of the eccrine sweat glands that need treatment.