Hypohidrosis is inadequate sweating. Diagnosis is clinical. Treatment is avoiding raising the core body temperature and using various cooling methods.
Hypohidrosis due to skin abnormalities is rarely clinically significant. It is most commonly focal and caused by local skin injury (eg, due to trauma, radiation, infection [eg, leprosy], inflammation) or by atrophy of glands resulting from systemic rheumatic disease (eg, systemic sclerosis, systemic lupus erythematosus, Sjögren syndrome) (1).
Hypohidrosis is a feature of some genetic conditions (eg, hypohidrotic and anhidrotic ectodermal dysplasia). A mutation of the gene ITPR2, which encodes a calcium channel, results in anhidrosis, the complete absence of sweating (2).
Hypohidrosis may be caused by medications, especially those with anticholinergic properties. It is also caused by diabetic neuropathy and a variety of congenital syndromes.
Heatstroke causes inadequate sweating but is a central nervous system disorder rather than a skin disorder.
(See also Introduction to Sweating Disorders.)
General references
1. Chia KY, Tey HL. Approach to hypohidrosis. J Eur Acad Dermatol Venereol. 2013;27(7):799-804. doi: 10.1111/jdv.12014
2. Klar J, Hisatsune C, Baig SM, Tariq M, et al. Abolished InsP3R2 function inhibits sweat secretion in both humans and mice. J Clin Invest. 2014;124(11):4773–4780. doi: 10.1172/JCI70720
Diagnosis of Hypohidrosis
History and physical examination alone
The diagnosis of hypohidrosis is based on clinical observation of decreased sweating or heat intolerance.
Treatment of Hypohidrosis
Various methods to prevent overheating and to cool
Management of hypohidrosis includes avoidance of exogenous triggers (eg, medications with anticholinergic effects).
Because of the risk of hyperthermia, heat exhaustion, and heat stroke,patients should avoid activities that raise internal core temperature and use cooling measures (eg, air-conditioning, wet garments) (1).
Treatment reference
1. Chia KY, Tey HL. Approach to hypohidrosis. J Eur Acad Dermatol Venereol. 2013;27(7):799-804. doi:10.1111/jdv.12014
