Sweating (Hyperhidrosis): Classification

Hyperhidrosis can be divided into.

  • Primary and secondary forms:

    • Primary (idiopathic) hyperhidrosis is always focal
    • Secondary forms are usually generalized, less often regional or localized (focal)
  • Generalized, regional and localized forms.

Hyperhidrosis Disease Severity Scale (HDSS).

Grade How would you rate the extent of your sweating?
I My sweating is never noticeable and never interferes with my daily activities.
II My sweating is tolerable and sometimes interferes with my daily activities
III My sweating is barely tolerable and frequently interferes with my daily activities.
IV My sweating is unbearable and always interferes with my daily activities.

The validity and reliability of the HDSS has been analyzed by studies and correlates strongly with hyperhidrosis and gravimetric sweat production.

Categories of night sweats according to Quigley et al.

Expression Definition
Mild No need to change bedding, sweating is not answered positively until asked.
Moderate No bed linen change required, washing of affected body areas required, sweating presented as a “specific problem”.
Strongly Patient reports being “drenched in sweat,” change of bedding or nightclothes or both is necessary.