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Hyperhidrosis is a disease characterized by perspiration in excess of the physiologic amount necessary to maintain thermal homeostasis. Hyperhidrosis is most commonly primary in nature, but may be secondary to medication use or conditions such as endocrine or neurological diseases, menopause, or neoplasia. Primary hyperhidrosis can be focal (most commonly), affecting the palms, soles, axillary or craniofacial areas, or generalized. Secondary hyperhidrosis is typically generalized and management should be directed toward identification and treatment of the underlying cause. Topical, systemic, and procedural therapies for the treatment of primary hyperhidrosis are presented below, along with the authors’ recommendations on their priority for treatment (1st-4th line). See Table 73-1.
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