Cold Sweat : Causes, Symptoms, Diagnosis & Treatment

Last Updated: 29/09/2022

Cold sweat is excessive sweating, which is accompanied by cold skin, chills. The symptom occurs against the background of weakness, dizziness. There are various reasons for the development of cold sweat: disorders of the autonomic nervous system, blood loss and other emergency conditions, endocrine and cardiac diseases. To identify the cause of the disorder, ECG, echocardiography, ultrasound, x-ray imaging methods, and laboratory tests are used. To eliminate cold sweat, the underlying disease is treated.

Causes of cold sweat

severe stress

The protective reaction of the body to any stressful situation is the release of hormones from the adrenal medulla (mainly adrenaline). This substance constricts the blood vessels of the skin and activates the sweat glands. A person feels profuse cold sweat, which appears in the form of drops, more often in the head area, and sometimes can drain in trickles. Such a manifestation is characteristic of the strongest emotional upheavals. Short-term sweating during stress is a variant of the norm, but when it is combined with dizziness, pre-syncope, medical assistance is needed.


A person is thrown into a cold sweat at the height of a painful attack. In addition to severe headaches, the patient feels lightheadedness, weakness, and general sweating is observed. Hands and feet are cold, damp, sweat may run down the face and neck. This condition persists throughout the migraine attack and disappears on its own after the pain stops. Severe pain provokes excessive production of adrenaline, which causes sweating. Unpleasant symptoms are aggravated by exposure to light and sound stimuli.

Vegetovascular dystonia (VVD)

This is a common cause of cold sweats, especially in young, emotionally labile patients. A person with VSD reports that attacks of increased sweating have a different frequency - from several times a month to several times a day. Sweating is provoked by staying in a stuffy room, excitement. Patients note that the symptom is combined with severe weakness, dizziness, some people think that they are about to faint. Cold sweat is released all over the body, sweating of the palms, head, and armpits is most pronounced.



In diabetic patients, cold sweating most often develops against the background of a decrease in blood glucose levels. Often a symptom is observed with long breaks between meals, erroneous administration of more insulin. At first there is a strong feeling of hunger, then on the face, the body sweats profusely, while the limbs are very pale and cold. Increased sweating is sometimes accompanied by motor excitement, a feeling of fear. The condition requires emergency care, as hypoglycemia can turn into a coma.

Cardiac pathology

Cold sticky sweat, which is caused by a large amount of stress hormones entering the bloodstream, appears on the skin during myocardial infarction. The symptom appears against the background of sharp pains in the chest with irradiation to the shoulder blade or left arm. In addition to pain, there is pronounced weakness, coldness of the extremities, cold perspiration appears on the face and body. The patient is very pale, verbal reactions may be inhibited. Sometimes the cause of cold sweat is the development of acute heart failure with a sharp drop in pressure and activation of the sympathetic nervous system.


The loss of a large amount of blood (more than 10% of the BCC) is always accompanied by a violation of the general condition. With external bleeding from large vessels, cold sweat occurs immediately after an injury, its appearance is due to both neurohumoral disorders and a strong emotional shock from the type of blood. With massive internal bleeding, hemorrhages in the abdominal or pleural cavity, sticky sweat, a sharp cooling of the skin, and diffuse cyanosis are observed. Profuse blood loss can lead to loss of consciousness.

Infectious diseases

Cold sweat usually occurs before sleep, or the patient wakes up at night with a strong chill and notices increased sweating. The development of a symptom is associated with intoxication of the body with particles of bacterial or viral agents, an increase in body temperature. In some infections, complaints of prolonged perspiration (more than 1 month), cold extremities are typical. Abundant sweat can be combined with muscle trembling, weakness. Cold sweating is characteristic of diseases such as:

  • Bacterial infections : pneumonia, tuberculosis, sepsis, etc.
  • Viral processes : influenza, infectious mononucleosis, hemorrhagic fever (Crimea-Congo, Marburg, Ebola).
  • Parasitic invasions : malaria, toxoplasmosis.
  • HIV infection .

withdrawal syndrome

Profuse cold sweats, which are predominantly observed at night, occur in people with dependence on alcohol and drugs. Perspiration appears 2-3 days after the cessation of the use of these psychoactive substances. Sometimes the sweat is so profuse that the sheets and pillowcases get soaked through, and the person suffering from withdrawal symptoms has to change bedding in the middle of the night. Increased sweating is accompanied by aching and burning sensation throughout the body, weakness, severe headaches. Characterized by irritability, emotional instability.


There are many acute conditions in which cold sweats can occur. Perspiration always appears with severe damage to the internal organs, in which the nervous regulation changes, there is a sharp release of biologically active compounds into the blood. At the same time, the skin turns pale sharply, the nasolabial triangle, nails, fingertips acquire a bluish tint. Sticky sweat appears on the entire surface of the body. Concomitant symptoms depend on the cause that provoked the appearance of cold sweat. With profuse sweating and cold extremities proceed:

  • Critical conditions : acute respiratory or hepatic failure, renal colic.
  • Pathology of the gastrointestinal tract : peritonitis, strangulated hernia, thrombosis of the mesenteric vessels.
  • Diseases of the pelvic organs : ovarian apoplexy, tubal pregnancy, uterine perforation.
  • Neurological disorders : concussion, subdural or epidural hematomas, stroke.

Rare Causes

  • Oncological diseases : lymphogranulomatosis, non-Hodgkin's lymphomas, acute and chronic leukemias.
  • Idiopathic hyperhidrosis .
  • Endocrine pathology : hypothyroidism, chronic insufficiency of the adrenal cortex.
  • Cardiac arrhythmias : Morgagni-Adams-Stokes syndrome, paroxysmal tachycardia, QT interval prolongation syndrome.


The clarification of the factors that caused excessive sweating is handled by a general practitioner or a specialist therapist. The main task of the examination is to detect the main cause - pathology, one of the symptoms of which is cold sweat. Diagnostic search involves laboratory and instrumental methods for assessing the general condition of the body and the functioning of individual organs. The following studies are considered the most valuable:

  • Cardiodiagnostics . To exclude cardiac causes of the origin of cold sweat, an electrocardiogram is recorded in standard leads. The recording evaluates the voltage of the teeth, the size of the intervals between them. If pathological signs are detected, echocardiography is performed to clarify the diagnosis.
  • Neurological examination . Standard research includes checking deep and superficial reflexes, skin dermographism. To exclude vegetovascular disorders, the Danini-Ashner phenomenon and an orthostatic test are used. In some situations, an electroencephalogram recording is recommended.
  • functional trials . Methods are used when idiopathic hyperhidrosis is presumably considered as the main cause that provoked cold sweat. The amount of perspiration is estimated using evapometry and gravimetry. To measure the area and intensity of hyperhidrosis, Minor's test (iodine-starch test) is performed.
  • visualization methods . During the initial examination of patients with complaints of cold sweat, ultrasound of the abdominal cavity and small pelvis is informative. In the presence of concomitant symptoms, an X-ray examination of the chest and abdomen is indicated. Sometimes a CT scan or MRI is prescribed.
  • Analyzes . A clinical blood test can detect signs of infectious diseases, which are often manifested by cold sweating. A coagulogram is performed in the presence of bleeding. In all cases of the disorder, a biochemical blood test with a proteinogram, measurement of fasting glucose is recommended.

The presence of a general infectious syndrome is an indication for bacteriological examination and performance of serological reactions to identify the type of pathogen (RIF, ELISA, PCR). With prolonged sweating, it is necessary to determine the concentration of insulin, thyroid hormones and adrenal cortex. To examine patients with cold sweat, other specialists (endocrinologist, phthisiatrician, oncologist) may be involved.


Help before diagnosis

Cold sweat can be a sign of various diseases, so only a doctor determines the exact causes of unpleasant symptoms. Before establishing the cause of sweating, it is recommended to take a hygienic shower regularly and change bed linen more often. With strong sweating, sedatives are used that normalize the functioning of the nervous system. If cold sweat arose against the background of severe weakness or dizziness, the patient should be seated, provided with air, and when fainting, give a sniff of ammonia.

First aid in critical conditions


Conservative therapy

Medical tactics depend on the underlying cause that caused the appearance of excessive sweating. In critical conditions, resuscitation, oxygen support and the introduction of infusion glucose-salt solutions are required. In the case of a satisfactory condition, drug therapy is carried out. Cold sweat caused by autonomic dysfunction is treated with the use of physiotherapy and psychotherapy. The treatment regimen may include the following groups of drugs:

  • Sedative drugs . Means are effective when cold sweat is associated with disorders of the nervous system. Both herbal and synthetic medicines are used. In difficult situations, resort to "daytime" tranquilizers.
  • Analgesics . The occurrence of cold clammy sweat associated with pain requires the appointment of non-narcotic painkillers. With severe pain, traumatic shock, opioid analgesics are used.
  • Antibacterial drugs . Medicines help eliminate sweating associated with infectious diseases. In tuberculosis, specific long-term treatment regimens are used with combinations of several anti-tuberculosis drugs.
  • Thrombolytics . The drugs are prescribed to patients with myocardial infarction, against which cold sweat occurs. They allow you to restore the blood supply to the heart muscle and significantly reduce the period of convalescence.


In case of cold sweat caused by severe organic lesions of internal organs, surgical intervention is indicated. Diseases accompanied by an "acute abdomen" require laparotomy, revision and sanitation of the abdominal cavity. In case of pathology of the organs of the reproductive system in women, resection of the altered tissue is performed with the preservation of childbearing function, with extensive lesions, oophorectomy and adnexectomy are necessary. Bone marrow transplantation is possible for leukemias and lymphomas.

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