Decreased Sweating : Causes, Symptoms, Diagnosis & Treatment

Last Updated: 20/09/2022

Decreased sweating (hypohidrosis, anhidrosis) is a decrease in sweating in limited areas of the skin or on the entire surface of the body. The symptom occurs with age-related skin changes, severe dehydration, polyneuropathy and other systemic lesions, in which sweat glands are involved in the pathological process. To determine the cause of reduced sweating, a pilocarpine test, gravimetry, biochemical and genetic analyzes, and instrumental methods are prescribed. Symptomatic medications are recommended to eliminate discomfort.

Causes of decreased sweating

Skin aging

Dysfunction of the sweat glands in the elderly is associated with natural dystrophic and degenerative changes in the peripheral nerves and capillaries. A decrease in sweating is noted throughout the body, while there is no specific unpleasant smell of sweat. With a decrease in sweating, patients complain of severe dryness and peeling, the color of the skin is pale with an expanded network of blood vessels. Sweating is one of the elements of thermoregulation, so patients also do not tolerate high air temperature well, they cannot stay in the sun for a long time in the hot season.


The symptom develops with insufficient water intake in stuffy weather, hot climates. First, there is increased sweating, then as the fluid is lost, a small amount of concentrated sweat with a sharp unpleasant odor is released. With a decrease in sweating, a strong overheating of the body occurs, which is fraught with heat stroke. If the decrease in sweating is accompanied by intense headaches, weakness, fainting, urgent medical attention is required.

Massive pathological fluid loss from the body triggers compensatory reactions aimed at maintaining the BCC, so the functioning of the sweat glands is inhibited. The first signs may appear in patients with intestinal infections who suffer from repeated vomiting and diarrhea. There is a diffuse decrease in sweating, which causes dryness and a decrease in skin elasticity. If the dyspeptic causes of dehydration are combined with elevated body temperature, the skin will be hyperemic and hot to the touch.

Dermatological diseases

A common cause of a local decrease in sweating is foci of atrophic dermatitis. Pathological processes develop in the skin, the number of sweat glands decreases up to their complete disappearance. In the affected areas, sweat does not appear even in conditions of extreme heat, dryness and large-lamellar peeling, hair loss are disturbing. Similar changes, capturing most of the skin, are typical for radiation dermatitis.

Reduced sweating also becomes a consequence of scleroderma - a systemic process (collagenosis) involving the skin, joints and internal organs. More often, a decrease in sweating is observed in the face and neck, where specific changes are localized - compaction and swelling of the dermis, a characteristic milky white color with separate pink spots. In other parts of the body, especially in the armpits, compensatory increased sweating occurs.



Damage to the sympathetic nerve fibers reduces sweating due to the lack of a stimulating effect of the nervous system on the work of the sweat glands. A person with polyneuropathy notices that he began to sweat less even in the summer or when he was in hot rooms. The symptom is accompanied by other skin manifestations: itching, "marbling". Patients often report paresthesias in the legs. The main neurological causes that cause a decrease in sweating are diabetic neuropathy, trauma to the nervous system, exposure to neurotropic poisons.

Sjögren's disease

The disease is characterized by a decrease in sweating as a result of the action of an autoimmune cause - the sweat glands are destroyed by autoantibodies. Patients (more often menopausal women) notice that they sweat less and can hardly stand the heat. Symptoms of Sjögren's disease gradually progress: at first there is a slight decrease in the amount of sweat, over time anhidrosis occurs, which provokes severe dryness, excruciating skin itching. There are frequent complaints about the constant drying of the conjunctiva, due to which vision deteriorates, inflammatory processes develop in the eye.

Complications of pharmacotherapy

In the first place among drugs that have the ability to reduce sweating, are antiepileptic drugs. These medicines are prescribed for long-term use, therefore, over time, the sweat glands are inhibited, a progressive decrease in sweat production begins. This condition is accompanied by violations of thermoregulation, heat intolerance. In addition, a decrease in the amount or complete absence of sweat is observed after the use of anticholinergic or ganglion blockers, which affect the transmission of nerve impulses to the sweat glands.

Rare Causes

  • Congenital diseases : Fabry disease, ectodermal dysplasia, idiopathic anhidrosis.
  • Spinal cord injury : traumatic lacerations, syringomyelia.
  • Mental disorders .
  • paraneoplastic syndrome .
  • Autoimmune pathologies : discoid lupus erythematosus, dermatomyositis, periarteritis nodosa.


A decrease in sweating can be caused by various reasons, so the patient needs to consult a therapist or dermatologist who organizes the initial examination. During the diagnosis, the fact of a violation of the work of the sweat glands is established, instrumental and laboratory methods are used to determine the origin of the disease. The most diagnostic value are:

  • specific samples . Sweating dysfunction can be detected using the pilocarpine test - normally, after subcutaneous administration of this substance, increased sweating is observed. For quantitative assessment, a gravimetric method is used, which involves recording the rate of sweat release per unit of time. Evapometry is prescribed to study transepidermal water loss.
  • Laboratory tests . To rule out an autoimmune cause of decreased sweating, the amount of specific antinuclear and antineutrophil antibodies is examined. In a biochemical analysis, the glucose level, the ratio of protein fractions and the presence of acute phase indicators are assessed. With a possible hereditary nature of the pathology, genetic analyzes are performed.
  • Skin research . The most informative is a biopsy of the skin of the affected area with subsequent histopathological analysis. During the study of the sample, attention is paid to the presence of degenerative processes (dystrophy, hyperkeratosis, acantholysis), specific cells or inclusions. If rashes or erosive changes in the skin are detected, the cultural method and bacterioscopy are indicated.
  • Instrumental Techniques . To exclude Sjögren's disease, ultrasound of the salivary glands and pancreas is prescribed. If diabetic complications are suspected, the results of vascular dopplerography are indicative. X-rays of the lungs and joints are done to confirm scleroderma. Electroneurography is recommended as a specific method for diagnosing polyneuropathies.


Help before diagnosis

Self-treatment of reduced sweating at home is impossible, but the patient should be provided with the most comfortable conditions. At home, it is advisable to install a humidifier with a hygrometer in order to maintain the humidity in the room at least 55-60% - this reduces the feeling of itching and tightness of the skin. It is forbidden to stay outside for a long time during the hot season. It is important to maintain an adequate drinking regimen. In order not to irritate dry skin, it is advisable to choose clothes made from soft natural materials.

Moisturizing and nourishing the skin


Conservative therapy

Medical tactics for a pathological decrease in sweating depends on the cause of the condition. With senile skin changes, they are limited to non-pharmacological means - regular water procedures, moisturizing lotions and creams. If the symptom is due to dehydration, adequate rehydration by oral fluids or parenteral saline is necessary. Of the drugs most often used:

  • Cholinomimetics . The drugs contribute to the accumulation of the neurotransmitter acetylcholine in synapses. Due to the stimulating effect of cholinomimetics, sweat, salivary and lacrimal glands begin to work more actively. Medicines are used for severe generalized anhidrosis.
  • Glucocorticoids . They have a powerful anti-inflammatory effect, reduce the production of autoantibodies that affect body tissues. Corticosteroids also slow down the progression of pathological skin changes in collagenoses.
  • Neuroprotectors . With neuropathies, injections of vitamins from group B are indicated, which improve the trophism of the nerves, accelerate the conduction of the nerve impulse. For a complex effect on the nervous system, alpha-lipoic acid is added.
  • Local funds . To periodically moisturize the skin with a pronounced decrease in sweating, water with a 1% solution of glycerin is applied to the skin, spraying it from a spray bottle. Such irrigation reduces dryness and discomfort.

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