The HDSS test: do I have hyperhidrosis?
“Do I just sweat a lot, or is this hyperhidrosis?” Doctors answer that question not by the amount of sweat but by how much it gets in the way of life. There is a short scale for this, the HDSS: one question and four possible answers. You can take it yourself right now and see where to start.
Short answer
The HDSS (Hyperhidrosis Disease Severity Scale) asks you to pick one of four statements about how noticeable your sweating is and how much it interferes with daily activities. According to a review in American Family Physician (AAFP), 1 point means sweating is not noticeable and does not interfere; 2 is mild; 3 and 4 are severe. The scale rates severity but does not make a diagnosis: a doctor also looks at how long it has lasted and where and when you sweat. For primary hyperhidrosis, the AAFP names an aluminium chloride antiperspirant as the first step.
Take the HDSS
There is one question: how much does sweating interfere with your everyday life? Choose the statement that best describes the last few weeks. The wording follows the AAFP review (McConaghy and Fosselman, 2018).
- 1 point: my sweating is not noticeable and never interferes with my daily activities.
- 2 points: my sweating is tolerable but sometimes interferes with my daily activities.
- 3 points: my sweating is barely tolerable and often interferes with my daily activities.
- 4 points: my sweating is intolerable and always interferes with my daily activities.
What your score means
According to the AAFP, a score of 2 is mild, while 3 or 4 is severe. Doctors use the scale to choose treatment and then to judge the result: a lower score counts as success.
Importantly, the HDSS does not measure the amount of sweat but its effect on your life. Two people can sweat equally, yet one scores 2 and the other 4, and that is fine. This makes the scale useful to repeat: a few weeks after changing your product or routine, you can see whether things have got easier.
Signs of primary hyperhidrosis
The score on its own does not tell you whether it is hyperhidrosis. For primary (focal) hyperhidrosis, the AAFP lists these criteria: visible, excessive sweating of specific areas for more than six months without an apparent cause, plus at least two of the following:
- both sides of the body sweat equally, for example both underarms or both palms;
- sweating interferes with daily activities;
- episodes happen at least once a week;
- it started before the age of 25;
- you do not sweat during sleep;
- someone in your family has the same.
When to look for another cause
Heavy sweating can be the result of another condition or a medicine. This is called secondary hyperhidrosis. The International Hyperhidrosis Society (IHHS) describes the differences: it usually starts in adulthood, affects larger areas of the body and often happens during sleep, whereas primary hyperhidrosis begins in childhood or adolescence and affects specific areas.
The NHS advises seeing a doctor if self-care does not help, the sweating has lasted at least six months, happens at least once a week, stops you from getting on with daily activities, happens at night, runs in your family, or you take medicine for another condition. More in “What is hyperhidrosis, and when should you see a doctor?” and “Night sweats: when they are normal and when to see a doctor”.
What to do with your result
According to the AAFP recommendations, the first step for primary hyperhidrosis in almost every case is an aluminium chloride solution: it is applied to the affected areas at night, and once sweating decreases, the intervals between applications are lengthened. If that is not enough, a doctor may suggest iontophoresis for palms and soles, botulinum toxin injections, tablets and, only as a last resort, surgery. All the options are covered in “Hyperhidrosis: what treatment options are there?”.
- 2 points: starting with the right antiperspirant and routine is usually enough: in the evening, on dry skin.
- 3–4 points: see a dermatologist; an antiperspirant remains the first step, and the doctor will choose the next one if needed.
- Sweating started in adulthood, all over the body or at night: see a GP first to rule out other causes.
- Take the scale again after 2–4 weeks and compare your scores.
Bottom line: take the test before and after
The HDSS is a simple way to answer honestly how much sweating bothers you and then to check whether a product has helped. Write down today’s score and compare it after a few weeks of a regular routine.
OKEY fits this well: it is based on aluminium chloride, the active ingredient doctors name as the first step for excessive sweating. According to its instructions, after the first evening applications, using it 1–2 times a week or as needed is enough to maintain the effect.
OKEY is a long-lasting, fragrance-free antiperspirant for women and men in a 35 ml roll-on bottle. It suits all areas prone to excessive sweating. According to the instructions, it is applied in the evening before bed in a thin layer to clean, completely dry and intact skin, and any residue is washed off in the morning. OKEY is available on Kaspi for 7990 ₸ with a 14-day bottle return. Regular customers can buy it on our website okeystaydry.com for 6990 ₸ with free delivery to a Flip pickup point, without a return option. The buy button is below.
