It’s frequently not easy to define where the line between «normal» sweating and hyperhidrosis lies. A quantative specification of the amount of sweat produced, and therefore defining a graduation of hyperhidrosis is essential. This is achieved with two examinations: gravimetric measurement (quantitative) and the Minor test (starch-iodine, semi-quantitative). If a focal hyperhidrosis is shown, which is triggered or aggrevated by emotional stimuli, it is essential to implement a plan by stages. In the process, some therapy forms are better suited for axillary hyperhidrosis, and others are more appropriate for excessive sweating of the palms of the hands and soles of the feet and the forehead. Generalised hyperhydrosis calls for yet another course of action.
In gravimetric measurement of sweating, the flow of perspiration is measured for one minute, in milligrams. In doing so, absorbent material is placed on the hyperhidrotic area for a certain amount of time. The filter paper is gauged exactly before and after measurement. The difference between the two values (value after measurement minus value before measurement) equals the secretion of sweat in milligrams per minute.
The Minor test
For this starch-iodine test, the hyperhidrotic area is first moistened with a solution containing iodine, and then dusted with powdered starch. Areas that produce more sweat will turn a dark purple color. This semi-quantative test allows a visual demonstration of hyperhidrosis, and is therefore well-suited for follow-ups of treated patients.