Acquired idiopathic generalized anhidrosis
Acquired idiopathic generalized anhidrosis (AIGA) is a rare skin condition in which people cannot sweat normally over most of the body. This makes it hard to regulate body temperature, especially in heat or during exercise. People may also have facial flushing, headaches, disorientation, fatigue, high body temperature, weakness, and palpitations. Sweating is usually reduced or absent across the trunk, while sweating on the palms, soles, or armpits is less common. Some individuals may develop heatstroke.
AIGA can be caused by problems in the nerves that control sweating, issues with acetylcholine receptors or signaling, or direct sweat gland failure. It’s important to rule out congenital conditions that can look similar (such as Fabry disease or ectodermal dysplasia) and secondary sweating disorders from neurological or metabolic diseases and certain medicines.
Diagnosis is made by excluding other causes of anhidrosis and may involve sudomotor tests and skin biopsy. Some advanced tests (like quantitative sudomotor axon reflex testing and microneurography) are mainly used in research and aren’t widely available.
AIGA has three subtypes with different underlying mechanisms: idiopathic pure sudomotor failure (IPSF), sweat gland failure (SGF), and sudomotor neuropathy.
Early treatment with corticosteroids may help, though delaying treatment or ongoing sweat gland damage can lessen benefit. Other treatments that have been used include antihistamines, cyclosporine, and gabapentin.
The condition is very rare and exact prevalence is unknown. About 80% of reported cases have been in men, and most start in the second to fourth decades of life, though it can begin at any age. Heat exposure or physical activity can trigger symptoms, and some people may experience cholinergic urticaria (prickling sensation and rash). The course is often long-lasting, but some cases improve on their own.
This page was last edited on 3 February 2026, at 15:05 (CET).