Psychological sweating: a systematic review focused on aetiology and cutaneous response

Psychological sweating in response to emotive stimuli like stress, anxiety and pain occurs over the whole body surface, but is most evident on the palms, soles, face and axilla. This is primarily a consequence of high eccrine sweat gland densities at these body sites. Cholinergic innervation is the primary effector eliciting activation of eccrine sweat glands during periods of acute psychological stress. A dual innervation pathway for eccrine glands (adrenergic and cholinergic) may augment increased sweat output, but this remains to be substantiated. Circulating catecholamines appear not to mediate eccrine gland activity, but may play a role in the activation of apocrine sweat glands. Apocrine sweating is strongly regulated by psychological stimuli and localised to those body sites hosting apocrine glands, with adrenergic peripheral pathways being the primary effector. Accordingly, in the axilla psychological sweating leads to increased sweat output and malodour formation, although this form of sweating at this body site is not observed until puberty.