Hyperhidrosis Improved by Samhwangsasim-Tang: A Case Report

Hyperhidrosis is a disorder characterized by excessive sweating beyond physiological requirements, which significantly interferes with daily functioning and quality of life. It affects approximately 4%-5% of the population worldwide, yet its underlying pathophysiology remains unclear, with proposed mechanisms involving autonomic nervous system dysregulation, metabolic imbalance, and psychological factors. Here, we describe a case of chronic hyperhidrosis in which spontaneous sweating and facial flushing improved markedly following administration of Samhwangsasim-tang as monotherapy. A 66-year-old man presented with chronic hyperhidrosis occurring without identifiable triggers. Even minimal physical activity caused profuse craniofacial sweating accompanied by facial flushing, which was exacerbated by heat exposure and conditions associated with increased core body temperature. Based on his symptom pattern, Samhwangsasim-tang extract granules were prescribed. No other treatments, including acupuncture, cupping therapy, or conventional medications, were administered during the treatment period. Symptom severity was evaluated using the Numeric Rating Scale (NRS) and the Hyperhidrosis Disease Severity Scale (HDSS). After approximately 42 days of treatment, spontaneous sweating resolved completely (NRS 10 → 0; HDSS 4 → 1), and facial flushing was reduced to 20%-30% of baseline severity (NRS 10 → 2-3). This case suggests that the heat-clearing, anti-inflammatory, and metabolic-regulating properties of Samhwangsasim-tang may contribute to the normalization of skin temperature, sweating regulation, and peripheral circulation. Further clinical and mechanistic studies are warranted to elucidate its therapeutic potential in hyperhidrosis.