Sweating while feeling cold, sometimes called paradoxical diaphoresis, is a common human experience that seems counterintuitive. This response occurs because the body’s temperature regulation system is complex, relying on multiple signals that can sometimes conflict. The body prioritizes maintaining a stable internal environment over the feeling of comfort.
The Body’s Conflicting Temperature Signals
The body’s internal thermostat is located in the hypothalamus, a region deep within the brain that works to maintain a stable core temperature (homeostasis). The hypothalamus receives two primary types of temperature information: one from central thermoreceptors monitoring the core, and another from peripheral thermoreceptors sensing the skin’s surface. When the core temperature rises above the set point, the hypothalamus triggers heat dissipation mechanisms, most notably the activation of sweat glands.
A conflict arises when the skin registers a cold temperature due to environmental exposure. In response to cold, the body attempts to conserve heat through peripheral vasoconstriction, which narrows the blood vessels near the skin’s surface. This shunts warm blood inward toward the vital organs, making the skin feel colder and causing a chilling sensation.
The core temperature signal often overrides the peripheral signal because maintaining the internal temperature is the priority. If the core temperature is elevated, the hypothalamus commands the eccrine sweat glands to produce sweat, regardless of the cold skin temperature. This simultaneous occurrence of a cold skin surface and active sweating is the core physiological reason for the “sweating while cold” feeling.
This conflict can be observed when the body is actively trying to generate heat through shivering, a process of rapid muscle contraction. Shivering dramatically increases metabolic heat production, which quickly raises the core temperature. If the core temperature rises too high while the skin remains cold from vasoconstriction, the body may simultaneously shiver to generate heat and sweat to dump excess core heat.
How External Conditions Trigger Sweating
The feeling of sweating while cold is often related to over-insulation in a cold environment. Wearing excessive layers of clothing traps the heat and moisture generated by the body, leading to a rise in core temperature and subsequent sweating. The moisture-laden inner layers then become inefficient insulators, and the trapped sweat makes the skin feel clammy and cold.
Another common scenario involves post-exertion cooling. When a person exercises vigorously, the body generates significant metabolic heat, requiring heavy sweating to maintain a stable core temperature. If that person stops exercising and is exposed to a cold environment, the body continues to sweat to cool the core. The sweat evaporates rapidly in the cold air, leading to a quick chilling of the skin and creating the sensation of being cold and clammy.
The efficiency of evaporative cooling is affected by moisture. If clothing is damp from sweat or external water, it prevents the efficient evaporation necessary for cooling the skin. Wet clothing cools the skin rapidly by conduction, enhancing the feeling of coldness while the body may still be trying to dissipate heat from the core.
Internal States That Cause Cold Sweats
Cold sweats can be a symptom of internal states where the nervous system is highly activated, often independent of temperature control. A prime example is hypoglycemia, or low blood sugar, which triggers a stress response. When glucose levels drop, the adrenal glands release hormones like epinephrine (adrenaline) to signal the liver to release stored glucose.
This rush of adrenaline stimulates eccrine sweat glands, causing generalized sweating. Concurrently, adrenaline also causes vasoconstriction, diverting blood away from the skin, resulting in the characteristic pale, clammy, and cold feeling. Therefore, the sweating is not to cool the body but is an alarm response to the lack of metabolic fuel.
Emotional states like high stress, anxiety, or panic attacks can similarly cause cold sweats. The “fight-or-flight” response activates the sympathetic nervous system and releases adrenaline, mimicking the physiological effects of hypoglycemia. This type of sweating is often concentrated on the palms, soles of the feet, and armpits, involving apocrine glands in addition to eccrine glands.
Illness and fever also create a situation where the body feels cold while actively sweating. During the onset of a fever, the hypothalamus raises the core temperature set point. The body initiates responses like shivering and vasoconstriction to reach this new, higher temperature. Once the fever breaks, the set point is abruptly lowered, and the body must rapidly cool down, triggering a flush of sweat and the feeling of being cold.