Excessive Sweating

What Is Hyperhidrosis and How Is It Treated?

Do you find yourself sweating more than the average person? If it’s excessive, you might have a medical condition called hyperhidrosis. The term “hyper” means in excess, while “hidrosis”
relates to sweating. Hyperhidrosis goes well beyond sweating when it’s hot, or during a workout. That is normal, because the body needs to sweat to cool itself off. Primary hyperhidrosis is excessive sweating for no visible or apparent reason, whereas secondary hyperhidrosis can be the result of an underlying abnormality of the thyroid gland, the adrenal gland amongst other medical problems.
In primary focal hyperhidrosis sweating is prominent in just 1-2 specific areas (axillae, palms, soles, head) while the rest of the body typically stays dry. Generalized hyperhidrosis is the
excess uncontrolled sweating from all over the body. Hyperhidrosis often interferes in normal daily activities, aside from embarrassment. For example, with sweaty palms, using your phone or turning a doorknob is challenging. Clothes become stained due to the excessive sweating, and skin can develop infections due to the moisture.
Fortunately, a dermatologist can help. There are various treatments to consider, once a person has been diagnosed. Appropriate evaluation of signs and symptoms, triggers as well as physical
evaluaton is necessary to treat the condition right.
Treatments for Hyperhidrosis
There are a few options for treating hyperhidrosis. Some treatment options include:
Antiperspirants
Your doctor might suggest a clinical grade antiperspirant with higher concentration of aluminum chloride.
● Use – applied directly to the area that sweats
● How it works- as it lies on your skin, tiny little crystals plug up the glands. It is meant to trick your body to stop producing sweat.
● Side effects – Possible irritation or burning sensation
Iontophoresis
Iontophoresis is a popular option for sweaty hands and feet. With this treatment, you place your hands or feet into a shallow pan of tap water. The device will then send a low-voltage current
throughout the water. Many people have found some relief with this treatment, but it can be time-consuming.
● Use – for hands or feet

● How it works – This works by the current temporarily shutting down the sweat glands so they don’t produce sweat. About 6-10 treatments are typical for it to take effect, and the
treatments run 20-40 minutes each. There is also long-term maintenance.
● Side effects – Irritation, dry skin, and slight discomfort are possible.
Botulinum Toxin Injections
Botulinum toxin is injected into the underarm area, palms and soles. It’s done with several tiny injections spaced out 1 cm apart. Despite how it sounds, very little discomfort is experienced
with this treatment, if done properly.
● Use – Underarms, head, feet and hands.
● How it works – The injection is intended to chemically block the interaction between the nerves and the sweat glands. On average, a person feels results about 5 days post
injection, and should last up to 6 months. Once it wears off, you could go through the process again.
● Side effects – Normally none, but a person might feel temporary muscle weakness.
Prescription Medication
Glycopyrrolate and oxybutinin are prescription medications that can be used to temporarily block the body from sweating. This approach does not target a single area, but rather the entire
body. However, the FDA just granted approval to a topical version of glycopyrrolate, which in the form of towlettes could bring relief to sweating of the underarms.
● Use – The entire body, and women from post-menopausal who suffer with heavy head sweating
● How it works – These medications block all body secretions (sweat, urine, stool, saliva, tears). This is not recommended for those who need to sweat in order to cool down,
such as athletes, people in warmer climates, or working in a hot setting. The body needs to be able to cool itself. It is not recommended to people with baseline constipation or
heart disease.
● Side effects – dry mouth, skin, and eyes, as well as blurred vision and heart palpitations. The higher the dose, the higher the risk for side effects.
Surgery
Surgery is an option when other options have failed. As with any surgery, it’s permanent and there are risks. The 2 surgical options to consider are to remove the sweat glands, or
sympathectomy which intentionally destroys nerves.
Removing the sweat glands:
● Use – Underarms and palms
● How it works – Your dermatologist will surgically remove the sweat glands from the underarms, through outpatient or in the doctor’s office. The options for removal are
liposuction (suction), excision (cutting), laser (vaporizing), or curettage (scraping).
● Side effects – You could experience some bruising or an infection.

Sympathectomy:
Unlike the procedures for sweat gland removal, sympathectomy is a major surgical procedure, and performed at the hospital. The doctor will surgically destroy the nerves in the underarm
area.
● Use – Underarms
● How it works – A small camera is inserted in your chest, near the underarm. The lungs will then be intentionally collapsed temporarily so the surgeon is able to reach the
nerves.
● Side effects – Infection and bruising are possible. A patient might also experience permanent numbness under the arm, as well as scarring. It is also possible to have the
opposite effect with the patient sweating more afterward. More serious possible side effects include nerve damage between the eyes and brain, irregular heartbeat, extreme
low blood pressure, and intolerance to heat.
Electromagnetic Energy Treatment and Radiofrequency
A handheld device that emits electromagnetic energy is a fairly new option. It’s been approved by the FDA, but far too new for valuable information such as long-term results and side effects.
The doctor uses the handheld machine to destroy the sweat glands, in just 1-2 office visits. The glands are permanently destroyed and no further treatment is necessary.
Microneedling radiofrequency has also been used off-label to treat this condition but further evaluation is needed to confirm its safety and efficacy.
Make an appointment with the dermatologist to see if you are a good candidate for one of the above treatments. It could make a positive impact on your life.