What Are the Treatments for Hyperhidrosis?

People with hyperhidrosis sweat excessively even when they are not overheated or physically exerting themselves. The sweating can occur on any part of the body but most often involves the armpits, hands and feet. Treatment options for hyperhidrosis range from strong antiperspirants to electrotherapy and surgery.

Antiperspirants

• Antiperspirants work by stopping up, or plugging, the skin pores through which sweat passes. People with hyperhidrosis will need to use an antiperspirant such as Drysol from Person and Covey or Hypercare from Stratus that contains, at a minimum, between 10 percent and 15 percent aluminum chloride hexahydrate. The strongest antiperspirants can irritate patients' skin, and the aluminum can stain and damage clothes.

Medications

• Medications classified as anticholinergics have a strong dehydrating effect on patients who take them. Because of this, some doctors prescribe the anticholinergics glycopyrrolate (e.g., Robinul from Baxter Healthcare) or propantheline to patients with hyperhidrosis. Patients for whom stress triggers excessive sweating may receive prescriptions for a beta blocker such as propranolol (e.g., Inderal LA from Wyeth) or a benzodiazepine such as alprazolam (e.g., Xanax from Pfizer). Before taking any of these medications, patients need to speak with their doctors about potential side effects.

Electrotherapy

• Some patients with hyperhidrosis may benefit from a procedure called iontophoresis. During iontophoresis, a patient places his feet or hands in a water-filled tank, and a technician passes an electrical current through the water. The electrical current temporarily stuns the sweat glands. An iontophoresis procedure takes between 10 and 20 minutes, and most patients will experience no side effects beyond a tingling sensation during the procedure. Rarely, the skin on the treated appendages becomes cracked or blistered.

Botulinum Toxin Injections

• Injecting botulinum toxin (e.g., Botox from Allergan; Myobloc from Elan) directly into overactive sweat glands will paralyze the glands and stop them from producing perspiration for several months. In July 2009, the U.S. Food and Drug Administration asked makers of pharmaceutical-grade botulinum toxin to add a warning to their products' prescribing information stating that the toxin can spread from its injection site and cause potentially fatal muscle paralysis in patients' hearts, lungs or digestive tracts.

Nerve Surgery

• One of two final resorts for people with otherwise uncontrollable hyperhidrosis, the surgical procedure known as endoscopic thoracic sympathectomy involves cutting and permanently disabling part of a nerve in the spinal column that controls sweating. Patients who undergo endoscopic thoracic sympathectomy run a very small risk of heart attack, stroke, damage to other nerves in the spinal column or loss of the ability to sweat from the face or keep eyes fully open.

Sweat Gland Removal

• Another surgery that might be an option for people with severe hyperhidrosis is sweat gland removal. The most commonly removed sweat glands are those in the armpits. A leading complication from this surgery is, paradoxically, excessive sweating. Surgeons may use liposuction, a scalpel or a scraping device known as curette to remove sweat glands. Patients who have sweat glands removed can expect scarring.