Hyperhidrosis

There are a variety of treatment options available for patients with hyperhidrosis, including:

• Antiperspirants. Excessive sweating may be controlled with strong anti-perspirants, whichplug the sweat ducts.Products containing 10% to 15% aluminum chloride hexahydrateare the first line of treatment forunderarm sweating.Some patients may be be prescribeda product containinga higher dose ofaluminum chloride, which isapplied nightly onto the affected areas. Antiperspirants can cause skin irritation, and strong doses of aluminum chloride can damage clothing. Note: Deodorants do not prevent sweating, but are helpful in reducing body odor.
• Medication.Anticholinergics drugs, such as glycopyrrolate (Robinul, Robinul-Forte),help to prevent the stimulation of sweat glands.Although effective for some patients, these drugs have not been studied as well as other treatments. Side effects include dry mouth, dizziness, and problems with urination.
• Iontophoresis. This FDA-approved procedure useselectricity to temporarily turn off the sweat gland. It is most effective for sweating of the hands and feet. The hands or feet are placed into water, and then a gentle current of electricity is passed through it. Theelectricity is gradually increased until the patient feels a light tingling sensation. The therapy lasts about 10-20 minutes andrequires several sessions. Side effects include skin cracking and blisters, although rare.
• Botox.Botulinum toxin type A (Botox) was approved by the FDA in 2004 for the treatment of severe underarm sweating, a condition called primary axillary hyperhidrosis.Small doses ofpurified botulinum toxin injected into the underarmtemporarily block the nerves that stimulate sweating. Side effects include injection-site pain and flu-like symptoms. If you are considering Botox for other areas of excessive sweating talk to your doctor in detail.Botox used for sweating of the palms can cause mild, but temporary weakness and intense pain.
• Endoscopic thoracic sympathectomy (ETS). In severe cases, a minimally-invasive surgical procedure called sympathectomy may be recommended. This surgery turns off the signalwhich tells the body to sweat excessively.ETS surgery isdone while the patient is asleepunder general anesthesia. The doctor makes two or three tiny cuts under the arm. The patient's lung is collapsed so the surgeon has more room to work. A tiny camera, called an endoscope, is inserted to guide the surgeon to the appropriate nerve. After the nerve associated with the overactive gland is identified, it is removed or destroyed. The lung is restored to normal,and the wound closed with stitches.The identical procedure is done on the other side of the body. The surgery takes about a half hour. Patients usually go home the next day, but may experience pain for about a week. ETS requires special training. Before having this surgery, make sure your doctor is properly trained. The procedure is usually performed on patients with excessively sweaty palms. It is not as effective on those with excessive armpit sweating. Risks include artery damage, nerve damage, and increased sweating. New sweating occurs in about 50% of patients.

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