Treatments for hyperhidrosis

Generally, there are different treatment strategies for hyperhidrosis which have to be tailored to the individual patient both in what they find acceptable, what their wishes are as a result, and also the pattern of hyperhidrosis they are suffering from.

Simple measures:
If certain situations cause anxiety and sweating, it may be possible to avoid these.  Certainly, counseling or hypnosis can reduce anxiety and can help with anxiety related hyperhidrosis. 

By wearing looser clothes that do not show the sweat, quite often confidence can be improved and the hyperhidrosis becomes a thing of the past.

Certain behaviours or buildings might also cause hyperhidrosis.  By reducing caffeine input, by reducing excessive drinking, by losing weight, by opening windows or using air conditioning or other simple measures, many people with some excessive sweating can improve the condition.

Deodorants:
Deodorants, either sprays or roll-ons, either mask or reduce the smell that might occur with sweating (see before).  They do not reduce the sweating themselves if they are purely deodorants. 

Anti-perspirants:
Anti-perspirants are chemicals that can be sprayed onto the skin, rolled onto the skin or rubbed onto the skin to reduce sweating from the skin.  Many are based on aluminium compounds although other metals are used.  Although these can be very effective, quite often they can leave a white residue on the skin that mark the clothes and be unsightly.  In addition, some of the stronger ones can also cause considerable skin irritation.

Anti-perspirants are certainly very useful for a large number of patients but some patients with heavier sweating or true hyperhidrosis, they are even not sufficient or have to be used in levels that cause skin irritation.

Drugs:
Several drugs have been used for hyperhidrosis.  Glicopyrrolate (Robinul) is very useful, although it can also cause a dry mouth and dry eyes.  In addition, if over-used it can cause a very fast heartbeat and overheating and therefore should only be used under medical supervision.

Some people in the past have used beta blockers.  These reduce the effects of adrenaline and noradrenaline in the body.  Unfortunately, these tend to also calm down the excitement response in patients.  Although it is quite fun to appear cool, to actually be so cool that you don’t really care, usually destroys the fun in life.  Also, in some males, long term use of beta blockers has been associated with impotence.  As such, they really aren’t good drugs to be used for hyperhidrosis.

Other drugs have also been used but, similarly, side-effects are usually prohibitive for long term use.

Botulinum toxin:
Botulinum toxin (trade name Botox or Dysport) when injected just under the skin, destroys the ends of the sympathetic nerves that go into the sweat glands.  As such, you can stop the sweating in an area of skin for several months.  The length of time it is effective depends on how quickly the nerves regenerate in a certain person and also on the dose of the original injection.

For the underarms, Botulinum toxin has become the treatment of choice as it has virtually no side-effects or adverse effects and is highly effective.

Iontophoresis:
Iontophoresis is a technique where a very small electric current is passed through tap water with the hands or feet within the water bath.  Nobody is 100% sure how this works but, when used regularly, the hands and feet stop sweating.  The good part of iontophoresis is that it is effective on hands and feet and there are virtually no side-effects or complications.  However, the need to keep using it puts many people off.

Surgery – endoscopic transverse sympathectomy:
When one gets into the realms of surgery, one needs to be very aware of the pro’s and con’s.  Endoscopic transverse sympathectomy is excellent for stopping hand sweating and is reasonably good for stopping sweating of the face and head in about 70% of people.  However, being surgery, it has risks and side-effects and should only be considered after detailed discussion with the surgeon who performs the procedure.

New procedures and techniques:
Medicine is always moving on and hyperhidrosis is no exception.  There are always reports of new procedures or techniques for the treatment of hyperhidrosis.  The specialists on medical pages and their specialist websites or pages, will discuss new techniques as and when they become available.