Hyperhidrosis Treatment

Medical Author: Nili N. Alai, MD, FAAD
Medical Editor: William C. Shiel Jr., MD, FACP, FACR

Hyperhidrosis is excess sweating. While sweating is a normal human bodily function, some people naturally sweat more or less than others. Some individuals sweat in excess, causing problems with school, work, and social situations. Hyperhidrosis affects both males and females and can start at any age. It is often a severe and emotionally distressing problem for people with the condition. Effective treatments are now available to help those with hyperhidrosis.

Treatments for hyperhidrosis include over-the-counter antiperspirants, prescription antiperspirants like Drysol (20% aluminum chloride), iontophoresis, pills like glycopyrrolate (Robinul), and surgery. Robinul may be reserved for special occasions like school dances, job interviews, weddings, proms, anniversaries, first dates, and other really important events. There are no currently available pills to take daily, and there are always potential side effects associated with oral medications. Botulinum toxin injections (Botox) are now available for this condition.

Surgical sympathectomy is the specialized, permanent nerve cutting, or destruction surgery performed to help decrease some types of sweating. It does not work for all types of excess sweating or for all areas of the body. Consultation with a specialized thoracic surgeon is required and overall, surgery is usually reserved for severe or resistant cases because of potentially serious side effects.

Different types of physicians, including dermatologists, family physicians, neurologists, internal medicine doctors, and thoracic surgeons, may treat hyperhidrosis. You can check the physician finder section on http://www.sweating.org for a list of participating specialists.

The International Hyperhidrosis Society (IHHS, http://www.sweatsolutions.org) is the specialty foundation which provides in-depth information for the treatment of excess sweating.

If sweating causes disruptions in your normal life and causes you distress or embarrassment, you should see your physician. Your doctor will want to know how much you sweat and how it affects your daily activities.

What special anti-sweating pearls do you give patients?

    1. Try Certain Dri or Drysol first if your sweating isn't better with regular over-the-counter products.

    2. Robinul pills are a good option only for very special occasions like the prom, job interviews, and weddings. Try a test run with the pill before your big event to check for possible side effects.

    3. Remember botulinum toxin (Botox or Myobloc) may take one to two weeks before you see any results.

    4. Surgery with a specialized thoracic surgeon may be a last resort because of potential serious risks.

Some of the doctor's favorite antiperspirant picks:

  • Certain Dri antiperspirant pads

  • Xerac AC solution

  • Drysol 20% solution (prescription)

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