Excessive Sweating Treatment Options For Hyperhidrosis
Sufferers
A patient who has hyperhidrosis can see a variety of specialists
who will determine the type and cause of the sweating and recommend
the best treatment option.
Treatments available for primary hyperhidrosis include:
 topical and oral medications
iontophoresis
botulinum toxin (Botox) injections
surgery
These treatments are not permanent and must be applied continually
or reapplied when the effect wears off. Surgery is the only permanent
treatment.
Treating secondary hyperhidrosis requires that the underlying
condition be identified and treated.
Medications
Topical Medications (See
antiperspirant comparisons)
If the strongest
of the over-the-counter antiperspirants does not control
excessive sweating, a physician usually recommends a prescription
antiperspirant. This may control hyperhidrosis for some patients
with light to moderate hyperhidrosis. However, prescription antiperspirants
are strong solutions which may cause red, swollen and itchy skin,
and they may lose effectiveness over time. Most prescription
antiperspirants must be applied several times daily.
Prescription antiperspirants include:
aluminum hexahydrate in alcohol
tannic acid solution
formalin solution
glutaraldehyde solution
Oral Medications
Various oral medications can be prescribed and may help control
hyperhidrosis. Antianxiety medications can help patients whose
excessive sweating is primarily due to stress-induced anxiety.
Antidepressants also have helped patients cope with hyperhidrosis.
However, these medications often have side effects such as dry
mouth, blurred vision and difficulty with urination.
Oral medications include:
Tranquilizers
Anticholinergics
NSAIDs (nonsteroidal anti-inflammatory
drugs)
Calcium channel blockers
Catapres
Temporary Corrective Procedures
Iontophoresis
In this procedure, the patient uses a battery-powered device
to deliver a low current of electricity to the hands or feet,
and sometimes the armpits, while the patient's body is immersed
in water.
Although iontophoresis is quite safe, it may be no more effective
than a topical antiperspirant. The procedure is time consuming
and can be mildly to moderately painful with some mild skin irritation.
Frequent and lengthy treatments are necessary to control sweating.
Patients who are pregnant or have pacemakers cannot be treated
with iontophoresis.
Botulinum Toxin (Botox)
Researchers have discovered that Botox injections also effectively
treat hyperhidrosis by blocking the nerves that trigger the sweat
glands. Botox isn't a cure-all, however. It may take several
injections to achieve the desired results, the treatments can
be costly and painful, and the results only last from four months
to a year.
Surgery
Most patients with severe hyperhidrosis who have exhausted other
medical treatments have the option of surgery as a permanent
solution. There are basically two surgical options: sweat gland
removal and surgery to interrupt the nerve signal.
Axillary Sweat Gland Removal
If excess sweating occurs only in the armpits, removing the sweat
glands may help. Scars may sometimes form following surgery,
restricting shoulder motion. The glands may also be removed using
liposuction which results in very little scarring.
Surgery to Interrupt Nerve Signal
Mayo Clinic's surgeons have performed more than 60 endoscopic
procedures and hundreds of open procedures and are among the
world's most experienced with these procedures. More than 30
procedures have been performed in the past two years with excellent
results. All patients have had complete relief of palmar hyperhidrosis,
and, for most, additional relief of plantar hyperhidrosis. The
most common side effect, compensatory truncal sweating, occurred
in about 50 percent of patients, but was minimal.
Patients undergoing either procedure at Mayo Clinic start
by having a consultation with the neurologist, have a sweat test,
and see the surgeon and nurse. Further evaluation by others may
be suggested, and patients who are good candidates for the procedure
would be scheduled for the surgery.
The probability of success for these procedures varies with
the location of the excessive sweating. There is a 95-98 percent
success rate with palmar hyperhidrosis. Approximately 75-80 percent
of axillary hyperhidrosis cases can be permanently cured. Approximately
25 percent of patients with plantar hyperhidrosis will notice
some improvement. However, these procedures are not designed
to treat plantar hyperhidrosis and should not be used if the
feet are the only areas involved.
Endoscopic Transthoracic Sympathectomy
This procedure involves cutting the nerves that carry messages
from the sympathetic nervous system to the sweat glands and completely
removing part of the nerve chain. This surgery permanently interrupts
the nerve signal that causes the body to sweat excessively.
Endoscopic Transthoracic Sympathotomy
Sympathotomy involves cutting the nerve chain at the second rib
only as compared to a sympathectomy in which part of the nerve
chain is completely removed.
*These statements have not been
evaluated by the FDA, and are not meant to diagnose, cure or
treat any disease.
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