Excessive sweating, also known as hyperhidrosis, is a common disorder that affects approximately 3% of the population. Although not a dangerous or life-threatening condition, hyperhidrosis is a medical condition that can cause embarrassment, social anxiety and emotional stress. Hyperhidrosis commonly starts during early adulthood and may be generalized, or localized to specific areas such as the head & neck, palms & feet, or underarms.
While normal sweating is needed to help regulate the body’s temperature, patients with hyperhidrosis tend to sweat uncontrollably and beyond the body’s need for thermal regulation. Because sweating is controlled by the sympathetic nervous system, it’s believed that over-activity of the sympathetic nervous system leads to primary hyperhidrosis. Often times, nervousness or excitement may exacerbate the condition for many patients. Consequently, excessive sweating may increase anxiety and nervousness which can further exacerbate the condtion. Other triggers may also include certain foods, drinks, caffeine, nicotine or scents.
Fortunately there are a few different treatment options for hyperhidrosis:
- Over-the-Counter Antiperspirants: Antiperspirants containing aluminum chloride may help reduce sweating in patients with mild hyperhidrosis.
- Prescription-Strength Aluminum Chloride: Most patients with hyperhidrosis may require a higher concentration aluminum chloride (usually > 20%) for better control of their sweating. Aluminum chloride works by obstructing the sweat glands at the skin’s surface. Prescription-strength aluminum chloride is considered the first-line treatment of hyperhidrosis of the underarms, hands and feet. Although effective, treatment is not permanent and requires repeat applications for maintenance. The most common side effect includes irritation and burning of the skin.
- Iontophoresis: Treatment method which uses water to conduct a mild electrical current through the skin’s surface. It’s thought that electrical current causes the minerals in water to clog the sweat pores and reduce sweating in the treated areas. Commonly used for hyperhidrosis of the palms and feet. Results may vary and patients are required to purchase an Iontophoresis unit for use at home.
- Anticholinergic Medications: Prescription medications taken orally to help reduce the stimulation of sweat glands. May help with hyperhidrosis of the head and neck. Side effects can be restrictive and include dry eyes, blurry vision, dry mouth, constipation, and drowsiness.
- Botox: Non-invasive and effective treatment option for hyperhidrosis of the underarms which does not respond to topical therapy. Treatment requires multiple injections into each armpit administered by a physician. Once Botox is injected into the skin it blocks the neural stimulation of sweat glands, thereby reducing sweating. Results are effective and last approximately six months (usually 3-9 months).
- Surgery: Endoscopic thoracic sympathectomy (ETS) is a surgical procedure in which the sympathetic nerves along the spine are cut or burned to prevent stimulation of the intended sweat glands. It’s most effective for treatment of severe axillary (underarm) hyperhidrosis. ETS is usually reserved as a last option for patients who do not respond to other treatment modalities and suffer from severe hyperhidrosis. This is an invasive surgical procedure performed by surgeons, and not dermatologists.
- For more information on hyperhidrosis refer to Sweathelp.org or hyperhidrosis.org.
Depending on your symptoms and skin type, our physician can help discuss the treatment options that are best for you.