A variety of hyperhidrosis treatment options exist today. Excessive sweating is a common disorder that usually occurs in otherwise healthy individuals, affecting an estimated 2-3% of the population. Primary hyperhidrosis can be found to start during or before adolescence and is distinguished from secondary hyperhidrosis which can start at any point in ones life. The approach to hyperhidrosis treatment generally proceeds as ordered below.
Strong over the counter antiperspirants are often the first line sought out in hyperhidrosis treatment due to their ready availability. These commonly contain aluminum chlorohydate in low concentrations, which works to temporarily block the sweat ducts, but hyperhidrosis sufferers need higher concentrations in the 10-15% range.
These can be found in prescription strength antiperspirants, sold under brand names like Drysol, Maxim, & Odaban, which are applied nightly to affected areas. The downsides of antiperspirants are namely skin irritation, and possible discoloration and staining of clothes.
Introduced over 50 years ago, this FDA-approved procedure uses an electrical device to temporarily turn off sweat glands, and is most effective on the hands and feet. It’s exact mechanism of action is still unclear. Once the hands or feet are placed in water, a gentle electrical current is passed through it and gradually increased until a light tingling, non-painful sensation is felt.
These treatment sessions can last for 10-20 minutes, initially with two or three per week, and depending on the patient’s response, maintenance treatments may occur every one to four weeks. Accompanying side effects can include cracked skin and blisters, although rare. These devices may be purchased with a doctor’s prescription, and insurers sometimes cover the cost.
Oral Medication Hyperhidrosis Treatment
Several anticholinergic drugs like Oxybutynin(brand name Ditropan) and Glycopyrrolate(Robinul, Robinul-Forte) have shown promise in disabling the sweat glands. However due to side effects like drowsiness, dry mouth, and dizziness, these are not commonly used for excessive sweating, and haven’t been studied as thoroughly as other treatments. Additionally there are beta-blockers or benzodiazepines, Cogetin being one, which may help reduce stress-related sweating.
Botox Hyperhidrosis Treatment
Seen often in the news as a cosmetic treatment for wrinkles, Botulinum toxin (Botox) is a muscle poison that has seen use in many areas of medicine over time, from treating muscle spasms to certain types of headaches. Small doses of botox type a (BTX-A) are administered via injection, temporarily blocking the nerves that stimulate sweating, and may provide 4-9 months of relief depending on site of the injections.
Underarm hyperhidrosis treatment using this procedure has been given FDA approval. These injections are uncomfortable, but discomfort is minimized with a very small injection needle. Side effects can include pain at the injection-site and flu-like symptoms. With FDA approval for underarm use, many health insurers are providing coverage for the injections and the Botox itself, which is quite costly.
Surgery For Hyperhidrosis Treatment
For severe cases, a minimally-invasive surgical procure called endoscopic thoracic sympathectomy (ETS) may be recommended when other options fail. It is an operation intended to turn off the signal telling the body to sweat excessively, by cutting, burning, or clamping part of the sympathetic nerves supplying the sweat glands.
ETS is generally considered a “safe, reproducible, and effective procedure and most patients are satisfied with the results of the surgery”. It is primarily used to treat excessive hand sweating with a success rate of 85-95%. Side effects can range from trivial to devastating with the most common secondary effort being compensatory sweating. It is a last resort option for hyperhidrosis treatment.