The goal of treatment for hyperhidrosis is to control your heavy sweating. Once any underlying medical conditions have been addressed or ruled out, your treatment will depend on the severity of the problem. Sometimes you may need to try a combination of treatments. And even if your sweating improves after treatment, you may later experience a recurrence and need ongoing therapy.
Drugs used to treat hyperhidrosis include:
- Prescription antiperspirant. Your doctor may prescribe an antiperspirant with aluminum chloride (Drysol, Xerac Ac) as the first line of treatment. This product can cause skin and eye irritation. It's usually applied to the affected skin before you go to bed. Then you wash the product off when you get up, taking care to not get any in your eyes. If your skin becomes irritated, hydrocortisone cream might help.
- Nerve-blocking medications. Some oral medications block the chemicals that permit certain nerves to communicate with each other. This can reduce sweating in some people. Possible side effects include dry mouth, blurred vision and bladder problems.
- Antidepressants. Some medications used for depression can also decrease sweating. In addition, they may help decrease the anxiety that worsens the hyperhidrosis.
Botulinum toxin injections. Although best known for helping smooth facial wrinkles, botulinum toxin (Botox, Myobloc, others) injections can also block the nerves that trigger sweat glands. Your skin will be iced or anesthetized first. Each affected area of your body will need several injections. The effects last six to 12 months, and then the treatment needs to be repeated.
Further study is needed on possible side effects of using this method to treat hyperhidrosis. One possible side effect is temporary muscle weakness in the treated area. One report tells of a patient whose heavy sweating improved, but she had trouble typing text messages on her phone for about six weeks after treatment.
Surgical and other procedures
Other types of hyperhidrosis treatments include:
Electrical current. In a procedure called iontophoresis (i-on-toe-fuh-RE-sis), a device is used to deliver a low level of electrical current to water-soaked hands or feet, and sometimes the armpits. You will likely need the treatment twice a day for three to four weeks. This may reduce your sweating for several weeks, and then the treatment needs to be repeated. You may need less frequent treatments during maintenance therapy.
You may be prescribed a device to enable you to treat yourself. Or you can visit your doctor's office for therapy. In either case, your doctor will need to see you regularly to check on whether your condition is improving.
This treatment is not an option for people who have a pacemaker or are pregnant.
- Sweat gland removal. If excessive sweating occurs just in your armpits, removing the sweat glands there may help. Your doctor may use one of several techniques, such as making very small incisions through which the sweat glands can be removed by scraping (curettage) or liposuction.
- Nerve surgery. If you have severe hand hyperhidrosis that isn't responding to treatment, your doctor might suggest nerve surgery. During this procedure, the surgeon cuts, burns or clamps the spinal nerves that control sweating in your hands. In some cases, this procedure triggers excessive sweating in other areas of your body.
New techniques for treating hyperhidrosis are being studied, including laser, microwave and ultrasound therapies.
Aug. 18, 2015
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