No Need to Endure Excessive, Embarrassing Sweating

Tuesday, May 06, 2008

ROCHESTER, Minn. — When shaking someone's hand becomes a self-conscious ordeal because of excessive sweating, talk to a care provider. The May issue of Mayo Clinic Health Letter outlines treatment options to help minimize excessive sweating.

Called focal hyperhidrosis, this condition most commonly involves excessive daytime sweating of the palms, soles and underarms. It can make typical work and social activities hard to endure. The condition usually begins by age 20, isn't associated with an underlying health condition, and often runs in families.

Treatment options include:

Antiperspirants — Some nonprescription antiperspirants, such as Certain Dri, Secret Clinical Strength, Degree Clinical Protection and 5 Day, often work well to inhibit mild to moderate sweating. Prescription antiperspirants containing aluminum chloride (Drysol, Xerac) may work even better.

Iontophoresis — This treatment, which can be done at home, involves placing hands or feet in a pan of water while a battery-powered device delivers a low-voltage current through the water. Treatments last 15 to 30 minutes and are typically done daily for a couple of weeks and then less frequently for maintenance. Iontophoresis is believed to temporarily block the sweat glands, but results may not be any better than using an antiperspirant.

Oral medications — Drugs in the anticholinergic class can help. This approach isn't used often because of side effects that include dry eyes and mouth and difficulty urinating. Anti-anxiety medications may be helpful if stress-induced anxiety contributes to excessive sweating.

Botulinum (Botox) injections — Injections of Botox into the palms, soles or underarms can block the nerves that trigger sweat glands. This approach is effective for even severe hyperhidrosis, but the injections are painful. The effect from the Botox wears off after four to 12 months, and the treatment needs to be repeated.

Surgery — Two surgical approaches are options when other treatments haven't worked. They entail surgically removing sweat glands from the underarms or severing the nerve in the chest that carries messages to the sweat glands. Surgery is seldom used because it is a major procedure. If needed, it's effective.

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