Treating Excessive Sweating

Question: Is there a cure for hyperhidrosis (excessive sweating)?

Dr. Hibberd's Answer:

Hyperhidrosis, or excessive sweating, is very common, is embarrassing, and often stains clothing.

There are three main categories:

1) Axillary (armpit)

2) Palmoplantar (hands)

3) Generalized

There is no cure for idiopathic (no cause found) hyperhidrosis, but we do have effective treatments available:

a) OTC antiperspirants (especially those containing aluminum chloride, but may be irritating);

b) Prescription antiperspirants (usually contain aluminum hexahydrate, such as Drysol);

c) Lontophoresis (mechanism is unknown but involves multiple sessions where painless electrical current is applied using tap water);

d) Prescription medications (anticholinergics such as Robinul which have side effects including blurred vision and dry mouth);

e) Botox (botulinum toxin) for underarm sweating (50 units spread over 20 spots each armpit); and

f) Surgery (sympathectomy is risky and rarely done).

Most often, excessive sweating is triggered by heat and stress, but other cases have no precipitant. The large majority of people do not have an associated infection, internal disease, neurological disorder, tumor, or hormonal cause.

Obesity and stress are common causes followed closely by unknown (idiopathic) reasons. Less common reasons include chronic infections, endocrine conditions (such as hyperthyroidism and diabetes), vascular and cardiac disease, neurologic disorders, and malignancy. If you are not sure, be sure to consult your private physician or dermatologist.