When traveling in the tube in London in rush hour in summer, I sometimes can’t help wishing more people knew about effective treatments for hyperhidrosis. Hyperhidrosis is a term describing an excessive production of sweat in the skin’s sweat glands. The most common type is a localised, symmetric form, affecting for example the palms, soles and/or armpits. There are millions suffering with this problem worldwide. While there are some cases of excessive sweating caused by an underlying problem such as an over-function of the thyroid gland, most cases don’t suffer with any underlying condition and the cause remains unknown – we call this ‘primary hyperhidrosis’.
Hyperhidrosis can have a detrimental effect on a suffer’s social life and drastically decrease his quality of life. So if you suffer with excessive sweating without any underlying problem, what kinds of non-surgical treatments are there to improve the sweating? The first, simplest step might be to try an antiperspirant solution or powder containing aluminum chloride, which is available in any local chemist. Over time aluminum chloride reduces sweat production in sweat glands. It should be applied regularly once or if tolerated twice per day on dry skin. However, in some people it can lead to skin irritation.
In addition, there are also certain prescription drugs that can be tried such as propantheline tablets, glycopyrrolate tablets or topical glycopyrrolate solution. Another type of treatment, which is usually very well tolerated and works particularly well for hands and/or feet is iontophoresis. Iontophoresis is a method of passing a tiny electic current (don’t worry, it does not hurt, only tingles a bit) trough the skin while your hands and/or feet are soaking in water (or glycopyrrolate solution). I have seen great results in patients on iontophoresis and a home device can be bought for a few hundred pounds. Although there are pads available for treating the armpits, in my experience this area does not respond as well to iontophoresis as the hands and feet.
However, for the armpits there is another treatment method available, which I have to say is my favorite treatment for hyperhidrosis, as it achieves truly amazing results. This treatment involves injecting botulinum toxin (one brand name is ‘Botox’), which blocks the nerves that activate sweat glands in the skin. After application of numbing cream (so that you won’t feel the injections), very small amounts of the botulinum toxin solution are administered into the affected skin area. The sweat blocking effect is quite astonishing and the best thing is that it lasts about six to nine months, before the treatment has to be repeated. And for me as a doctor it is really wonderful to hear about the change in quality of life in patients after treatment.