Treatment of Hyperhidrosis

By Miguel Delgado, M.D.

Hyperhidrosis is a common sweat gland disorder that affects approximately 3% of the population who are considered otherwise healthy. Hyperhidrosis affects men and women equally and usually occurs under the arm, and/or hands and feet.

The profuse sweating may affect self-confidence, interfere with social and business situations, stain clothes and ruin romance. Emotions and heat can trigger excessive sweating, but some people sweat all the time no matter what the weather conditions are or their mood.

Many people learn to live with excessive sweating, unaware their problem is treatable. However, no treatment is perfect, and many have side effects.

Over the counter (OTC) treatments are usually tried first, antiperspirants that contain aluminum chloride or prescription medications containing the same with the addition of hexahydrate. However with repeated use it may cause irritation to the skin for some patients.

There are drugs that are being prescribed but are not FDA approved for hyperhidrosis and are being used “off-label.” While some patients get relief from oral medications, they come with many possible side effects such as; dry mouth, urinary retention, constipation, drowsiness, and vision problems. Prescriptions are best used for short-term use for special occasions.

Surgery may be an option, and has been successful for many patients. Surgical procedures interrupt certain nerve pathways giving relief; however some side effects may be dry mouth, blurred vision and insomnia. The major drawback with surgery is the possibility of compensatory sweating (sweating in different areas than prior to surgery). Also, there is the possibility that there may be nerve regeneration within 6 months with the sweating problem returning. Due to the many risks involved, it is rarely used, and only as a last resort.

Botox injections have been very successful for many patients, giving relief for 6 to 9 months. Since the FDA has approved Botox for the treatment of hyperhidrosis many insurers will cover the cost.

Currently, there are ongoing trials with Ultherapy treating Hyperhidrosis that shows promising results. Ultherapy uses ultrasonic energy to destroy sweat gland activity in the axilla (under arm). The focused sound waves target to a depth of skin where the sweat glands are located. At this time, the treatment is an “off-label use” but the trials are scheduled to be completed in the near future.

Miguel Delgado, M.D. states that severe cases may adversely affect a patient’s quality of life and left untreated may continue throughout a person’s life. He advises patients to keep in touch with their doctor for new and updated treatments.