(edited from the Skin Therapy Letter article: Treatment Options for Excessive Sweating and Hyperhidrosis)
Nearly everyone sweats as a normal reaction to intense physical activity, high temperatures or emotional stress. Sweating is an important bodily function that allows us to control and regulate our body temperature. However, some of us may sweat excessively without any extra stimulation.
This is a condition called hyperhidrosis, and affects about 1 in 20 people worldwide. The condition commonly affects areas such as the underarms, palms of the hands, and soles of the feet. It can be inherited, and often begins during adolescence.
There are two main types of hyperhidrosis, each with different causes.
Focal hyperhidrosis is a type of sweating caused by exaggerated responses to emotional stimuli, such as stress or anxiety. This typically causes sweating on the palms, soles and armpits.
Generalized hyperhidrosis is a second type of sweating that occurs over large areas of the body and doesn’t always have a specific cause. In some cases it happens for no apparent reason. A variety of underlying factors can trigger this type of sweating, such as medications, diseases, menopauses, low blood sugar or an overactive thyroid gland.
Although excess sweating isn’t detrimental to an individual’s physical health, it can have a negative impact on a person’s social or emotional lives. Routine activities like shaking or holding hands, and hugging can become awkward. If the sweating is general, soaked clothes and odors associated with sweat can also become a problem. Depending on occupation, sweating can be a practical problem too.
In most cases, excessive sweating can successfully managed or controlled by making adjustments to your daily routine, like bathing more frequently, using an antibacterial soap and wearing clean, loose fitting clothing made of absorbent natural materials (e.g., cotton).
To combat wetness, most people typically use antiperspirants. Antiperspirants that contain aluminum salts in concentrations ranging from 10%–25% are considered to be first-line therapies.
The nighttime application of an antiperspirant can help to provide a barrier against perspiration during the restful sleep phase. Clinical strength formulations that are applied the night before can offer extended dryness and odor protection that can last well through the next day, even if you shower in the morning. Making nighttime antiperspirant use a daily routine is an effective way to manage and control both wetness and body odor.
If antiperspirants are ineffective, other treatment options such as prescription medications or medical procedures may be considered.
Medications like glycopyrrolate can help to stop stimulation of the sweat glands, and are used for general hyperhidrosis that affect the entire body. However, they carry a risk of side effects such as blurred vision, constipation, and dry mouth.
Anticholinergic medications are sometimes effective in treating hyperhidrosis, but the dosages required to reduce sweating may also cause unpleasant side effects such as dry mouth, bloating, sensitivity to light and urinary retention.
Some medications such as sedatives and tranquilizers may be of benefit for stress related hyperhidrosis and for hyperhidrosis of the palms and soles of the feet. But again, these agents carry a risk of adverse effects.
The use of calcium channel blockers, beta-blockers and other cardiovascular medications, such as clonidine can be effective in some patients. Talk to your physician to see if these are right for you.
One of the dangers of using systemic medications to block the sweating reflex is the increased risk of heat related problems in warm weather. If your body cannot sweat, it is very difficult to lower the core body temperature and heat stroke can occur.
Botox injections are used to treat moderate to severe cases of hyperhidrosis. In this treatment, the injected Botox blocks the nerves, which stimulate sweating. The treatment is especially effective for the armpits, but can also be used to treat the hands, feet, and the face can also be treated.
Botox is considered to be a safe treatment method, without negative side effects. The treatment is not permanent however, and re-treatment is necessary every 4 to 7 months to maintain its effectiveness.
Another type of procedure is Iontophoresis. With this treatment, water is delivered into the skin using electric charges, which interfere and block sweat gland activity. This treatment has few side effects, and can be effective in treating certain types of hyperhidroses that affect the palms and the soles of the feet. One drawback of the procedure is that the treatment can be time consuming.
For more information, read the full article at: https://www.skintherapyletter.com/fp/2007/3.1/3.html