Introduction

It affects almost 5% of the global population and yet there is still a social stigma attached to it. It can hamper playing sports if the excessive sweating is in the palms/hands, and it becomes challenging to be a part of social/physical interactions because some people can be put off by a clammy handshake or standing in close proximity to someone who’s dripping with sweat.

Hyperhidrosis (excessive sweating) is a disorder where the sufferer experiences excessive sweating independent of environmental and thermoregulatory conditions. In hyperhidrosis, excessive perspiration is produced even when temperatures are cool, and usually occurs in the armpits, hands, scalp and feet without any apparent trigger. Hyperhidrosis can cause clothing to become soaked with perspiration, and it can also cause physical discomfort, anxiety and stress.

Surgery is known to effectively eliminate Hyperhidrosis, but there may be some unavoidable side effects. We believe that non-surgical methods to control hyperhidrosis should be tried before considering surgery depending on the type of HH you are inflicted with.

Primary focal hyperhidrosis 

The excessive sweating is not caused by any underlying condition or medication.

Secondary generalised hyperhidrosis 

The excessive sweating is caused by an underlying medical condition or is a side effect of a medication.

Areas of the body affected by hyperhidrosis

Palmar hyperhidrosis = sweaty hands

Plantar hyperhidrosis = sweaty feet

Axillary hyperhidrosis = sweaty underarms

Craniofacial hyperhidrosis = sweaty head and/or face

Let’s look at some non surgical treatments first:

Antiperspirants for underarms, hand, feet, face and more

Antiperspirants can help by temporarily plugging up sweat ducts, which reduces sweating, according to the International Hyperhidrosis Society (IHS).

Often doctors will tell their patients to apply antiperspirants to their underarms even at night to block any sweating that might occur (even though excessive nighttime sweating is uncommon).

For mild hyperhidrosis, using an antiperspirant every night for three weeks and then decreasing to three times a week, can help. Be careful when using higher-strength over-the-counter and prescription antiperspirants as they could cause itching and burning if used incorrectly. However, talk to your practitioner about the best plan for you.

Anti-wrinkle injections

 

(onabotulinumtoxinA) is FDA-approved to treat severe primary axillary hyperhidrosis when topical treatments are not effective. OnabotulinumtoxinA can temporarily block the release of the chemical that initiates the body’s sweat glands.

The IHS states, “By blocking, or interrupting, this chemical messenger, botulinum toxin ‘turns off’ sweating at the area where it has been injected. These injections are very shallow, meaning that the medicine is injected just below the surface of the skin, where it remains.”

Using it, on the hands can be difficult because the skin on the palms is thick, making it hard for solution to penetrate. Due to many nerve endings in the fingers and hands, it might be quite uncomfortable. Most patients need these injections every 4 to 6 months. Patients describe the results as genuinely liberating and life-changing, allowing them newfound confidence for their daily lives. Numerous studies have demonstrated its efficacy in reducing anxiety. For example, according to a study published in the journal Scientific Reports in 2021, people who received these injections at four different sites reported anxiety significantly less frequently than those who received different treatments for the same conditions. The risk of anxiety was found to be reduced by 22-72% in our patients.

miraDry for underarms

miraDry was cleared by the U.S. FDA in 2011 and is CE-marked in Europe to treat sweaty underarms also called axillary hyperhidrosis. It is also now available in more than 50 countries worldwide.

This FDA-approved treatment for axillary hyperhidrosis uses a handheld device to direct microwave energy to the skin where sweat glands are located. The heat it generates eliminates or damages sweat glands in the underarm, says the IHS.

The effects are almost immediate. While one treatment is sometimes enough, some people benefit from a second procedure three months after the first.

Oral medications

 

Prescription medications can also help stop the sweat glands from producing sweat.

Anticholinergics, a class of medicines including glycopyrrolate, oxybutynin, benztropine, propantheline, are the most common oral medications used for hyperhidrosis. However, these drugs have not been studied in controlled clinical trials specifically for hyperhidrosis. They are, however, FDA-approved in the USA.

For example, the most common medication given orally would be oxybutynin, which stops sweating as a side effect, but is FDA-approved to treat bladder problems, and it also dries out your mouth and eyes.

Beta blockers (propranolol) and benzodiazepines are other oral medications used to treat excessive sweating that occurs from specific anxiety-inducing situations like giving a presentation. These medications “block” the physical manifestations of anxiety, says the IHS. The key, experts say, is that these medications should not be used alone, but combined with other therapies to optimise their benefits and minimise side effects. An example of how combination therapy for excessive sweating might work is: taking an oral medication to bring down sweating levels but also using anti-wrinkle injections for underarms, iontophoresis  for the hands and/or feet, and an over-the-counter antiperspirant. This may sound like a lot, but with combination therapy, you can lessen the dose of oral medications to help lessen any potential side effects. These may be less effective in the older age group as an effective treatment.

Additionally, dermatologists are pioneering the treatment of other excessively sweaty localised (or relatively small) body areas such as areas in the groin, under the breasts, and on the back or chest.

It is advised to talk to your medical provider/GP about excessive sweating. If you or a member of your family or friend haven’t done so, now is the time.

Learn more about how you and your healthcare team can work together to find the right treatment, or combination of treatments to manage your hyperhidrosis.

If you’re considering an oral medication to treat excessive sweating, please know that experts in the field recommend that you try antiperspirants, iontophoresis, or anti-wrinkle injections, too (or a combination of these).

Click on the links provided to learn more about the usefulness of these treatments.

https://hyperhidrosisuk.org

https://hyperhidrosisuk.org/you-are-not-alone/

https://mylifeasapuddle.com/about/

https://www.sweathelp.org/sweat-help-home/advocates.html

 

This is not the time to be alone, so come forward, share your story and get help, no matter what affliction you may be suffering from. There’s no need to suffer in silence.