Excessive Sweating

What Is Excessive Sweating (Hyperhidrosis)?

Hyperhidrosis, or excessive sweating, is a common disorder which produces a lot of unhappiness. An estimated 2%-3% of Americans suffer from excessive sweating of the underarms (axillary hyperhidrosis) or of the palms and soles of the feet (palmoplantar hyperhidrosis). Underarm problems tend to start in late adolescence, while palm and sole sweating often begins earlier, around age 13 (on the average). Untreated, these problems may continue throughout life.

Sweating is embarrassing, it stains clothes, ruins romance, and complicates business and social interactions. Severe cases can have serious practical consequences as well, making it hard for people who suffer from it to hold a pen, grip a car steering wheel, or shake hands.

What Causes Hyperhidrosis?

Although neurologic, endocrine, infectious, and other systemic diseases can sometimes cause hyperhidrosis, most cases occur in people who are otherwise healthy. Heat and emotions may trigger hyperhidrosis in some, but many who suffer from hyperhidrosis sweat nearly all their waking hours, regardless of their mood or the weather.

What is the Treatment for Hyperhidrosis?

Through a systematic evaluation of causes and triggers of hyperhidrosis, followed by a judicious, stepwise approach to treatment, many people with this annoying disorder can sometimes achieve good results and improved quality of life.

The approach to treating excessive sweating generally proceeds as follows:

  • Over-the-counter antiperspirants containing a low dose of metal salt (usually aluminum) are usually tried first because they are readily available. Antiperspirants containing aluminum chloride (for example Certain Dri) may be more effective when other antiperspirants have failed.
  • Prescription strength antiperspirants, which contain aluminum chloride hexahydrate.
  • Iontophoresis, a device which passes ionized tap water through the skin using direct electricity.
  • Oral medications, Anticholinergics reduce sweating.
  • Botox (botulinum toxin)-A, has been approved in the U.S. by the FDA for treating excessive axillary (underarm) sweating.
  • miraDry. This technique uses microwave energy to permanently kill sweat glands.
  • Lasers. Lasers can target and kill the underarm sweat glands.
  • Surgery. A procedure called thoracic sympathectomy may be considered as a last resort.