Treatment Options and Outlook
Treatment options currently available in the
United States include topical products, oral med-
ications, BOTULINUM THERAPY, iontophoresis, and,
when other treatments are unsuccessful, surgery.
- Topical products block the pores of the sweat
 glands. Those commonly used include alu-
 minum chloride preparations, boric or tannic
 acid solutions, glutaraldehyde, and potassium
 permanganate. These products may stain the
 skin and clothing. Most people apply them at
 night and wash them off in the morning.
- Oral medications interrupt the action of the
 nerves that regulate sweat gland activity. Those
 commonly used are anticholinergics such as
 propantheline and benztropine, which block
 the action of the NEUROTRANSMITTER acetyl-
 choline. Dermatologists sometimes prescribe
 other medications such as beta-blockers and
 calcium channel blockers. These medications
 may have unacceptable side effects, however,
 and they are not approved for this use in the
 United States.
- Iontophoresis uses mild electrical current in a
 water-based solution to shrink the sweat gland
 pores and is a treatment option for hyperhidro-
 sis of the hands and feet. Relief generally
 requires daily treatments over a period of sev-
 eral weeks.- Botulinum therapy (localized injection of puri-
 fied botulinum toxin) blocks acetylcholine,
 interrupting the flow of NERVEsignals to the
 muscles that contract to push fluid from the
 sweat glands. The effect can last for six months
 or longer.
 
 
 
 
- Botulinum therapy (localized injection of puri-
- Surgery to sever some of the nerves supplying
 the sweat glands, or to remove clusters of sweat
 glands such as in the axillae, is a treatment of
 last resort for severe hyperhidrosis that does
 not respond to other treatments. The effects are
 permanent.
Many people who have hyperhidrosis use com-
binations of these approaches to control their
symptoms. Hyperhidrosis is often deeply embar-
rassing to those who have it, particularly adoles-
cents. Because stress plays a key role in
hyperhidrosis, stress management techniques are
often helpful for coping with the condition as well
as reducing the stimuli that exacerbate symptoms.Risk Factors and Preventive Measures
When an underlying health condition is the cause
of the hyperhidrosis, treating the condition elimi-
nates the hyperhidrosis. Primary hyperhidrosis is a
lifelong condition for which there are no known
risk factors or preventive measures.
See also OFF-LABEL USE; STRESS AND STRESS MAN-
AGEMENT; TINEA INFECTIONS.hyperhidrosis 165