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