Hyperhidrosis Treatments

EXCESS SWEATING

At The Devonshire Clinic, our consultants can offer several treatments which can help with hyperhidrosis (excessive sweating). Your doctor will recommend some that you can use as self-help first of all. If these do not help improve your excess sweating or enable you to manage your condition, we can explore more medical hyperhidrosis treatment options.

Self-help for hyperhidrosis

To help manage hyperhidrosis, the first agents to try are topical products that can help to absorb the excess sweat, such as talcum powder and cornstarch powder (e.g. Zeasorb® ). These are usually only helpful in mild cases.

Stronger antiperspirants containing aluminium chloride e.g. Driclor ® and AnHydrolForte® can be used for armpits, hands and feet. They are applied 2-3 times a week at night and washed off in the morning to avoid damage to clothes. Application can be effective especially for underarm sweating. However they can cause the skin to become irritated over time. If this happens you should consult your doctor.

Botox injections

Botulinum Toxin Type A injections (BOTOX) provide an effective treatment for hyperhidrosis in many people.

Treatment involves injecting small doses of Botulinum Toxin Type A into the skin of the affected areas. BOTOX works by blocking the action of nerves that supply theeccrine (sweat) glands. This stops the glands from producing sweat.

Treatment totally blocks the nerve ending for about 6-12 weeks but then new nerve endings start to form. This means the effects of Botox for the treatment of hyperhidrosis lasts for several months but will eventually wear off.

What does BOTOX treatment involve?

You will need a number of small injections with a fine needle into the affected areassuch as your armpits. The injections may cause some discomfort and your skin may be slightly red and inflamed immediately after treatment. This normally resolves within a few hours.

Are there any side effects?

Side effects include bruising or tenderness at the injection sites and increased sweating at other sites. Rare side effects include itching, muscle aches, allergic reactions and muscle weakness.

How long does it take to work?

Most patients notice some positive changes within the first week after treatment. The effects usually last between 4-7 months.

Other treatments for hyperhidrosis

Iontophoresis

Iontophoresis involves immersing the parts of your body where the worst of yourhyperhidrosis symptoms occur in warm water. A mild electric current is then passed through the immersion fluid . Some clinicians add the anticholinergic glycopyrrhonium bromide to enhance the effects.

Because your body’s natural electrical charge is negative, positive ions in the water induced by the current flow straight through the sweat ducts, interrupting the sweating process by an unknown mechanism.

Iontophoresis has been in clinical use for several decades and is not dangerous. Few people report discomfort, apart from some tingling, and sometimes a dry mouth.

To become effective, iontophoresis is usually delivered in multiple treatment sessions and maintenance sessions are necessary to help manage your hyperhidrosis.

Robinul

Robinul is an anticholinergic drug that inhibits sweating. It may be useful for patients with hyperhidrosis at multiple body sites. Patients commonly experience side effects such as dry eyes and mouth, and blurring of vision.

Surgery for hyperhidrosis

Surgical procedures may be considered when other methods have been tried first. Two types of surgery are available:

Subcutaneous sweat gland curettage

Over-active sweat glands are removed under general anaesthetic. The procedure canreduce sweating by up to 50% in many cases.

Transthoracic sympathectomy

This involves cutting the nerves that supply the sweat glands. If necessary, the surgeon performs partial removal of the involved nerve fibres and ganglia in the spine (T2 and T3) under general anaesthetic. This eliminates excessive sweating in the hands and underarms and is permanent. It is an effective treatment for severe hyperhidrosis on the palms and under the arms but there is between 40-69% risk of compensatory hyperhidrosis in which new areas of excessive sweating develop, usually on the trunk and lower parts of the body).

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