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. We provide medical hyperhidrosis treatments at our clinic in the Harley Street area of London.
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.
Botulinum toxin injections
Botulinum toxin injections provide an effective treatment for hyperhidrosis in many people.
Treatment involves injecting small doses of the same agents used to aid skin wrinkles into the skin of the affected areas. They work by blocking the action of nerves that supply the eccrine (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 the treatment of hyperhidrosis lasts for several months but will eventually wear off.
What does the treatment involve?
You will need a number of small injections with a fine needle into the affected areas such 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 involves immersing the parts of your body where the worst of your hyperhidrosis symptoms occur in warm water. A mild electric current is then passed through the immersion fluid. Some clinicians add 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.
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 can reduce sweating by up to 50% in many cases.
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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