How Is Hyperhidrosis Treated?

How do you fix excessive sweating? Treatment options for hyperhidrosis, or sweating more than usual, include antiperspirants, Botox injections, and medications. You may use medical devices that reduce sweating, or a healthcare provider may advise surgery.

Those treatments often depend on the affected body part. What option works best can vary between people. You may also need to try different approaches, or a combination of several, to find relief. Read on to learn how to stop sweating so much with hyperhidrosis treatments.

Medications

There are over-the-counter (OTC) and prescription oral and topical medications that help treat hyperhidrosis. Options include:

• Anticholinergics: These oral medications help stop sweat glands from producing sweat. A healthcare provider may prescribe benztropine, glycopyrrolate, oxybutynin, or propantheline. The Food and Drug Administration has anticholinergics to treat other health conditions, so healthcare providers use them "off-label."
• Antiperspirants: These temporarily plug up sweat ducts in the underarms, hands, feet, or hairline. People with hyperhidrosis often use antiperspirants since they are not invasive or costly. Certain Dri is an extra-strength OTC option. Other extra-strength formulas, like Drysol, require a prescription. Many dermatologists recommend applying antiperspirants to dry underarms at night to improve their efficacy and then washing them off in the morning.
• Beta-blockers (propranolol) and benzodiazepines: These oral medications, available by prescription, treat excessive sweating in anxiety-inducing situations, such as giving a presentation.
• Topical wipes: The Food and Drug Administration approved Qbrexza (glycopyrronium) in 2018. This topical anticholinergic medicine is available by prescription to treat hyperhidrosis on the underarms in adults and children aged 9 and older.

Some high-strength OTC and prescription antiperspirants may cause itching and burning if used incorrectly. Wipe off antiperspirants first thing in the morning to avoid skin irritation, Adam Friedman, MD, a professor of dermatology at the George Washington University School of Medicine & Health Sciences, told Health.

Surgeries and Procedures

A healthcare provider will typically recommend certain procedures, such as Botox or lasers, if topical treatments are ineffective. Some surgeries can remove sweat glands in severe cases.

Options include:

• Botox: The Food and Drug Administration approved Botox (onabotulinumtoxinA) in 2004 to treat severe primary hyperhidrosis on the underarms. A healthcare provider will inject Botox right below your skin's surface to temporarily block the release of the chemical that activates sweat glands. Some people use Botox alongside a topical treatment. 
• Endoscopic thoracic sympathectomy (ETS): A healthcare provider inserts a camera underneath your armpit to cut or destroy nerve paths that connect to overactive sweat glands. ETS is often the final option if hyperhidrosis severely affects your quality of life. The procedure is irreversible and may cause excessive sweating in other body parts.
• Fractional microneedle radiofrequency: A 15- to 20-minute procedure where a device with tiny, sharp needles punctures the sweat glands to administer radiofrequency in affected areas. You will likely need repeated sessions.
• Iontophoresis: This treatment uses a device that generates a low-voltage current. The device temporarily shuts down sweat glands. You'll immerse your hands or feet in a pan of shallow water through which the current passes. A healthcare provider will place pads that connect to the machine on your skin for other body parts. Some at-home iontophoresis devices exist.
• Lasers: Healthcare providers use lasers to target and destroy sweat glands in your underarms via small incisions. Treatments typically take less than one hour to complete. Of note: There's no definitive evidence that lasers are effective. Still, some healthcare providers provide the option.
• miraDry: The Food and Drug Administration approved miraDry to treat underarm sweating in 2011. miraDry is a handheld device that directs microwave energy to sweat glands on your skin. The device generates heat that eliminates or damages sweat glands in your underarms.
• Surgery: Other procedures that treat hyperhidrosis of the underarms include excision (cuts out), curettage (scrapes out), and liposuction (suctions out) of the sweat glands. Healthcare providers sometimes use a combination of these procedures. Keep in mind that each option results in permanent effects.
  

Living With and Managing Hyperhidrosis

Hyperhidrosis is not a life-threatening health condition. Still, people with excessive sweating might have emotional distress or trouble working. Severe hyperhidrosis often has a poor prognosis, especially if treatments fail.

Here are some ways to manage hyperhidrosis to help improve quality of life:

• Maintain a sweat journal: This can help you keep track of what triggers sweating. Some triggers include alcohol, caffeine, and spices.
• Talk to a dermatologist: They can help determine the best treatment for you. Let a dermatologist know how often you sweat, what triggers sweating, and whether you sweat at night.
• Take care of sweaty feet: This helps reduce your risk of skin infections (e.g., athlete's foot). For example, do not wear the same shoes two days in a row, and wear sandals as much as possible. Change your socks daily, and wash them between uses.
• Use antiperspirant instead of deodorant: Antiperspirant prevents sweating, while deodorant masks body odor. It's best you use antiperspirant on dry skin before going to bed.

A Quick Review

Hyperhidrosis is sweating more than your body needs to cool itself. Treatment options may include antiperspirants, Botox injections, and medications. A healthcare provider may recommend other procedures, such as lasers and miraDry, or surgery in severe cases. The best options depend on the affected body parts, the severity, and how well you have responded to noninvasive options.