Apr 11, 2017

Excessive sweating and treatment options

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By Jordan V. Wang, MD, MBE

Do you think you sweat much more than a normal person? Have over-the-counter antiperspirants not helped at all? And does this excessive sweating cause increased anxiety and distress when around others? Then you may have a medical condition that 2%-3% of Americans suffer from.

Hyperhidrosis is a common disorder where your body produces abnormally high levels of sweat, typically in the underarms or palms of your hands. This excessive sweating can often be debilitating for people, both emotionally and physically. Although the primary cause of this condition is unknown, it is believed to be due to overly active sweat glands and its regulating chemicals or hormones. Treatment of this condition can often prove very difficult.

Antiperspirants remain the mainstay for first-line treatment of hyperhidrosis. They are inexpensive, the least invasive, easy to use, and the safest of all treatment options. Antiperspirants work by physically blocking your sweat glands and pores, which also signals your body to decrease its sweat production. These can be found over-the-counter, in both regular and clinical strength, and also by prescription from your physician--in increasing order of strength and efficacy.

In 2004, Botox (onabotulinumtoxinA) was approved by the FDA for the treatment of severe underarm hyperhidrosis that did not resolve with antiperspirants. Since then, it has gained popularity with both patients and physicians who recommend it. It works by temporarily blocking the chemicals responsible for signaling the body’s sweat glands to start production. This can be a very effective form of treatment. However, repeat injections are needed every 4-10 months, which can differ on an individual basis.

In 2011, miraDry was approved by the FDA to treat axillary hyperhidrosis. It was later approved to also treat the odor-producing glands as well. MiraDry is a non-invasive medical device that delivers electromagnetic energy to target the body’s sweat glands and heat them until they are destroyed. Some patients only require one treatment, while others seldom require two or rarely three treatments. The results from this method are long-lasting.

More recently, lasers are being utilized to treat this condition. Lasers can safely target and destroy the body’s sweat glands when used by an expert physician trained in their use. A single laser treatment has been shown to be both safe and effective for providing long-lasting results. Although large-scale studies have yet to be completed, smaller studies have been very encouraging.

If you have grown frustrated with excessive sweating, just know that several treatment options are available to you. Please see a certified physician trained to treat this condition to go over your individualized options.

For more, follow Jordan V. Wang on Twitter at @JWangMD.

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