Hyperhidrosis (Excessive sweating)

Disclaimer: The educational material provided is for general guidance purposes only. If you have any health concerns or are considering any treatments, it is necessary and highly advisable to consult with your treating physician for personalized advice and guidance.

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Excessive sweating can result from primary hyperhidrosis without a clear underlying cause or secondary hyperhidrosis linked to conditions such as hyperthyroidism. In primary hyperhidrosis, sweat glands do not exhibit histopathologic changes. A medical review is crucial to rule out secondary hyperhidrosis and determine suitable treatments. The management of primary hyperhidrosis depends on whether hyperhidrosis is localized or generalized. Treatment of primary hyperhidrosis of palms and soles includes antiperspirants, iontophoresis treatment with tap water (contraindicated in patients with pacemakers, other implanted electrical devices, or metal implants), and anticholinergic drugs. Another treatment option is botulinum toxin injection.

 

Primary axillary hyperhidrosis can be managed through antiperspirants containing aluminum chloride and botulinum toxin A injections. The latter is well-tolerated for the axillary area, offering symptom resolution for 6 to 9 months in about 80% of patients. 

 

For generalized hyperhidrosis, oral medications are the primary treatment. However, patient responses to systemic treatment vary, and treatment is halted in a third of patients due to troublesome side effects.