Hyperhidrosis (Excessive Sweating)
Hyperhidrosis, or excessive sweating, is a somewhat rare disorder affecting about 2.8% of Americans. It most often affects the palms, feet and face, causing embarrassment, staining clothing, and complicating social interactions. In some cases, hyperhidrosis can affect a person’s ability to perform simple tasks such as holding a pen, gripping a steering wheel, or shaking hands. It is estimated that over half of sufferers of hyperhidrosis do not seek treatment, in some cases because they do not realize it is available. Fortunately, there is hope. If treated properly, the symptoms of hyperhidrosis can be eliminated entirely for most patients.
There are two types of hyperhidrosis, primary and secondary. In primary hyperhidrosis, emotional stimuli are believed to trigger excessive sweating. It is unknown why this occurs. Secondary hyperhidrosis is associated with an underlying medical condition. Conditions triggering excessive sweating may include: infection, malignancy, spinal cord injury, and neurologic or endocrine disorders. Because the sweating is caused by these disorders, treatment for secondary hyperhidrosis focuses on determining and resolving the underlying condition.
For mild to moderate cases of hyperhidrosis, a clinical strength, over-the-counter antiperspirant applied to affected areas, is usually recommended. If this treatment does not succeed in reducing symptoms, the next step is a prescription antiperspirant containing aluminum chloride. Prescription antiperspirants are applied to affected areas before bed and should be removed in the morning. Possible side effects include red, swollen, and itchy skin where applied.
- Oral Medications:
There are several types of oral medications used to control hyperhidrosis. Anticholinergics, for example, block nerve impulses to sweat glands, thereby blocking sweat output. Carbonic anhydrase inhibitors inhibit sweating. Clonidine reduces nerve stimuli, thereby reducing sweat. Some types of antidepressants or anti-anxiety medication may also control excessive sweating.
Iontophoresis is a procedure that uses a battery-operated device to deliver electricity to the hands, feet, and sometimes armpits, through water-saturated pads. This alters the outer surface layers of the skin to prevent sweat form coming to the surface. The process of iontophoresis must be performed twice daily for 3-4 weeks. The results will last for several weeks before the procedure needs to be repeated. With the proper device, you can complete the treatment at home. Although safe, iontophoresis can be painful, and may be no more effective than a topical antiperspirant.
- Botulinum toxin (Botox):
Botulinum toxin is a protein produced by the bacterium clostridium botulinum, and when injected into the problem areas, most commonly armpits and palms, temporarily blocks the nerves that trigger your sweat glands. The treatment lasts for up to six months before needing to be repeated.
There are two approaches of hyperhidrosis surgery. One involves interrupting the nerve signal triggering sweat. The other is to remove some sweat glands entirely. Surgery is generally considered for extremely severe cases of hyperhidrosis, and only after all other treatment options have failed. If you are a candidate for hyperhidrosis surgery, Dr. Jerri Alexiou, Jeanine Wilson, PA-C or Julie Clements, PA-C will discuss all the risks and benefits with you.
Qbrexza is a topical prescription medication in the form of a wipe that is applied to the skin to treat excessive sweating.