hyperhidrosis; excessive sweating; localised; affect the whole body

Hyperhidrosis / Sweaty Palms and Feet - Treatments

Topical antiperspirants:

Aluminum chloride is the usual active ingredient in antiperspirants.
These are usually applied at nights over affected sites (e.g. soles, feet, armpits)
It is recommended to apply every night until sweating is controlled. The frequency of application is then reduced to control sweating of affected areas.
Irritation and redness can occur as a side effect. If this occurs, the frequency of treatment can be reduced, or mild topical steroid creams may be applied.
Treatment has to be continued in order to maintain dryness. Sweating will recur weeks to months after stopping treatment.

Iontophoresis:

This is a method of passing a small electric current through areas of skin immersed in a dish of water.
It can be used for the treatment of hyperhidrosis of the palms, soles and armpits.
Treatment needs to be done regularly (several times a week) and lasts for 10-20 minutes each.
Iontophoresis can cause a tingling sensation. If this occurs, the current can be reduced. Small, superficial burns can rarely occur.
Treatment has to be continued in order to maintain dryness. Sweating will recur weeks to months after stopping treatment.

Botulinum toxin ("Botox"):

Derived from bacteria, it can be injected into the skin in very small doses to block the action of the nerves that activate the sweat glands.
The effects can last from 3 to 12 months.
It is most commonly used for treatment of the armpits but can also be injected into the palms and soles.
An anaesthetic cream (EMLA) can be applied before injections to minimise the pain.

Oral medications:

Medicines that can help to control hyperhidrosis include propantheline, oxybutynin and glycopyrrolate.
These medications block the chemical signal between the nerves and the sweat glands.
Side effects of the medications include dry mouth, blurred vision, tummy cramps, constipation and less commonly, difficulty in passing urine.
A smaller dose is given initially and this is gradually increased.
Sweating will recur after the medications are stopped.

Sympathectomy:

This is the only method of treatment to cure hyperhidrosis.
It is most useful for the treatment of hyperhidrosisof the hands and face, especially after other treatments have failed.
Sympathectomy is a major surgical operation, performed under general anaesthesia, which carries a number of risks.
Some patients may develop compensatory sweating at other body sites, and for a proportion of patients, this can be more severe than the original problem.
The operation is performed by neurosurgeons or cardiothoracic surgeons.