Encyclopedia of Health and Medicine

hyperhidrosis 165
Treatment Options and Outlook
Treatment options currently available in the
United States include topical products, oral medications,
BOTULINUM THERAPY, iontophoresis, and,
when other treatments are unsuccessful, surgery.
• Topical products block the pores of the sweat
glands. Those commonly used include aluminum
chloride preparations, boric or tannic
acid solutions, glutaraldehyde, and potassium
permanganate. These products may stain the
skin and clothing. Most people apply them at
night and wash them off in the morning.
• Oral medications interrupt the action of the
nerves that regulate sweat gland activity. Those
commonly used are anticholinergics such as
propantheline and benztropine, which block
the action of the NEUROTRANSMITTER acetylcholine.
Dermatologists sometimes prescribe
other medications such as beta-blockers and
calcium channel blockers. These medications
may have unacceptable side effects, however,
and they are not approved for this use in the
United States.
• Iontophoresis uses mild electrical current in a
water-based solution to shrink the sweat gland
pores and is a treatment option for hyperhidrosis
of the hands and feet. Relief generally
requires daily treatments over a period of several
weeks.
• Botulinum therapy (localized injection of purified
botulinum toxin) blocks acetylcholine,
interrupting the flow of NERVE signals to the
muscles that contract to push fluid from the
sweat glands. The effect can last for six months
or longer.
• Surgery to sever some of the nerves supplying
the sweat glands, or to remove clusters of sweat
glands such as in the axillae, is a treatment of
last resort for severe hyperhidrosis that does
not respond to other treatments. The effects are
permanent.
Many people who have hyperhidrosis use combinations
of these approaches to control their
symptoms. Hyperhidrosis is often deeply embarrassing
to those who have it, particularly adolescents.
Because stress plays a key role in
hyperhidrosis, stress management techniques are
often helpful for coping with the condition as well
as reducing the stimuli that exacerbate symptoms.
Risk Factors and Preventive Measures
When an underlying health condition is the cause
of the hyperhidrosis, treating the condition eliminates
the hyperhidrosis. Primary hyperhidrosis is a
lifelong condition for which there are no known
risk factors or preventive measures.
See also OFF-LABEL USE; STRESS AND STRESS MAN-
AGEMENT; TINEA INFECTIONS.