Hyperhidrosis | Cedars-Sinai

How is hyperhidrosis treated?

Nonsurgical treatments

• Drysol: (brand name for aluminum chloride hexahydrate): This medication is commonly prescribed for hyperhidrosis. Generally, treatment is repeated nightly until sweating is under control. This may happen after as few as two treatments. Thereafter, you can apply Drysol once or twice weekly or as needed.
• Botox: Botox injections have been used for the hands and the armpit area. The treatment requires many injections of Botox during a single session. These are usually effective in reducing the sweat, and the effect will last for three to six months.
• Iontophoresis: This treatment involves placing hands or feet in water with low-voltage DC electrical current.
• Anti-anxiety drugs: These types of drugs have been tried but they have very little role in the treatment of hyperhidrosis.  While sweating may increase with tension and anxiety, these symptoms do not necessarily point to hyperhidrosis.
• Psychotherapy: Psychotherapy has been tried but seems to play little role in the treatment of hyperhidrosis, because while the sweating may increase with tension and anxiety, these symptoms do not necessarily point to hyperhidrosis.
• Drying medicines: There are pills that can be taken to dry up the sweating, but these medicines can cause dry mouth and dry eyes.

Surgical treatment options

Surgery for hyperhidrosis has been performed for 70 years. The procedure is performed with minimally invasive surgery and on an outpatient basis. There are several methods for surgical treatment of hyperhidrosis, including cutting the affected nerve, clipping the nerve and removing the nerve.

Almost all patients have substantial reduction in sweaty hands after the operation, however, improvement in the armpit and plantar (foot) sweating is much less consistent and predictable.

While the procedure is usually performed with low risk on an outpatient basis, there are risks to every procedure, including bleeding, infection and collapsed lung. Normally, patients have mild chest pain for a few days (though it can last longer or be severe). But they are normally able to work after a few days.

After surgery, most patients experience compensatory hyperhidrosis, which means they experience increased sweating in other areas of the body, such as the scalp, chest wall, thighs or feet. The increased sweating may decrease in the months following the operation, and patients usually do not mind mild increased sweating because the hand sweating has improved so much.

About 5 percent of patients experience severe compensatory sweating. Some patients may find this so severe that they are unhappy that they underwent the procedure.

Horner’s Syndrome (droopy eyelids) occurs in about 1 percent of people undergoing the procedure. If this occurs, it may be temporary or may require eye surgery to correct the droop.