The 7 most effective treatments for excessive sweat - hyperhidrosis

What is Hyperhidrosis?

Hyperhidrosis is a disease that appears due to excess sweat in certain parts of the body, mainly in the hands, armpits, feet and face. It occurs when the sweat glands produce more sweat than is necessary.

Currently there is still a certain taboo when it comes to talking about hyperhidrosis. It is important to make it visible since it is a disease that can greatly affect the daily lives of people who suffer from it, even affecting their mental health. Fear, shame and frustration are common travel companions for people with hyperhidrosis, who see how their social and even work relationships are affected by this condition. Luckily, there is a solution.

Why does it occur?
Hyperhidrosis occurs when the sweat glands work more than they should, producing more sweat than usual and necessary. This occurs due to increased activity of the sympathetic nervous system or abnormal processing of emotions.

Why is it important to treat hyperhidrosis?
In addition to the psychological problems already mentioned that hyperhidrosis can cause, this disease is related to other conditions such as psoriasis, onychomycosis and the increased risk of suffering from skin diseases caused by fungal, bacterial or viral infections. It is also common for Excess sweating causes pain, cracked skin and eczema.

For all these issues, it is important to find a solution for a problem that can condition both physically and mentally the daily lives of people who suffer from it.

How many people are affected by hyperhidrosis?
It is estimated that hyperhidrosis affects 3% of the population. Although it mainly appears in adolescence, it can occur at any age. Depending on the age at which it occurs, there are parts of the body that are more affected than others. In young people up to 18 years old, the most affected places are the palms of the hands and the soles of the feet. After 18, the armpits take the brunt of it.

What are the warning signs and symptoms?
The main symptoms of hyperhidrosis are characterized by excessive sweating.
Sweating in the palms of the hands, soles of the feet, face, chest or armpits.
Skin irritation or fungal infections caused by humidity.
Interference with daily activities due to sweating.
Insecurity and embarrassment caused by stains on clothing or odor.
Possibility of suffering from anxiety and depression.

How do I know if I have hyperhidrosis or just excessive occasional sweating?
If there is excessive sweating for at least 6 months and without an obvious cause, it could be hyperhidrosis and we should visit the doctor to diagnose and address it. Other characteristics that may make us suspect that we are facing hyperhidrosis are:

It affects daily activities.
It happens at least once a week.
There is a bilateral and symmetrical sweating pattern.
The onset of symptoms occurs before the age of 25
Absence of night sweats
Family history of hyperhidrosis.
Focused on armpits, palms and soles of the feet and/or craniofacial area

What treatments currently exist for hyperhidrosis?
Although there are different types of treatment, it is important to know that the most effective ones require medical intervention or prescription, so, if hyperhidrosis is suspected, it is highly recommended to consult with a specialist to find the most appropriate solution for each person.

Iontophoresis
It consists of placing the hands and/or feet in trays filled with liquid. With the help of electrodes, an electric current is generated in the submerged areas that will act on the sweat glands without damaging them. It is often used for the palms of the hands, although sometimes also in the armpits. It is an electrical current and can cause pain.

Botulinum toxin
When injected into the skin, the protein blocks the action of the nerves that activate the eccrine sweat glands, thus preventing them from producing sweat. After 4 to 6 months, Botox needs to be injected again into the affected area because over time the nerve transmission is regenerated and it stops working.

Today we can find Ecrisens from Prospera Bitech, a neuromodulatory cream, especially indicated for hyperhidrosis.

Thermal damage (the famous Miradry)
The sweat gland is eliminated by microwave. We scorched it a little, wow. The good news is that with two sessions and with local anesthesia, a very high percentage of sweating can be eliminated permanently. The bad thing is that it is not financed and is a bit expensive.

Sympathectomy
It consists of ?cutting to the chase? and eliminating the ganglia responsible for stimulating sweating in the armpits and hands. It is effective only that in a significant percentage of cases compensatory sweating appears, that is, you can sweat in other areas of the body, such as the buttock.

Antiperspirants
They are usually formulated with aluminum salts and are applied in the form of roll-ons, lotions or wipes. In people with hyperhidrosis, these options are usually not enough.

There is also the possibility of using 20% aluminum chloride hexahydrate, a master formula subject to medical prescription. It can be useful, although people with hyperhidrosis also tend to fall short and fail to solve the problem.

Oral anticholinergic drugs
They are prescription medications that suppress sweat formulated with active ingredients such as oxybutynin. They can cross the blood-brain barrier (that is, they are capable of reaching the brain) and therefore generate some adverse effects.

They suppress sweat but also other fluids, which can cause dry mouth, blurred vision, dry eyes or gastrointestinal problems, among others.

Topical anticholinergic drugs
It is the ?cousin? of the previous ones, but in cream. It is a topical treatment with local action, which contains the active ingredient glycopyrronium, effective in reducing sweat production, also with a prescription. It has minimal penetration through the blood-brain barrier, so the aforementioned side effects are minimized.

The recommended dosage is 2 pumps per armpit. For the first four weeks of treatment, this medication is applied to each armpit evenly, once a day, preferably at night. Starting from the fifth week, the frequency of application of this medication can be reduced to twice a week, depending on the response to treatment. To maintain the effect in primary axillary hyperhidrosis, continuous treatment is needed.

References:

Abels et al. Br J Dermatol. 2021;185:315-322.

Callejas et al. Actas Dermosifiliogr. 2010;101(2):110-118.

Parashar et al. Am J Clin Dermatol. 2023:1?12.

Wohlrab et al. Dermatol Ther (Heidelb); 2023;13:453-463.

Gonzalez. Adolescere. 2022; X(1): 73-82.

Heiskanen et al. Acta Derm Venereol. 2022;102:adv00656.

Arora et al. J Cosmet Dermatol. 2022;21:62?70.

Rivera Solís et al. Science and Health Magazine. 2022;6(4):63-70.

Lenefsky et al. Am J Manag Care. 2018;24(23 Suppl):S491-S495.

Trettin et al. J Dermatolog Treat. 2022;33(2):928-934.