Anticholinergic medications may be helpful, but carry many side effects including dry mouth, blurred vision, and urinary retention. These side effects often significant and not well tolerated by patients. Benzodiazepines (like Valium) are useful in treating excessive sweating that is caused by stress, but carry the risk of dependence.
Antiperspirant Treatment for Sweating
Antiperspirants and deodorants may be used to stop sweating. In people with excessive sweating, special antiperspirants containing aluminum chloride hexahydrate (Drysol ®) are often the first therapeutic measure recommended. They work by blocking the opening of sweat glands. Side effects include skin irritation, and the results are often not sufficient to stop excessive sweating. Topical agents are most effective in individuals with light to moderate hyperhidrosis.
Iontophoresis Treatment to Stop Sweating
Iontophoresis uses low-intensity electrical current to disrupt the function of the sweat glands. During inotophoresis, each hand or foot is rested on a wet pad in a tray that is connected to an electrical current that passes through the pads. The currents are sent through the skin to sweat glands, which results in blocked sweat glands and reduced sweating. Iontophoresis is a safe, non-invasive treatment and causes only minor discomfort. The biggest drawback is that the iontophoresis process is time consuming, and must be repeated at regular intervals. Each iontophoresis treatment may take 15 to 30 minutes to complete. Often the intervals between treatments can be lengthened once control is achieved. Iontophoresis has been shown to stop excessive sweating in around 85% of patients with sweatys. (1)(2)
Botox® treatment for Excessive Sweating
Botox ® (botulinum toxin type A) is a medication that is used to stop sweating. Botox is a toxin that blocks the function of nerves. When the toxin is spread througout the body, paralysis will occur. When the toxin is injected into a specific site, only the nerves in that area will be paralyzed. Botox injection leads to decreased sweating in the area where it is injected. One of the primary side effects is pain at the site of injection. Injections to stop sweating tend to be less painful than when used to stop hand sweating or to stop palm sweating.
Endoscopic Sympathectomy Surgery for Excessive Sweating
The creation of endoscopic thoracic sympathectomy to stop sweating has lowered the complication rate of surgery for excessive sweating. Surgical treatment is a good option for patients who cannot control symptoms on medication alone. The most common side effect of endoscopic thoracic sympathectomy is compensatory sweating, where the patient may experience increased sweating in other areas that previously were not a problem. Please visit our section on surgical treatment for excessive sweating.
The surgery has been shown to be effective to stop sweatys. Overall, the surgery is safe and effective for the treatment of hyperhidrosis.
Studies on endoscopic thoracic sympathectomy to stop sweating have shown the procedure to reduce increased sweating in the majority of patients. In one study of 850 patients, 98% of the patients said that the results of the surgery were satisfactory, (3) while another study of 233 patients showed satisfactory results in 95% of patients. (4)
The main side effects of sympathectomy for sweating include hemothorax (blood in the thoracic cavity, behind the lungs) in 1% to 2%, recurrence of symptoms in around 2% of patients, and compensatory sweating (increased sweating in other areas of the body) in 55% to 67% of patients.
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