Hyperhidrosis,or excessive sweating, is of 2 types. Excessive sweating can be due to an underlying medical condition or medication, or it can be due to a common genetic condition. The latter is called primary focal hyperhidrosis, and it causes excess sweating from the underarms, palms, soles and other areas of the body. The condition generally begins in adolescence, causing symmetrical sweating which occurs only in the daytime.
Sweating is caused by 2 kinds of glands. Eccrine glands cool the body and secrete odorless watery fluid. Apocrine glands secrete a thicker fluid and cause odor. Both apocrine and eccrine glands are present in the armpits. These glands are stimulated by nerves that trigger excessive sweating from hormonal and emotional stimuli, temperature and physical activity.
Patients with primary focal hyperhidrosis sweat four or five times more than is necessary, or normal. The condition is embarrassing, uncomfortable, and interferes with personal and professional life. Hyperhidrosis afflicts millions of people around the world, at least 3% of the world’s population.
Fortunately, there are treatments available for excessive sweating. Some patients benefit from over-the-counter topical preparations such as Certain-Dri, which can be used on the palms, soles and underarms. For maximum effect this is best applied at night time when excessive perspiration won’t wash the topical medication away. If Certain-Dri is not successful in controlling the sweating, a prescription strength aluminum chloride solution Drysol can be tried. The most common side effect from this product is irritation in the area of treatment, particularly in the underarm region.
Another option for treatment of excessive sweating of the hands and feet is iontophoresis. The hand and feet are submerged in a water bath through which an electric current is passed. The current passes through the skin and “turns off” the sweat glands. The iontophoresis device is covered by some insurance plans. Unfortunately, some patients do not respond.
Botox® is FDA approved for excessive sweating of the underarm, and is also used off label for sweating of the palms. Botox® treatment is expensive, needs to be repeated at least every 6 months, requires multiple injections, and is often challenging to get covered by insurance.
Of all the treatments for excessive underarm sweating, only one non-invasive treatment is permanent. Safe, effective, FDA-approved miraDry is an exciting new procedure that is painless with minimal downtime. It is extremely cost effective with very high patient satisfaction. Click here to find out more about this cure for underam sweating and odor, now available at Krauss Dermatology.