Sweating (Hyperhidrosis)
Why do I sweat so much?
Hyperhidrosis is too much sweating, usually from the armpits, but can also happen on the hands, feet, groin, scalp, or face. Sweat normally cools your body when you are hot or exercising, but hyperhidrosis is when you sweat too much when you are anxious, stressed, or nervous. There seems to be a genetic component because hyperhidrosis can run in families.
Some medical conditions can cause excessive sweating: diabetes, low blood sugar, hot flashes (menopause), thyroid issues, heart attack, some cancers, infections. If you are concerned about any of these or have other symptoms aside from sweating, please see a doctor.
How do I get my sweating to stop?
The mainstay of treatment for sweating (hyperhidrosis) is clinical strength antiperspirant. Most antiperspirant formulations are made for the armpits, but also work for the hands, feet, and groin. I find that only aluminum-containing products work for excessive sweating. Other natural products may help as deodorants but are not really effective at preventing sweating.
Apply clinical strength antiperspirant twice a day.
Aluminum in antiperspirants works by clogging the sweat glands to prevent sweating.
You must apply it to completely dry skin at times when you are least likely to sweat (usually at bedtime) to give it time to absorb into the sweat glands.
NOTE: Twice daily use is often needed for the first 2-3 weeks.
EXTRA NOTE: Aluminum can irritate the skin. Use hydrocortisone 1% ointment twice a day if you get irritation.
Maintenance use is just once a day or less.
After you have stopped sweating, you only need to apply antiperspirants once a day or less to keep the sweat away.
What if Antiperspirants aren’t working for my sweating?
If antiperspirants are not working, other options exist, but they all require a prescription. Here’s a quick run-down of my favorite options:
Glycopyrrolate pills - these are great at stopping sweating temporarily. They tend to last 2-6 hours, so they are excellent for specific situations - when you are giving a presentation, going on a date, or shaking hands at a special function. Not a great long-term option. NOTE: I like to combine these pills with antiperspirants. The pills will stop sweating long enough to give the antiperspirants more time to clog the sweat glands and stop sweating.
Iontophoresis - this is a device that runs a gentle current through your skin to “shock” the sweat glands and reduce sweating. It needs to be done 3 times weekly for several weeks to stop sweating, and then only needs only weekly maintenance treatments. Cash price at an office is ~$50 per 20 min session for one area (hands or feet). Iontophoresis works best for hand and foot sweating, but special pads can also help stop armpit sweating. If it is working at an office, you can purchase a unit for home use from RA Fischer ($700-1000) or Hidrex ($500-1000), but this needs a prescription in the U.S.
Botox injections - this works quite well for most people, but it is not comfortable (20-30 needle pokes into each armpit or palm) and only lasts 2-3 months before you have to do it again. Sometimes insurance will cover it, but you have to jump through a lot of hoops with other cheaper treatments first.
miraDry - this is the fanciest option that uses thermal (heat) energy to permanently eliminate sweat glands. The results are great, but it is very expensive ($2,000-$3,000).
For support, discounts on treatments, and additional information, go to sweathelp.org.
What if my sweating isn’t getting better?
Usually, using antiperspirants as described above can help most people get their sweating better. Sometimes people need additional help. For prescription pills, iontophoresis, Botox, or miraDry, look for a board-certified dermatologist in your area. If you are in or near Utah, see one of my excellent colleagues at the University of Utah or me virtually with Honeydew.
DISCLAIMER
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