Contents
Medical treatments for hyperhidrosis (excessive sweating)
Treatments depend on the extent of the problem. Usually, people who see a doctor or dermatologist have tried several over-the-counter deodorants and antiperspirants with unsatisfactory results.
Anti-sweat
Before seeing a doctor, one can experience antiperspirants stronger than common antiperspirants by consulting a pharmacist. These products are kept behind the pharmacy, because their use requires a good understanding of the procedure.
The products suggested in case of excessive sweating contain aluminum chloride, more effective than aluminum or zirconium hydrochloride, commonly used in regular antiperspirants2.
Products offered without a prescription:
- A alcohol solution ethyl alcohol containing aluminum chloride in varying concentrations: 6% (Xerac AC®), 6,25% (Drysol Mild®) and 20% (Drysol®). Available as an underarm applicator and as a bottled solution for the hands and feet;
- Un gel hydroalcoholic containing 15% aluminum chloride, for armpits, hands and feet (eg Hydrosal®). The gel usually causes fewer skin reactions than the alcohol solution;
- Product Certain Dri® also contains aluminum chloride (12%). It is for its part offered in pharmacies on the shelves, because it is in aqueous solution.
The risk of irritation, itching and redness is greater than with conventional antiperspirants. Follow the manufacturer’s and pharmacist’s directions.
If these products do not control the sweating satisfactorily, a doctor or dermatologist may prescribe an antiperspirant that contains a mixture of aluminum chloride and other active ingredients.
We often confuse anti-sweat et déodorants, two products with very different effects. Deodorants mask the bad smells by replacing them with perfumes, while antiperspirants decrease the sweat production. Antiperspirants are made from metal salts (aluminum or zirconium) which block the ducts of the sweat glands. They also have antibacterial properties. Antiperspirants have the disadvantage of causing irritation, redness and itching in some people. |
In more serious cases
Ionophorèse. Iontophoresis consists of using a Electric power to decrease the secretion of sweat. It is indicated for people who suffer from severe hyperhidrosis of the hands or feet. The hands, for example, are immersed in two tubs of water, in which an electrode connected to a device which generates a current of 20 milliamps is placed. The session lasts about twenty minutes and is repeated several times a week. Once the person is familiar with the procedures, they can get a device and do their treatments at home. This method must be continued to maintain its effectiveness. It has certain contraindications. Check with your dermatologist.
Botulinum toxin injection. Subcutaneous injection of botulinum toxin (Botox®) is used to treat severe hyperhidrosis of the armpits, hands, feet and face. Botulinum toxin blocks nerve transmissions to the sweat glands. The effect of the injections lasts for about four months. Local anesthesia is necessary. It can be done by injection of lidocaine or by a gun (without a needle). One treatment requires several injections and costs a few hundred dollars. This use of Botox® is authorized by Health Canada, and in France for severe axillary hyperhidrosis. Contraindications apply.
Disclaimer. If you have difficulty swallowing, breathing or speaking after treatment with Botox, consult a doctor promptly. Health Canada issued a warning in January 2009 indicating that the botulinum toxin can spread throughout the body and cause serious side effects: muscle weakness, swallowing problems, pneumonia, speech disturbances and difficulty breathing3. |
Anticholinergic drugs. These drugs taken by mouth, such as glycopyrollate and propantheline, block the action of acetylcholine. This chemical messenger stimulates a host of biological reactions, including the production of sweat. However, this option is not widely used and of little interest in the long term because of the side effects (dry mouth, constipation, loss of taste, dizziness, etc.). Anticholinergics are mainly used in cases of generalized sweating (on all the body). There are also topical anticholinergics in the form of aqueous solutions, applied to the forehead and scalp.
Cognitive-behavioral therapy, antidepressants. When the psychic component is important, some doctors prescribe tranquilizers, antidepressant drugs or anxiolytics. Cognitive behavioral therapy may also be recommended.
Surgical treatments
Thoracic sympathectomy. This surgery, which consists in permanently destroying the sympathetic ganglia which innervate the sweat glands, treats hyperhidrosis of the armpits and hands. The procedure can be done with an endoscope, which reduces both the size of the incision and the recovery time. However, compensatory hyperhidrosis may occur in the back or the back of the legs.
Excision of the sweat glands. By surgery, it is possible to remove part of the sweat glands in the armpits. Local complications are rare.
Tips for better everyday comfort:
|