Hyperhidrosis Treatment

What is hyperhidrosis?

Hyperhidrosis is a condition that causes excessive sweating in certain parts of the body, such as the underarms, palms, or soles of the feet.

There are two main types of hyperhidrosis:

• Primary hyperhidrosis – excessive sweating without an underlying medical condition.
• Secondary hyperhidrosis – excessive sweating caused by another medical condition or as a side effect of certain medications.

In primary axillary hyperhidrosis (excessive underarm sweating), the sweat glands become overactive, releasing too much acetylcholine — a chemical messenger from the nervous system that triggers sweating.

This condition can affect a person’s quality of life by causing:

• Physical discomfort
• Difficulty performing daily or work-related activities
• Social anxiety or embarrassment
• In some cases, social withdrawal or isolation

Treatment options for hyperhidrosis

Several treatments are available to help manage hyperhidrosis. The most suitable option depends on factors such as the affected area, the severity of symptoms, and how the condition impacts your life. Your doctor will discuss these options with you and help you decide on an appropriate approach.

1. Antiperspirants and deodorants

• Products containing aluminum chloride hexahydrate may help block sweat glands.
• Deodorants help control body odour but do not reduce sweating.
• These products may sometimes cause skin irritation or itching.

1. Medications

• Certain medicines, such as anticholinergics (e.g., glycopyrrolate), may reduce sweating by blocking the chemical signals that stimulate sweat glands.
• Possible side effects include dry mouth, dizziness, and blurred vision.

1. Iontophoresis

• A low-level electrical current is used to temporarily block sweat gland activity.
• Most commonly used for palms and soles of the feet.
• Limitations:
• Requires frequent sessions (often multiple times per week).
• Not typically effective for underarm sweating.
• Results are temporary.

1. Surgery

Surgical options may include:

• Sweat gland removal in the affected area.
• Endoscopic thoracic sympathectomy (ETS) – a procedure that interrupts nerve signals to the sweat glands.

Surgery is generally considered a last resort because ETS may cause compensatory sweating, where other areas of the body begin to sweat excessively, sometimes more severely than before treatment.

How muscle relaxation injections may help treat hyperhidrosis

When other topical or non-surgical treatments are not effective, muscle relaxation injections may be recommended. These injections temporarily block the nerve signals that activate the sweat glands in the underarm area.

The effects usually last 6 to 10 months, after which the procedure may be repeated if needed.

Who may not be suitable for this treatment

This treatment is not suitable for people who:

• Have a known allergy or hypersensitivity to the substance used in the injection.
• Have an active infection at the injection site.

Your doctor will review your medical history to determine whether this treatment is appropriate for you.

Possible risks and side effects

While many people tolerate this treatment well, there are potential side effects and risks, including:

• Temporary pain, redness, or swelling at the injection site
• Headache or dizziness
• Dry mouth
• Localised muscle weakness
• Rare but serious side effects such as breathing difficulties, double or blurred vision, or the spread of the injected substance to other areas of the body
• Allergic reactions, including rash or itching

Your practitioner will discuss these risks in detail before treatment so you can make an informed decision.

Next steps

If you are considering treatment for hyperhidrosis, it is important to:

• Have a face-to-face consultation with a qualified practitioner.
• Discuss your symptoms, medical history, and expectations.
• Understand the potential benefits, risks, and limitations of each treatment option.