Hyperhidrosis

by Colby Crile, PA-C

April 2025

Hyperhidrosis is a medical condition characterized by excessive sweating that goes beyond what is necessary for regulating body temperature. While sweating is a natural response to heat or physical exertion, those with hyperhidrosis experience it in abnormal amounts, often without triggers. This condition can be embarrassing and difficult to manage, affecting a person’s quality of life in both personal and professional settings. Let’s dive into the details of hyperhidrosis, its causes, and treatment options.

What Is Hyperhidrosis?

Hyperhidrosis can be classified into two types:

1. Primary (Focal) Hyperhidrosis: This type occurs without any underlying medical condition and typically affects specific areas of the body, such as the hands, feet, underarms, or face.

2. Secondary (Generalized) Hyperhidrosis: This form is caused by an underlying medical condition, such as diabetes, menopause, hyperthyroidism, or infections. It can also be a side effect of certain medications. Unlike primary hyperhidrosis, secondary hyperhidrosis causes excessive sweating across the entire body, and it may come on suddenly.

Treatment Options for Hyperhidrosis

While there is no cure for hyperhidrosis, several treatments can help manage symptoms and improve quality of life.

1. Lifestyle Modifications

• Antiperspirants: Strong clinical-strength antiperspirants can reduce sweat, especially when applied at night before bed.

• Breathable clothing: Wearing loose-fitting, moisture-wicking fabrics can keep sweat from accumulating and help you stay comfortable.

• Dietary changes: Avoiding caffeine or spicy foods, which can trigger sweating, may provide relief.

2. Medications

Topical therapy: Drysol (aluminum chloride) or Qbrexza (glycopyrronium) are both topical agents that can help control sweating.

• Oral anticholinergic drugs: These medications block the signals from the nervous system that trigger sweating.

• Botox injections: Botulinum toxin injections are FDA-approved for treating excessive sweating in areas such as the underarms, hands, and feet. Botox works by blocking the nerves responsible for sweating.

3. Iontophoresis

This treatment uses a low-voltage electrical current to temporarily stop sweat glands from producing sweat. It is most effective for hands and feet and usually requires repeated treatments.

4. Surgery

In extreme cases, when other treatments fail, surgery may be considered. Options include:

• Sympathectomy: A procedure that involves cutting or clipping the nerves responsible for excessive sweating. This is typically used for hand sweating.

• Sweat gland removal: Involves the surgical removal of sweat glands from the affected area, such as the underarms.

Hyperhidrosis can be an overwhelming and challenging condition to live with, but it is important to remember that there are effective treatments available. Whether you experience excessive sweating in specific areas or your whole body is affected, managing hyperhidrosis is possible with the right care plan. If you believe you may have hyperhidrosis, please reach out to see what treatment plan works best for you.