Excessive sweating, or hyperhidrosis, is very common with an estimated 2 to 3 percent of Americans suffering from it. This excessive sweating can occur in the underarms, palms of the hands, or soles of the feet.

The underarm sweating usually starts late in adolescence, but the palms and soles can begin sweating as soon as 13 years of age. It’s embarrassing and can ruin clothes, romance, business and social interactions. There are some tips that have been found to at least cut down on the amount of sweating even if not curing it totally.

The approach to treating hyperhidrosis usually runs as follows:

1. Antiperspirants purchased over the counter: This is typically the first option tried due to the availability. Antiperspirants with aluminum chloride may work better when others have failed.

2. Prescription antiperspirants: For cases of excessive sweating not alleviated by over the counter antiperspirants, doctors may try aluminum chloride hexahydrate, or Drysol. Applied at bedtime 7 to 10 nights consecutively then about once a week for maintenance, usually helps the underarm sweating, although not the palms and soles.

3. Iontophoresis: Introduced more than 50 years ago, this treatment for excessive sweating is still not fully understood in how it works. However, this procedure uses water to “shock” the skin in order to fight sweat production. The current is applied for roughly 10 to 20 minutes each session.
At first, there are 2 to 3 sessions a week then 1 to 2 sessions a week for maintenance. These treatments may sound painful but are not.

4. Oral medication: Some people are prescribed oral anticholinergic medications like glycopyrrolate, or Robinul. These may work but often carry side effects such as blurred vision and dry mouth.

5. Botox, or botulinum toxin: Recently approved for the treatment of excessive underarm sweating, 50 units of Botox are injected into about 20 spots under each arm. The injections can be painful but are effective for about 6 months.

6. Surgery, or Cervical Sympathectomy: This is considered a last resort as the surgery is meant to destroy a portion of the nerve supply to sweat glands. It’s considered to be both effective as well as risky.