Solutions to Heavy Sweating

More than 9 million Americans have overactive sweat glands that crank out up to five times more fluid than normal—an embarrassing, uncomfortable and often stress-inducing disorder called hyperhidrosis. Symptoms include frequent, noticeable sweating that can soak or stain clothing; abnormally heavy, bothersome perspiration on your feet, armpits, head or face; and clamminess or dripping on the palms, making it awkward to shake hands, grasp a pen or hold a car's steering wheel. Profuse sweating can also trigger complications, by making people more prone to fungal and bacterial infections, warts and skin rashes.

Although doctors don’t fully understand the cause, genetic factors may be involved since the condition often runs in families. Stress also plays a role in some cases, by causing the brain area that controls temperature regulation to overreact to normal stimuli. Excessive sweating can also be triggered by other conditions, including anxiety disorders, hyperthyroidism, use of certain medications, menopause, infections, and low blood sugar. Despite several therapies that can help, more than half of sufferers go undiagnosed and untreated. Here’s a look at solutions:

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  • Stronger antiperspirants. Since this is the least expensive option, the first step is to try topical antiperspirants, which work by plugging up sweat gland ducts in the armpits. If over-the-counter “clinical strength” products aren’t enough to solve the problem, your doctor may prescribe aluminum chloride (Drysol, Xerac). Prescription antiperspirants are most helpful for light to moderate hyperhidrosis, and give the best results if applied at night to areas prone to sweating. Improvement typically occurs within a week. Since Rx antiperspirants can cause skin irritation, it’s best to wash the medication off in the morning.
  • Anticholinergic drugs. If you’re affected by entire body sweating, drugs such as glycopyrrolate (Robinul, Robinul Forte) block the activity of a body chemical called acetylocholine that helps stimulate sweat glands. Medication typically takes about two weeks to improve heavy sweating, but can also have side effects, including dry mouth, constipation, blurred vision, dizziness and diminished sense of taste. Another downside of medication is that it can sometimes work too well. The body’s 2 to 4 million sweat glands perform an important function for survival, by cooling the body when it’s at risk for overheating, so medication may not be the best approach for athletes and outdoor workers.
  • Botox. FDA approved for treatment of excessive underarm sweating, Botox can be highly effective for people who don’t get relief from antiperspirants. In a clinical trial of 322 patients with severe underarm sweating, 81 percent of those who received Botox injections experienced a more than 50 percent reduction in sweating, with the improvement lasting for at least 201 days in half of the patients. Botox temporarily blocks a nervous system chemical that activates sweating. The shots are administered in the doctor’s office and need to be repeated in 7 to 16 months.

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  •  Iontophoresis. If the problem is excessive sweating in the hands or feet, iontophoresis uses a simple device that is 83 percent effective, according to the American Academy of Dermatology. Treatment involves placing hands or feet into trays of water as the iontophoresis device conducts a mild electrical current through the water. Each treatment takes 20 to 40 minutes and is thought to work by microscopically thickening the outer layer of skin, thus blocking the flow of sweat. The treatment is repeated every other day for 5 to 10 days, until the desired dryness is achieved. After that, the maintenance schedule involves sessions every one to four weeks. People with epilepsy, pacemakers or other implanted devices (such as joint replacements) and pregnant women shouldn’t use this treatment. Iontophoresis devices cost $700 and up and can be prescribed by doctors for home use.
  • MiraDry. A new device called MiraDry, recently FDA-cleared for treatment of excessive underarm sweating, is expected to be in doctors’ offices by fall. It zaps underarm sweat glands with microwaves to cause thermal destruction. The treatment is non-invasive and is performed in two sessions, each lasting one hour, after application of local anesthesia. In clinical trials, 89 percent of participants reported significant improvement during follow-up evaluation three months after the treatment, and after 12 months, 69 percent of those treated continued to find MiraDry an effective solution. No serious side effects were reported in the clinical trials, but some people had temporary armpit swelling and pain. Since sweat glands don’t grow back after being zapped, the treatment is expected to provide a long-term solution to dry up excessive armpit sweating.

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