Excessive Sweating (Hyperhidrosis) Treatment

Excessive Sweating (Hyperhidrosis) Treatment2019-02-28T18:59:44+00:00

Excessive Sweating (Hyperhidrosis) Treatment

What is hyperhidrosis (hi-purr-hi-DROE-sis)?

This is a medical condition that causes excessive sweating. The word “hyperhidrosis” means too much (hyper) sweating (hidrosis).  Excessive sweating happens when a person sweats more than is necessary. Yes, it’s necessary to sweat. Sweating cools the body, which prevents us from overheating. People who have hyperhidrosis, however, sweat when the body does not need cooling.

Many people who have hyperhidrosis sweat from one or two areas of the body. Most often, they sweat from their palms, feet, underarms, or head. While the rest of the body remains dry, one or two areas may drip with sweat.

This excessive sweating can interfere with everyday activities. Hands can be so sweaty that it becomes difficult to turn a doorknob or use a computer. Sweat from the underarms often soaks through clothes, causing obvious sweat marks. Because the skin is often wet, skin infections can develop.

Signs and symptoms

If you have this medical condition, you may notice:

  • Visible sweating: When you are not exerting yourself, do you often see beads of sweat on your skin or have sweat-soaked clothing? Do you sweat when you’re sitting?

  • Sweating interferes with everyday activities: Does sweating cause difficulty holding a pen, walking, or turning a doorknob? Does sweat drip heavily on to your papers or computer?

  • Skin turns soft, white, and peels in certain areas: Does your skin stay wet for long periods?

  • Skin infections: Do you get frequent skin infections on the parts of your body that sweat heavily? Athlete’s foot and jock itch are common skin infections.

Two types of hyperhidrosis

Both types cause excessive sweating, but there are some differences.

  • In one or a few areas of the body: “Focal” means that the excessive sweating (hyperhidrosis) affects one or a few parts of the body. The areas of the body most commonly affected are the underarms, hands and/or feet, and forehead.

  • On both sides of the body: If the excessive sweating occurs in the underarms, the person usually notices both underarms sweat excessively. The same holds true for the hands and feet.

  • After waking up: Sweating may begin soon after the person wakes up, but the person usually does not notice damp sheets or wet clothing unless the room is hot.

  • At least once a week: For many people, it occurs much more often.

  • This type of hyperhidrosis usually begins when the person is a child or adolescent. Most people who have this type are otherwise healthy. In medical terminology, the word “primary” means that the cause is not another medical condition.

Secondary hyperhidrosis

In medical terminology, “secondary” means that the excessive sweating (hyperhidrosis) has an underlying cause. The cause could be a: medical condition, side effect of taking a medicine or food supplement or medical conditions that can cause excessive sweating include: diabetes, frostbite, gout, Injury (such as head trauma caused by an accident), menopause, obesity, overactive thyroid (hyperthyroidism)or tumor. If a person has this type of hyperhidrosis, the person may notice:

  • The entire body sweats excessively: Sometimes, only parts of the body sweat.

  • Sweating occurs during sleeping: If you sweat excessively while asleep, it is important to see a dermatologist to learn why this happens.

This type of sweating usually begins when the person is an adult. It also may begin after an accident or frostbite. Many medicines also can cause this type of hyperhidrosis.

Anxiety and embarrassment

Both types of hyperhidrosis can cause people to feel extremely anxious and embarrassed. Students often avoid raising their hand during class. Many teens never date. Adults may hide the sweat stains by wearing layers of clothing or changing frequently throughout the day.

Who gets hyperhidrosis?

It is difficult to say how many people have excessive sweating. Many people never see a doctor. Some are too embarrassed to talk with a doctor. Others do not realize that this is a treatable medical condition. Dermatologists estimate that 3% of people in the United States have excessive sweating.  We know that some people are more likely to get hyperhidrosis. Researchers have learned that most people have one of the following:

  • Family member who sweats excessively.

  • Medical condition that causes the sweating.

  • Medicine or food supplement that they take, which can cause excessive sweating.

When the excessive sweating occurs in one or two areas of the body, it is likely that a family member also has this condition.  Many medical conditions can cause excessive sweating. These include diabetes and gout. A tumor or injury also can cause excessive sweating.

Women often sweat excessively when they get hot flashes during menopause. The cause is obvious. Some women, however, develop excessive sweating after they have gone through menopause. This sweating does not have an obvious cause.

People of all races get hyperhidrosis. The excessive sweating can begin at any age. For many people, it begins when they are a child or teen. Dermatologists believe that more children and adolescents have this condition than are diagnosed. Whether you live in a cold climate or a warm one, you can have hyperhidrosis.

What causes hyperhidrosis?

Certain nerves tell the body when to sweat. It is possible that these nerves overreact, causing excessive sweating.  We know that you cannot catch it from someone.  Dermatologists continue to study what causes this condition. They also continue improve treatments. If excessive sweating interferes with your life, you may want to see a dermatologist. Many effective treatments are available.

Dermatologists help many patients control excessive sweating. Before treatment begins, it is important to find out why a patient has excessive sweating.

How do dermatologists diagnose hyperhidrosis?

To diagnose this condition, a dermatologist gives the patient a physical exam. This includes looking closely at the areas of the body that sweat excessively. A dermatologist also asks very specific questions. This helps the doctor understand why the patient has excessive sweating.

Sometimes medical testing is necessary. Some patients require a test called the sweat test. This involves coating some of their skin with a powder that turns purple when the skin gets wet.  To find an underlying medical condition, other medical tests may be necessary.

What Does MSI Offers to Patients with hyperhidrosis?

Treatment depends on the type of hyperhidrosis and where the excessive sweating occurs on the body. Your dermatologist also considers your overall health and other factors.  Treatments that dermatologists use to help their patients control hyperhidrosis include:


This may be the first treatment that a dermatologist recommends. It is affordable. When applied as directed, an antiperspirant can be effective. Your dermatologist may recommend a regular or clinical-strength antiperspirant. Some patients need a stronger antiperspirant and receive a prescription for one. The antiperspirant sits on top of your skin. As you sweat, the antiperspirant is pulled into your sweat glands. This plugs the sweat glands. When your body senses that its sweat glands are plugged, this should signal your body to stop producing so much sweat.

Iontophoresis (the no-sweat machine)

If excessive sweating affects your hands, feet, or both areas, this may be an option. You will use this treatment at home. It requires you to immerse your hands or feet in a shallow pan of tap water. As you do this, a medical device sends a low-voltage current through the water.  The electric current shuts down the treated sweat glands temporarily.

Most people need about 6 to 10 treatments to shut down the sweat glands. To get improvement, you begin by using the device as often your dermatologist recommends. At first, you may need 2 or 3 treatments per week. A treatment session usually takes 20 to 40 minutes.  Once you see results, you can repeat the treatment as needed to maintain results. This can range from once a week to once a month.

If this treatment is right for you, your dermatologist will teach you how to use the device and give you a prescription so that you can buy one. Some patients also receive a prescription for a medicine that they add to the tap water.

Botulinum toxin injections

BoNTA-ONA is approved for treatment of hyperhidrosis in the United States. It is injected intradermally to treat hyperhidrosis and inhibits the release of acetylcholine at the neuromuscular junction and from the sympathetic nerves that innervate eccrine sweat glands.  Your dermatologist can inject a weak form of this medicine into your underarms. To treat excessive sweating, a patient will need to have very tiny amounts injected in many areas of the underarms. When performed properly, patients have little pain or discomfort. Findings from some research studies suggest that this treatment may be effective for other areas of the body. It may help post-menopausal women who sweat excessively on the head. It may be effective for excessive sweating that affects the hands and feet.

Prescription medicine

Some patients receive a prescription for a medicine that temporarily prevents them from sweating. These medicines work throughout the body.  These medicines prevent the sweat glands from working. Athletes, people who work in a hot place, and anyone who lives in a warm climate should use extreme caution when using this treatment. The body may not be able to cool itself.


If other treatments fail to bring relief, surgery may be considered. Surgery is permanent and carries risks. The following surgeries can stop excessive sweating: Surgically remove sweat glands or sympathectomy. Prof. Moawad can surgically remove sweat glands from the underarms. This surgery can be performed MSI surgical suite. Only the area to be treated is numbed, so the patient remains awake during the surgery. Prof. Moawad may use one or more of the following surgical techniques to remove sweat glands from the underarms:

  • Excision (cut out sweat glands)
  • Liposuction (remove with suction)
  • Curettage (scrape out)
  • Laser surgery (vaporize)

In a novel approach Prof. Moawad perform liposuction of the axilla as an effective treatment for axillary hyperhidrosis, as a local surgical procedure, apocrine glands as well as eccrine glands are removed by the liposuction technique through one or two tiny incision holes without sacrifice of overlying axillary skin. The success of this technique may be due to disruption of the nerve supply to the sweat glands and removal or destruction of the apocrine glands that are present in high density in the axilla.

At MSI surgical suite, the areas of axillae are marked and prepared after shaving the axillary hair. After cleaning the skin, a tumescent anesthesia is injected into incision sites. A small 3–5-mm incision is made on each side. Usually, a total of 100-200 mL of tumescent agents is injected into each axilla. For. twenty to thirty minutes an ultrasound handle massage the area, besides the adipose tissue, the glandular tissues in the dermal layer may also be affected by the ultrasound with its thermal and mechanical energy. A special liposuction cannula is attached to vibroliposcution handle 2mm is used to scrape subcutaneous and dermal tissue. The scraping technique is performed by curette against the underlying skin like moving a windshield wiper in two to four cycles with the aid of vibroliposuction handle to ensure complete removal of sweat ducts. After curettage, a 3-mm cannula (one or three holes) is inserted to suction fatty layer and debris. With mastery of the technique, Prof Moawad perform this procedure successfully with few complications and low recurrence rates.

The unpleasant odor associated with axillary osmidrosis is believed to be caused by interaction of secretions from the apocrine glands with microorganisms in the axilla and often related to hyperhidrosis. For many people, this condition is a social handicap it is necessary; hence a more permanent and radical treatment is needed. Surgical ablation of apocrine glands is the only possible way to permanently eliminate or reduce axillary osmidrosis and hyperhidrosis. Our approach of ultrasound-power (vibro) assisted liposuction of the axilla with curettage of axillary vault proved to be ideal method , have high success rate and few complication and little or no recurrence.,

Side effects: All surgeries carry some risk. When sweat glands are removed from the underarm, there is risk of developing an infection. Patients may have soreness and bruising. These will go away.  Permanent side effects also can occur. Loss of feeling in the underarm and scarring are possible.

Hand-held medical device destroys sweat glands

Proudly at MSI, a newer bipolar RF device are effective in reducing the amount of sweating. The combination of RF and fractional microneedle technology, termed fractional microneedle radiofrequency (FMR), creates an effective method with a better safety profile for treating various dermatologic conditions. Novel bipolar RF devices can destroy eccrine glands by a process of thermolysis at the interface of the deep dermis and subcutis while minimizing damage to the surrounding tissue Fractional microneedle radiofrequency (FMR) treatment appears to be a new safe and effective treatment alternative for moderate to severe primary axillary hyperhidrosis. Prof Moawad suggests It is repeated sessions of FMR be considered to achieve a complete response.

What other option I have?


Sympathectomy is another surgery used to treat hyperhidrosis. This is major surgery (not Done at MSI) which a surgeon performs in an operating room.  During sympathectomy, the surgeon tries to stop the nerve signals that your body sends to the sweat glands. To do this, the surgeon will cut or destroy certain nerves. To find these nerves, the surgeon inserts a mini surgical camera into the patient’s chest just beneath the underarm. The patient’s lung must be temporarily collapsed so that the surgeon can cut or destroy nerves. While surgical removal of sweat glands is used to treat the underarms, sympathectomy is mainly used to treat the palms

Advances in endoscopic surgery have reduced some risks from sympathectomy. Serious side effects can still occur. Some patients develop a condition known as compensatory sweating. For some people, this causes them to sweat more heavily than did the hyperhidrosis. Other possible side effects from sympathectomy include damage to the nerves that run between the brain and eyes, extremely low blood pressure, irregular heartbeat, and inability to tolerate heat. Patients have died during this surgery.


By seeing a dermatologist, many people find treatment that effectively controls their excessive sweating. This often greatly improves their quality of life.  Many people control their hyperhidrosis by combining treatment with tips for managing.

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