Lal: Hyperhidrosis — understanding and managing excessive sweating

Dr. Karan Lal

Submitted photo

Hyperhidrosis, commonly known as excessive sweating, can lead to feelings of self-consciousness, fatigue and discomfort. This prevalent condition affects various body areas, including the feet, face, hand and underarms, and significantly impacts the quality of life for those who experience it.

The challenges of living with hyperhidrosis often extend beyond physical symptoms. Many people with this condition face heightened anxiety and depression, and teenagers may feel particularly vulnerable. At school, teens with hyperhidrosis might isolate themselves or choose specific clothing to hide visible sweat marks.

Excessive sweating can be severe enough to interfere with daily activities, such as a child struggling to hold a pencil due to sweaty palms. In other cases, frequent clothing changes may be necessary to manage accumulated sweat in specific areas.

Untreated hyperhidrosis can exacerbate mental health issues, causing individuals to withdraw from social interactions and distance themselves from friends and family.

Types of hyperhidrosis

There are two main types of hyperhidrosis: primary and secondary.

Primary hyperhidrosis is often inherited and can begin during childhood. It typically affects specific areas of the body, such as the palms or underarms.

Secondary hyperhidrosis is usually a result of underlying medical conditions, such as menopause, diabetes or alcoholism. Unlike primary hyperhidrosis, this type can cause sweating across larger or more generalized areas of the body.

While there is no cure for hyperhidrosis, a range of effective treatments is available to help manage symptoms:

Topical treatments

FDA-approved options like Qbrexa, a medicated wipe for underarm sweating, can be prescribed for patients as young as 9 years old.

Oral medications

Prescription medications, often covered by insurance, can help reduce sweating. Consult your dermatologist to determine what will work best for you.

Botox injections

Botulinum toxin injections, commonly known as Botox, block nerve signals to sweat glands. This treatment is effective for reducing sweat but is temporary, typically requiring two to three sessions per year.

Radiofrequency treatments

The Agnes treatment is newer method treatment that uses radiofrequency energy for longer-term reduction of sweating, often is achieved in two to three treatment sessions.

Ultrasound-based treatments

Non-invasive techniques that target sweat glands through sound waves is another typ of treatment to consider.

Surgery

In severe cases, surgical procedures may be considered to remove or disable sweat glands.

Prescription antiperspirants

Dermatologists may recommend prescription-strength antiperspirants containing aluminum chloride, such as Xerac AC. These products are applied to dry skin before bedtime and washed off in the morning, with results typically noticeable after a few days of consistent use.

Consult a dermatologist

All treatment plans for hyperhidrosis should be discussed with a board-certified dermatologist to determine the most suitable option based on individual needs and medical history.

Editor’s note: Dr. Karan Lal is director of pediatric dermatology and cosmetic surgery at Scottsdale-based Affiliated Dermatology. Reader reactions, pro or con, are welcomed at AzOpinions@iniusa.org.