What are the treatment options for hyperhidrosis?

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Last updated: June 3, 2025View editorial policy

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From the Research

Treatment for hyperhidrosis should start with clinical-strength antiperspirants containing aluminum chloride, with botulinum toxin injections being a highly effective option for focal hyperhidrosis, particularly for underarms, palms, and soles, as supported by the most recent and highest quality study 1.

Treatment Options

  • Clinical-strength antiperspirants containing aluminum chloride (like Drysol or Certain Dri) applied at night to dry skin
  • Oral medications such as anticholinergics like glycopyrrolate (1-2mg twice daily) or oxybutynin (5-10mg daily) to reduce sweating systemically, but may cause side effects like dry mouth and blurred vision 2
  • Iontophoresis, which uses a mild electrical current through water to temporarily block sweat glands, requires 20-30 minute sessions several times weekly initially, then maintenance treatments 3
  • Botulinum toxin (Botox) injections provide 4-6 months of relief for focal hyperhidrosis, particularly for underarms, palms, and soles, with a high satisfaction rate among patients 4
  • For severe cases unresponsive to other treatments, endoscopic thoracic sympathectomy (ETS) surgically interrupts the sympathetic nerves controlling sweating, though this permanent procedure carries risks including compensatory sweating elsewhere 3
  • MiraDry uses microwave technology to permanently destroy underarm sweat glands in 1-2 office treatments

Lifestyle Modifications

  • Wearing breathable fabrics
  • Avoiding spicy foods and caffeine
  • Stress management techniques to complement medical treatments by reducing sweat triggers 1

References

Research

Hyperhidrosis: Management Options.

American family physician, 2018

Research

Treatment options for hyperhidrosis.

American journal of clinical dermatology, 2011

Research

Treatment of hyperhidrosis with botulinum toxin.

Aesthetic surgery journal, 2012

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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