From the Research
Treatment for hyperhidrosis should start with topical medications, such as aluminum chloride, as the first-line treatment, followed by other options like iontophoresis, botulinum toxin injections, and oral medications, with surgery being considered for severe cases unresponsive to other treatments. The treatment options for hyperhidrosis can be categorized based on the severity and location of the condition.
- For mild cases, lifestyle modifications such as wearing breathable fabrics, avoiding spicy foods and caffeine, and stress management techniques can help reduce symptoms.
- For axillary hyperhidrosis, topical treatment with aluminum chloride is recommended as the first-line treatment 1.
- For palmoplantar hyperhidrosis, a trial of oral medications like glycopyrrolate 1-2 mg once or twice daily is considered as second-line therapy due to its low cost, convenience, and emerging literature supporting its excellent safety and reasonable efficacy 1.
- Iontophoresis is considered third-line therapy for palmoplantar hyperhidrosis, with high efficacy but also high initial costs and inconvenience 1.
- Botulinum toxin injections are considered fourth-line treatment for palmoplantar hyperhidrosis, with high efficacy but expensive and requiring repeated injections every 3-6 months 1, 2.
- For severe cases unresponsive to other treatments, surgical options like endoscopic thoracic sympathectomy (ETS) can be considered, but they carry risks of compensatory sweating elsewhere 1, 3. The choice of treatment depends on the severity of hyperhidrosis, affected body areas, and individual response to therapies, with the goal of improving quality of life and reducing morbidity and mortality associated with the condition 3.