From the Research
Treatment for hyperhidrosis should start with topical aluminum chloride hexahydrate for axillary and palmoplantar hyperhidrosis, as it is a recommended first-line treatment. For axillary hyperhidrosis, botulinum toxin injections are recommended as second-line treatment, while for palmar and plantar hyperhidrosis, a trial of oral medications such as glycopyrrolate (1-2 mg once or twice daily) is considered second-line therapy due to its low cost, convenience, and emerging literature supporting its excellent safety and reasonable efficacy 1.
- Key treatment options for hyperhidrosis include:
- Topical aluminum chloride hexahydrate
- Botulinum toxin injections
- Oral medications (glycopyrrolate or clonidine)
- Iontophoresis
- Surgery (endoscopic thoracic sympathectomy)
- The choice of treatment depends on the severity of hyperhidrosis, affected body areas, and patient preferences, with a focus on minimizing morbidity, mortality, and improving quality of life.
- According to a study published in the American Journal of Clinical Dermatology, updated therapeutic algorithms are proposed for each commonly affected anatomic site, with practical procedural guidelines 1.
- Another study published in the New England Journal of Medicine found that intradermal injection of botulinum toxin A is an effective and safe therapy for severe axillary hyperhidrosis, with 98% of patients recommending this therapy to others 2.