From the Research
Hyperhidrosis during pregnancy can be effectively managed with non-medication strategies and topical treatments, prioritizing the patient's quality of life and minimizing potential risks to the fetus. The management of hyperhidrosis during pregnancy involves a step-wise approach, starting with non-medication strategies such as wearing loose, breathable clothing, using clinical-strength antiperspirants containing aluminum chloride, and avoiding triggers like spicy foods, caffeine, and hot environments 1. For mild cases, these measures are often sufficient to control symptoms. If these measures are insufficient, prescription-strength antiperspirants like Drysol (20% aluminum chloride hexahydrate) can be considered, applied to affected areas nightly for 2-3 weeks, then reduced to 1-2 times weekly for maintenance 2. Some key points to consider in managing hyperhidrosis during pregnancy include:
- Oral medications like glycopyrrolate may be considered for severe cases, but should be used cautiously and under medical supervision due to potential side effects 3, 2.
- Iontophoresis is generally considered safe for treating palms and soles during pregnancy 4, 2.
- The condition typically resolves after delivery as hormone levels normalize, and is caused by pregnancy hormones increasing metabolic rate and body temperature, stimulating sweat glands to work harder, as well as increased blood volume and weight gain contributing to the body's need for additional cooling through sweating. Recent studies, such as the 2022 pilot study comparing intradermal Botulinum Toxin A injection versus topical 2% glycopyrrolate for primary facial hyperhidrosis, have shown that both modalities can be effective in treating hyperhidrosis, with topical glycopyrrolate showing comparable results to Botulinum toxin A but with a faster onset and shorter duration of action 5. However, the use of Botulinum toxin A during pregnancy is not well established, and its safety and efficacy in this context require further study. Therefore, topical treatments and non-medication strategies should be prioritized in the management of hyperhidrosis during pregnancy, with oral medications and other treatments used cautiously and under medical supervision.