From the Research
Hyperhidrosis can be effectively managed through a stepwise approach, starting with clinical-strength antiperspirants containing aluminum chloride, as recommended by the most recent and highest quality study 1. The treatment of hyperhidrosis depends on the severity and location of excessive sweating.
- For axillary hyperhidrosis, topical aluminum chloride solution is the initial treatment, followed by botulinum toxin injections as second-line treatment, oral medications as third-line treatment, local surgery as fourth-line treatment, and endoscopic thoracic sympathectomy (ETS) as fifth-line treatment 2.
- For palmar and plantar hyperhidrosis, iontophoresis is considered an effective treatment option, with botulinum toxin injections as an alternative for those who do not respond to iontophoresis 3.
- For craniofacial hyperhidrosis, oral medications such as glycopyrrolate are considered first-line therapy, with topical medications or botulinum toxin injections as alternative options 2.
- Lifestyle modifications, such as wearing moisture-wicking fabrics, avoiding spicy foods and caffeine, and managing stress through relaxation techniques, can also complement medical approaches to managing hyperhidrosis. The choice of treatment depends on the individual response to therapy, as well as the severity and location of excessive sweating, as noted in the study by 1.
- Botulinum toxin injections have been shown to be effective in reducing sweating in patients with axillary hyperhidrosis, with significant improvement in symptoms 3.
- Iontophoresis has also been shown to be effective in treating palmar and plantar hyperhidrosis, although it may require repeated sessions to maintain efficacy 3.
- Oral medications, such as glycopyrrolate, can be effective in reducing sweating in patients with craniofacial hyperhidrosis, although they may have side effects such as dry mouth and sore throat 4.