Last week's #DermTipTuesday discussed one key part of maintaining underarm hygiene, controlling the odor. Well, what about controlling the sweat? It's a fine balance between necessity versus burden. Without sweat, our bodies lack the ability to regulate temperature, especially in hot climates or during exercise. Yet, too much sweating can cause odors (bromhidrosis) and make anyone self conscious due to the appearance alone. When a doctor has done a complete work-up to ensure that the cause for excessive sweating is not due to any internal abnormalities, we term the condition idiopathic hyperhidrosis.
Here are a few therapies that a dermatologist may suggest for those battling idiopathic hyperhidrosis.
Beyond Roll On Antiperspirants
1. Prescription Strength Antiperspirants
This option is by far the most common choice my patients elect for. Drysol® is one example of a higher concentration of aluminum chloride (the active ingredient in most over-the-counter antiperspirants). It is applied at night with the goal for sweat control the following day.
Can Drysol® be applied to areas other than the underarms? The answer is yes. Palm, sole, and scalp hyerhidrosis can all be treated with this topical method. It is not to, however, be applied to irritated skin or damp skin.
2. Oral anticholinergics
This is another option when my patients have failed topical therapy. The milligram and frequency of ingestion will vary per person. But, the overall goal is the same. That is to find the most effective dose that comes with the least amount of side effects.
Oral anticholinergics, like glycopyrronium bromide (Robinul), can cause dry eye, headache, blurry vision, and urinary retention to name a few. But, these side effects are uncommon at low dosages and those that I have prescribed it for are usually very pleased with the results.
Yes, Botox® (botulinum toxin) can be used for more than just wrinkles. My patients who don't like to be bothered with applying topical therapy daily or having to remember to take a pill love this option. The results last for several months after a few injections in the site involved. The underarm area is the most common site I treat with botulinum toxin for hyperhidrosis. Palms, soles, and scalp can be injected as well.
As a side note, woman who like to work out regularly, but don't want to sweat out their hairstyle may elect for this option.
4. Surgical intervention
Surgical treatment represents the final option after all else has failed.
Liposuction, surgical removal of tissue containing sweat glands, sympathectomy (cutting of the nerve responsible for s