Non-surgical treatments for patients with hyperhidrosis:
- Drysol: (brand name for aluminum chloride hexahydrate) is a prescription medication commonly prescribed for hyperhidrosis. Generally treatment is repeated nightly until sweating is under control. This may happen after just two or more treatments. Thereafter, you can apply Drysol once or twice weekly or as needed. Your physician will instruct you on how to take the medication.
- Botox: Botox injections have been used for the hands and the armpit area. For the hands and armpit, the treatment requires many injections of Botox during a single session. These are usually effective in reducing the sweat and the effect will last for three to six months.
- Iontophoresis: Iontophoresis when hands or feet are placed in water with low voltage DC electrical current.
- Anti-anxiety drugs: These types of drugs have been tried but they have very little role in the treatment of hyperhidrosis. While sweating may increase with tension and anxiety, these symptoms do not necessarily point to hyperhidrosis.
- Psychotherapy: Psychotherapy has been tried but seems to play little role in the treatment of hyperhidrosis because, while the sweating may increase with tension and anxiety these symptoms do not necessarily point to hyperhidrosis.
- Drying medicines: There are pills that can be taken to dry up the sweating, however, patients complain that these medicines can cause dry mouth and dry eyes.
Surgical treatment options for patients with hyperhidrosis:
Surgery for hyperhidrosis has been performed for 70 years. In the past, the procedure required a chest incision and spreading the ribs, which is painful and required admission to the hospital. Currently, the procedure is performed with minimally invasive surgery and on an outpatient basis. There are several methods for surgical treatment of hyperhidrosis, including cutting the nerve, clipping the nerve and removing the nerve. The most common method is cutting the nerve.
Almost all patients have substantial reduction in sweaty hands after the operation, however, improvement in the armpit and plantar (foot) sweating is much less consistent and not as predictable.
While the procedure is usually performed with low risk on an outpatient basis, there are risks to every procedure. Normally, patients have mild chest pain for a few days (though it can last longer or be severe). But they are normally able to work after a few days.
Most patients experience compensatory hyperhidrosis which means they experience increased sweating in other areas of the body, such as the scalp, chest wall, thighs or feet. The increased sweating may decrease in the months following the operation and patients usually do not mind mild increased sweating because the severely debilitating hand sweating has improved so much.
About five percent of patients experience severe compensatory sweating. Some patients may find this so severe that they are unhappy that they underwent the procedure.
Horner’s Syndrome (droopy eyelids) occurs in about 1 percent of people undergoing the procedure. If this occurs, it may be temporary or may require eye surgery to correct the droop.
Patients also have the usual risks of any operation, including bleeding, infection, and collapsed lung.