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Hyperhidrosis Treatments
Treatments for Primary Focal Hyperhidrosis
Medical Treatments for Children with Hyperhidrosis
Written by Katie Crissman
October 01 2020

Children need special consideration when it comes to medical care and this can complicate treatment for children who develop hyperhidrosis. It is estimated that hyperhidrosis effects .6% of prepubescent children and 1.6% of adolescents, and while this is a smaller portion of the population than adults who are affected, it is still a significant group.[1] If a child has symptoms of excessive sweating, or is already diagnosed, it is important to manage their hyperhidrosis with a doctor. There are several ways to help kids with hyperhidrosis at home, but in cases where sweating is severe or distressing there are several medical treatment options that are safe for children. In most cases, a child diagnosed with excessive sweating is suffering from primary focal hyperhidrosis, so most of the treatment options discussed below are related to relieving symptoms for that type of hyperhidrosis. However, there are some systemic interventions available for the few children experiencing secondary generalized hyperhidrosis.

Topical Treatments

Topical over-the-counter creams for hyperhidrosis are often a first line treatment for both children and adults. However, there has been limited success in use for children. Aluminum salts are used in most topical creams, both over-the-counter and prescription, and it is thought that they block the sweat gland pores and therefore reduce sweating. It has been successful in reducing sweat in children, but it often needs to be applied multiple times a day making it a burdensome option for younger children who cannot apply it themselves. Another drawback to this treatment is that there have been few studies on the pediatric population using these creams. Antiperspirants are safe for adults and no studies have shown that they cause negative health outcomes, but more research needs to be done before they can be declared safe for children. It is a popular treatment option and many doctors choose to manage hyperhidrosis with topical creams as an initial treatment option for children. It can be difficult for some parents to choose the right over-the-counter antiperspirant, so it is a good idea for parents to get a recommendation from their child's doctor. If a topical cream is not enough then there are other medical measures that can be taken to improve a child’s outcome.[1] Recently, a new medication called Qbrexza was released by a company called Dermira, it is a medicated wipe that children as young as nine are able to use. It requires a prescription from a doctor.

Baby powder may also be helpful for sweating issues that children with hyperhidrosis may have. It can be applied to areas that sweat frequently and can absorb moisture and prevent chafing. Other options, like foot powder which is also used to soak up sweat, may or may not be appropriate for children. It is best to speak to your pediatrician before using any new over-the-counter products on your child.

Anticholinergics

Anticholinergics are the main type of oral medications used to treat hyperhidrosis. Doctors most often prescribe glycopyrrolate or oxybutynin for people with hyperhidrosis, although there are other types of anticholinergics that are sometimes prescribed. They bind to receptors that accept the neurotransmitter acetylcholine and reduce sweat by disrupting communication to eccrine cells. These medications have been used commonly in the pediatric population and have had good results. One study with 31 pediatric patients found that 90% of them had a positive response to the medication.[1] There have been a handful of other studies also showing positive results. Another study found that 95% of children using Oxybutynin had an improvement in their quality of life.[2] Unfortunately, the medication does commonly produce side effects like dry mouth, blurred vision, tachycardia and constipation among others.[1] Medication can be a powerful tool to help a suffering child but should be used with caution in younger patients.

Other Potential Medications

Medications such as Calcium-channel blockers, clonidine, a-adrenoceptor antagonists and benzodiazepines have been used to treat children with some positive outcomes. However, there has been less research on these medications and their effectiveness in treating pediatric hyperhidrosis. Benzodiazepines, which can be used when anxiety from hyperhidrosis is pervasive, should be used only after careful consideration due to their potential side effects.[1]

Iontophoresis

Iontophoresis is a treatment used to treat palmar and plantar hyperhidrosis. It works by using an electric current to pass ions into a patient's skin. Typically, the hands or feet are placed in trays containing water and medication and an electric current is turned on so that the ionized medication can enter the skin. It can be done at a doctor’s office or at home. It is not painful and does not have many side effects. However, it has to be done frequently for the treatment to be effective which can be inconvenient, especially for children. There haven’t been specific studies on the pediatric population but children age 8 and up have been included in some studies on the efficacy of iontophoresis. In one study with participants ages 8 to 32 there was a satisfaction rate of 81.2%.[1] This appears to be a good possible treatment for children who need treatment for sweaty hands or sweaty feet. Iontophoresis is a treatment that really does work in most cases, if parents and children can keep up with the treatment schedule. For children who are not seeing benefits, there are ways to make iontophoresis more effective. Overall, it is a good treatment option for children because it does not expose them to systemic medications and it is not invasive.

Botox Injections

Botox has been used to treat palmar and plantar hyperhidrosis, and the FDA approved botox for axillary hyperhidrosis, in adult patients. Botox is a very effective treatment option. However, it is currently not FDA approved for the treatment of hyperhidrosis in children which often leaves families paying for expensive treatments out of pocket. This adds to the cost of hyperhidrosis treatments, and makes it harder for families to cope. Botox injections work by blocking acetylcholine from entering nerve terminals inside sweat glands which, in turn, reduces sweating. A major drawback is the pain associated with botox injection treatments, especially for children who may find treatment traumatic. Anesthetics are commonly used but these carry their own risk factors. There have not been enough studies to demonstrate whether this is a safe treatment option for pediatric patients. It has been used to treat some adolescents who had severe hyperhidrosis with success but there are some serious possible side effects. These can include the systemic effects of botulinum toxin including muscle weakness, incontinence, blurred vision, various other symptoms and death. This can occur in adults but is riskier for children. It may be an effective treatment for children in the future but more research needs to be done before it can be deemed safe for younger patients, especially smaller children.[1]

Surgical Treatment Options

There are various surgical treatment options available to those with hyperhidrosis including liposuction, VASER ultrasound and endoscopic thoracic sympathectomy. Liposuction is a type of local permanent procedure for axillary hyperhidrosis used to remove sweat glands from the armpit of patients and this creates a reduction in sweat. It has been effective in adult patients but there has been little to no study on the procedure in children at this point. VASER ultrasound is a minimally invasive surgical procedure that shows promise for the future, but it has not been studied in a pediatric population and is not currently FDA approved for the treatment of hyperhidrosis in adults or children. A surgical treatment for primary focal hyperhidrosis called endoscopic thoracic sympathectomy (ETS) currently shows the most promise for children with severe hyperhidrosis. It is an invasive procedure with likely potential complications but it does have a high success rate in treating axillary and palmar hyperhidrosis. The most common, and distressing, side effect of ETS is called compensatory sweating, in which a patient develops sweating on other parts of the body after the initial problem area is treated. However, it has been suggested that children recover better from this type of procedure than adults and that even if they are affected by compensatory sweating it is generally less severe. There have been studies of ETS on children and it has a very high success rate and does provide permanent relief, especially for palmar sweating.[3] It has a low mortality rate but there is a significant risk of compensatory sweating which can be as bad as the original issue. It is an option to consider if a child is severely impacted by the symptoms of hyperhidrosis but should only be reserved for extreme cases. More studies need to be done on the long-term outcomes of pediatric patients who receive this surgery. Children should not undergo endoscopic lumbar sympathectomy, a procedure used to treat plantar hyperhidrosis, as the potential side effects are serious and lifelong[1]

If a child is suffering from hyperhidrosis then parents should to talk to their doctor and explore the potential medical treatments for their condition. Depending on each child’s individual case a doctor can properly assess their condition and help to build a specific treatment plan for that child. It is always important to weigh the benefits and risks of a medical procedure before deciding to proceed.

Sources
  1. Pariser, D. M. (2014). Hyperhidrosis (4th ed., Vol. 32). Philadelphia, PA: Elsevier.
  2. Chang, M. W. (2015). I Wanna Hold Your Hand: Oxybutynin for Palmar/Plantar Hyperhidrosis in Children. NEJM Journal Watch. Dermatology. doi::10.1056/nejm-jw.NA36907
  3. Shalaby, M. S., El-Shafee •, E., Safoury, H., & Hay, S. A. (2012). Thoracoscopic excision of the sympathetic chain: An easy and effective treatment for hyperhidrosis in children. Pediatr Surg Int,28, 245-248. doi:10.1007/s00383-011-2984-3
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Antiperspirant

What You Need to Know About Carpe Clinical Regimen

By Katie Crissman /

One of the newest clinical strength antiperspirants to hit the market is Carpe’s Clinical Grade Regimen - it combines several high performing products with a specific care routine to provide long term sweat reduction for even the heaviest sweaters. Read on to see if Carpe Clinical Regimen is right for you!

Antiperspirant is great - for most people. You apply it once a day and it stops your sweat! It’s easy. But, what if that’s not what happened? You bought it, read the label, and used it exactly as directed and, unfortunately, you’re still sweating - excessively. If this is you, then you’ve come to the right place. There are products specifically made for heavy sweaters who haven’t had luck with traditional antiperspirants. These products typically include the words “extra strength”, “clinical strength” or “prescription strength” and they are, thankfully, available over the counter without a doctor’s prescription. 


The difference between clinical strength products and their weaker counterparts are the active ingredients they use. Clinical strength lines typically use one of several newer types of metallic salt ingredients that are known to be both stronger and less irritating than aluminum chloride (which is the standard active ingredient in antiperspirants) [1]. While there are many clinical strength products on the market, we are going to focus on a new clinical strength regimen that combines a strong active ingredient with a specific care routine to get excessive sweating under control. 


Carpe Clinical Regimen -  What It Is and How It’s Different

One of the newest clinical strength antiperspirants to hit the market is Carpe’s Clinical Grade Regimen. It’s different from other prescription grade products because it combines several strong products with a specific care routine to ensure maximum product performance. It’s also different from Carpe’s other products because it uses a stronger active ingredient and delivery system. The system is geared toward people who experience intractable armpit sweating, but Carpe also makes products for people who struggle with other types of sweat. The Carpe Clinical Grade Underarm includes three specific products that, when used together, have been found to be highly effective at reducing sweat production. These products include:

  • Carpe Clinical Grade Underarm Antiperspirant 
  • Carpe Clinical Grade Exfoliating Wash
  • Carpe Clinical Grade Underarm Wipes[2]

Carpe Clinical Grade Regimen uses an active ingredient called Aluminum Zirconium Tetrachlorohydrex GLY (20%) combined with other soothing inactive ingredients to effectively stop sweat in its tracks while reducing skin irritation.[3] Aluminum Zirconium Tetrachlorohydrex is a newer generation metallic salt that stops sweat production and is known to be more effective than other types of active ingredients antiperspirants typically use. One study mentioned in the journal Dermatologic Clinics found that antiperspirants using Aluminum Zirconium Tetrachlorohydrex were, on average, 34% more effective than antiperspirants that used aluminum chloride as an active ingredient.[1] Carpe’s traditional products use an active ingredient called Aluminum Sesquichlorohydrate at 15% which is effective, but less potent than Aluminum Zirconium Tetrachlorohydrex.[4]


It’s important to note that Carpe’s Clinical Grade Regimen provides a long term impact on sweat reduction from making short term lifestyle changes. This is because the results build up over time and peak at about 4 weeks. It takes 4 weeks of using the Carpe clinical grade products once each morning and every other night to see the full effect of what they can do. This is typical of all antiperspirants as their effects tend to build up with consistent use. Consistently using antiperspirant products is especially important for those with hard to treat sweat problems because it can be the difference between treatment success or failure.[1][2] 


If you’re frustrated with the way your current antiperspirant is working or how it isn’t working, then consider giving Carpe’s Clinical Grade Regimen a try! It’s active ingredient is comparable to other prescription strength products on the market but it’s multistep system with easy to use wipes is completely unique! Remember, an easy to use, consistent antiperspirant routine is going to give you long term sweat reduction so it’s important to find a system that works for your lifestyle. 


Sources
  1. Pariser, D. M. (2014). Hyperhidrosis (4th ed., Vol. 32). Amsterdam: Elsevier Pub. Co., 2014. Retrieved from https://www.elsevier.com/books/hyperhidrosis-an-issue-of-dermatologic-clinics/pariser/978-0-323-32607-0>https://www.elsevier.com/books/hyperhidrosis-an-issue-of-dermatologic-clinics/pariser/978-0-323-32607-0
  2. How It Works (Clinical). Carpe. https://mycarpe.com/pages/how-it-works-clinical
  3. Clinical Underarm  PM Wipes. Carpe. https://mycarpe.com/products/clinical-grade-underarm-antiperspirant-wipes?variant=34814174724229
  4. Underarm Antiperspirant for Excessive Underarm Sweating. Carpe. https://mycarpe.com/products/underarm-antiperspirant-tube?variant=39247505358981
Body Areas Affected by Hyperhidrosis

9 Outrageous Things People Try to Avoid Excessive Armpit Sweating

By Daniel McCarthy /

9 Outrageous Things People Try to Avoid Excessive Armpit Sweating


On my first day of work a few years ago, I got dressed to impress and walked the 20 minutes to my new office to meet my new colleagues for the first time. Having just moved to the southern US, I’d been getting used to the unbearable humidity and its effects on my excessive armpit sweating. Luckily (I thought), the sun wasn’t out and the temps dropped below 80, so maybe my sweat glands wouldn’t take center stage! Well...I arrived to meet my colleagues looking like a wet bass in business clothes. Thank goodness I arrived 15 minutes early, which brings me to the first outrageous thing people try to avoid armpit sweating. 

  1. The Hand Dryer 

I anxiously scurried to the nearest bathroom, declothed, and put the hand dryer to good use on my shirt stains and sweat stains. More outrageously, I awkwardly hovered my sweaty extremities (including my sweaty underarms) over the hand dryer. Thankfully, I reapplied my antiperspirant and headed out to meet my colleagues a decently dry man. That was the day I knew I really needed clinical strength antiperspirant for my excessive armpit sweating (and a car). 


  1. Pantyliners


Many with excessive underarm sweating already know that underarm pads are one way to help with sweating armpits. But if you find yourself sans pad and worried about your excessive armpit sweating, you would not be the first person to try pantyliners. That’s right, pantyliners have been used in a pinch to help keep sweat stains at bay. 

  1. Give a shirt

In 2019, a reddit user posted that to combat his excessive armpit sweating, he skipped the typical clothing and made his own shirt. He posted asking others to try out his creation and received over 250 replies! By creating and giving others shirts, this innovative reddit user designed his way into the hearts of many with smelly armpits. 

  1. Get inked

If you’ve been debating whether to get a tasteful tattoo and you have hyperhidrosis, this finding may just help you make your decision. A 2017 study found that getting inked helped reduce sweat [1]! Now, I don’t recommend choosing a tattoo as a means of treatment for excessive armpit sweating (and maybe don’t tattoo your armpit), but the connection is a fun little fact nonetheless. 

  1. Become a naked mole rat

If you can’t pull the trigger on an armpit tattoo, another method some people have tried is hair removal. Yes, like Steve Carrell (who actually has hyperhidrosis himself) in the hit movie 40-year Old Virgin, removing hair can help reduce sweat buildup for you too. Many likely already “naturally” lose hair thanks to some sweat prevention products, but more natural hair removal may just be the trick to solving excessive sweating

  1. Armpit art

Even though we know most sweaty armpit causes, like too much caffeine or spicy foods, it’s no fun to cut these out completely. A more outrageous approach to excessive underarm sweating is actually turning sweating armpits into art. Multiple users of the Reddit community r/Hyperhidrosis have created shirts, sweatshirts, and other clothing that includes beautiful tie-dye in the armpits. Creative, fun, and beautiful, and even better when combined with sweat prevention like antiperspirant or carpe underarm

  1. Vinegar your armpit

You may already know how to get rid of pit stains with vinegar, but there are other interesting ways it can help with excessive armpit sweating. Splashing vinegar on your sweaty underarms  is one method many recommend. Those that swear by this method also recommend using deodorant or antiperspirant, too. 

While we don’t know how this was discovered, I like to think someone accidentally splashed vinegar on their pits hundreds of years ago and voila! Too bad the first person to splash his pits with vinegar didn’t also have access to the best antiperspirant for his excessive armpit sweating. 

  1. Baking soda your sweaty underarms

If you find deodorant or antiperspirant irritating, one creative way to help alleviate your excessive underarm sweating is baking soda. Many crafty people with hyperhidrosis swear that not only can baking soda help reduce sweat, but it can also help alleviate pesky underarm smell with some of the best sweat prevention. 

  1. Restart the plaid fad

Black t-shirt, black sweatshirt, black button down, black tank top. If this sounds like your closet, you’re clearly an expert on the hyperhidrosis wardrobe. But if you want some variety as you fight excessive armpit sweating, add some plaid, a trick many with hyperhidrosis use that you may not know. Hey, you just may be starting the resurgence of the plaid fad, and at worst, you’ll add some fun, lumberjack variety to your dark closet. 


Sources: 

[1] Luetkemeier, M. J., Hanisko, J. M., & Aho, K. M. (2017). Skin Tattoos Alter Sweat Rate and Na+ Concentration. Medicine and science in sports and exercise, 49(7), 1432–1436. https://doi.org/10.1249/MSS.0000000000001244
Body Areas Affected by Hyperhidrosis

How to Cure Sweaty Hands Permanently at Home

By Daniel McCarthy /

How to Cure Sweaty Hands Permanently at Home 

Scenario 1: You’re invited into the office, confident you will land the job. You’ve prepared, you’re highly qualified, you have absolutely nothing to worry about. You walk in and confidently reach out to shake the CEOs hand. But then, your confidence turns to dread as the CEO pulls her hand back, wet with your sweat. 

Scenario 2: You’re at home, playing video games with your friends and absolutely dominating. They get so upset, they tell you to take a break to let another friend play. But there’s another problem... nobody wants to use your controller after you finish. Despite your domination, your palmar hyperhidrosis (excessively sweaty hands) has taken center stage. 

Do these scenarios sound familiar? Wondering how to cure sweaty hands permanently? Although you may not have had these exact things happen to you, your sweaty hands likely have caused something similar and you’re looking for a home remedy. To stop sweating these situations, let’s talk about how to cure sweaty hands permanently at home. 

One of the best ways to cure sweaty hands at home is actually not related to the hands at all. Instead, working on reducing anxiety can have immensely positive results on how to cure sweaty hands permanently naturally. There are many root causes of anxiety, and some or many may be related to your hyperhidrosis. Likewise, it is easier said than done to reduce anxiety. But there are also many ways to work on reducing anxiety that are worth a try. One interesting way to reduce anxiety, and in turn, sweaty hands, is to be grateful. Specifically, Petrocchi and Couyoumdjian found that “grateful people experience less anxiety mostly because they are able to encourage and be compassionate and reassuring toward themselves when things go wrong in life” [1]. Other ways include stepping outside for a walk, drinking tea, or even distracting yourself. In general, starting with anxiety reduction not only can help with how to cure sweaty hands, but also your wellbeing in general. 

Another great way to cure sweaty hands at home permanently is to reduce consumption of coffee and alcohol. Now you may be reading this and thinking “Hey, those are all my favorite things! I’m done with this article!”. And while I wholeheartedly agree and enjoy coffee and alcohol myself, consumption in moderation is key, especially with hyperhidrosis. Caffeine, for example, activates part of the brain that is already a main part in causing hyperhidrosis symptoms. Instead of giving it up, try to reduce consumption to under 200 mg or add in decaf to your routine. Alcohol can affect hyperhidrosis in a similar manner, but like coffee, 1-2 glasses of alcohol may be okay. When figuring out how to cure sweaty hands permanently naturally, it is important to find a balance of coffee, alcohol, and managing your hyperhidrosis. And remember to always drink responsibly, in moderation. 

Tackling how to cure sweaty hands permanently, naturally, and at home may require more than behavioral changes we’ve talked about so far. Luckily, there are other great remedies you can try at home! First, finding the right antiperspirant is of paramount importance, especially appropriate antiperspirant for hands. Another possible over the counter option is anti-sweat wipes. If neither of these work for you, another option to cure your sweaty hands permanently is to buy your very own iontophoresis machine for at-home use. This machine delivers mild electrical currents to your hands (or other affected body part) while submerged in water. A combination of these treatments may have your hands feeling less clammy in no time! 

Ultimately, your palmar hyperhidrosis may not be treatable at home and permanently, but these recommendations may help alleviate some of your symptoms. If symptoms persist, consult a medical professional for further assistance with how to cure sweaty hands. 



Sources

Sources

1. Nicola Petrocchi & Alessandro Couyoumdjian (2016) The impact of gratitude on depression and anxiety: the mediating role of criticizing, attacking, and reassuring the self, Self and Identity, 15:2, 191-205, DOI: 10.1080/15298868.2015.1095794

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