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.
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).
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.
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.
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 ! 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.
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.
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.
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.
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.
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: 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
Epidermolysis Bullosa (EB) refers to a group of diseases most associated with blistering due to fragile skin. The four main types of EB are: epidermolysis bullosa simplex (EBS), dystrophic epidermolysis bullosa (DEB), junctional epidermolysis bullosa (JEB), and Kindler . To care for the symptoms of EB, researchers have identified many therapies, but there is currently no cure. Prevention has also proven evasive as “most types of epidermolysis are inherited”. Ultimately, diagnosis and treatment form the foundation for EB management.
Symptoms and Diagnosis
There are a range of symptoms associated with EB. The Mayo Clinic lists these symptoms as one, or many, of the following:
- Fragile skin that blisters easily, especially on the hands and feet
- Nails that are thick or don't form
- Blisters inside the mouth and throat
- Thickened skin on the palms and soles of the feet
- Scalp blistering, scarring and hair loss (scarring alopecia)
- Thin-appearing skin (atrophic scarring)
- Tiny white skin bumps or pimples (milia)
- Dental problems, such as tooth decay from poorly formed enamel
- Difficulty swallowing (dysphagia)
- Itchy, painful skin
Diagnosis of EB can occur when a medical professional identifies or is made aware of one or many of the above symptoms. Also, because EB is often genetic, a medical professional may preemptively test for this skin condition. To confirm whether a patient has EB, a medical professional will most often conduct a skin biopsy, genetic testing via a blood sample, or even prenatal testing. Early diagnosis of EB can be especially important for infants who may suffer from extreme pain and potentially fatal blistering, which requires immediate, proper care . In general, appropriately caring for EB symptoms is crucial for patient health and wellbeing.
To properly manage EB symptoms, medical professionals emphasize proper skin protection and wound care by changing bandages often and using non-adhesive bandages to avoid further damage. If the skin does become infected (e.g. infected blisters), doctors will prescribe oral or topical antibiotics.
If effects on the skin or air pathways are more severe, there may be long-term effects, such as motion limitations to affected areas or even scarring of the esophagus. Occupational and physical therapy can help improve range of motion issues, while surgery may be needed in the most severe cases.
Current treatments detailed above outline EB management, but there is hope for improved outcomes based on current research. Specifically, clinical trials focused on “stem cell transplantation, protein replacements, gene therapies, and various wound care therapies show progress”. Until more treatments are found, EB is best managed through a combination of these existing patient-specific symptom treatments.
- The Dystrophic Epidermolysis Bullosa Research Association of America. (n.d.). About EB. Retrieved December 9, 2020, from https://www.debra.org/about-eb/
- Boesen, M. L., Bygum, A., Hertz, J. M., & Zachariassen, G. (2016). Newborn with severe epidermolysis bullosa: to treat or not to treat?. BMJ case reports, 2016, bcr2016214727. https://doi.org/10.1136/bcr-2016-214727
8 Random & Interesting Facts about Excessive Armpit Sweating
Our worries about shirt stains, sweaty underarms, and smelly armpits may dominate how we think about excessive armpit sweating. Hey, we may even avoid thinking about these all together. But guess what? There are some random and interesting facts that just may change how you think about excessive underarm sweating! Let’s take a look:
Fact number 1: Sweat by itself ISN’T smelly
Sweat is often associated with smelliness. But by itself, it doesn’t smell AT ALL. The reason sweat can smell (in places like your armpit) isn’t really about sweat. It’s about the sweat glands (and hair)! Apocrine glands are the biggest of sweat-producing glands and are usually located near hair. It’s this combo that leads to smelly armpits.
Fact number 2: Excessive armpit sweating is as old as cavemen
Hang with me here. Excessive underarm sweating is connected to the fight-or-flight response ingrained in even the most ancient of human predecessors. This excessive armpit sweating response has helped humans survive for millenia. And yep, it means our cavemen ancestors likely had sweating armpits, too. Even though they didn’t have to worry about shirt stains like us, we have the benefit of products like carpe underarm and antiperspirant in general to help with our excessive armpit sweating.
Fact number 3: Famous people worry about excessive armpit sweating too
Michael Gary Scott, fearless and deliciously cringeworthy leader of Dunder Mifflin Scranton on the show The Office, is perfectly played by actor Steve Carell. Carell seemed to play the role with such ease, comfort, and confidence that nobody would ever know he was worried about excessive underarm sweating due to his hyperhidrosis. Co-star Rainn Wilson (Dwight Schrute on the show) even pointed out that the set temperature was a cool 64 degrees to keep Carell’s sweaty underarms from becoming the focus of the scene.
Even though Carell’s excessive armpit sweating wasn’t part of the show, I like to think Michael’s approach to sweat stains could be summed up by his famous line: “I knew exactly what to do. But in a much more real sense, I had no idea what to do.”
Fact number 4: Other celebrities combat hyperhidrosis too
Steve Carell is not the only notable person looking for the best sweat prevention. As a longtime vampire and real-life human with hyperhidrosis, Robert Pattinson is another actor who combats hyperhidrosis (and werewolves) on the regular.
Like Pattinson and Carell, Halle Berry also has hyperhidrosis. Famously, Berry confidently showed her sweat stains on the Ellen Show back in 2010. So when you’re feeling a little self-conscious about your own excessive underarm sweating, remember you too can confidently move through your day like Berry barring her pits for the world.
Fact number 5: Ventilation over here please!
If you’re still worried about how to get rid of pit stains, some ventilation could provide a brief respite. Because we sometimes get pesky pit stains, it can feel like our excessive underarm sweating is due to our pits proclivity to produce the most amount of sweat. Yet, this annoying issue is more commonly attributed to a lack of ventilation, although sweaty armpit causes cannot be narrowed to one thing. Still, a little ventilation and clinical strength antiperspirant can go a long way in dealing with pesky pit stains and excessive armpit sweating.
Fact number 6: An underappreciated aspect of a non-meat diet
Sometimes even the best antiperspirant and deodorant may not feel like enough to help with excessive armpit sweating and underarm smell. That’s okay though because there are other interesting ways to approach this issue. A 2006 study showed that women found mens’ armpit odor “more attractive, more pleasant, and less intense” when these men ate a non-meat diet . If you haven’t already thought about eating less meat, the improved aroma of your pits (and the kitchen) may be another reason to eat a non-meat diet.
Fact number 7: Fashion matters
Choosing clothes is a fashion statement for many. And while fashion may matter more to some than others, there’s one interesting reason we can all get behind to choose our clothes. Our clothing choices can help deal with excessive underarm sweating. That’s right, there are clothes, materials, styles, and pads that all can help with excessive armpit sweating as well as excessive sweating and shirt stains in general.
Fact number 8: You aren’t alone
An estimated 2-3% of the US population suffers from axillary hyperhidrosis (excessive underarm sweating). Even though this percentage may seem small, 3% of the US population is right around 10 million people. That’s like all of NYC combating excessive armpit sweating at the same time. It can be easy to feel isolated in dealing with hyperhidrosis, but there’s some comfort in knowing many others are dealing with the same worries.
- Havlicek, J., & Lenochova, P. (2006). The Effect of Meat Consumption on Body Odor Attractiveness. Retrieved from https://academic.oup.com/chemse/article/31/8/747/364338
7 Effective Tips to Stop Sweaty Hands
Not sure how to stop sweaty hands and excessive sweating? You aren’t alone! Whether you’re working from home, gaming, or just trying to get your phone to recognize your thumbprint, it can get pretty dang annoying to constantly worry about how to stop having sweaty hands. In this article, we’ll cover 7 effective ways to help you stop sweaty hands:
- Reduce your stress
- Try (the right) antiperspirant
- Check with your doctor about underlying conditions
- Give a Botox shot
- Take a more surgical approach
1. Reduce your stress
This one is often easier said than done - but it can help a lot. Research has shown that higher levels of anxiety cause sweat glands to become more active . This is particularly true for hand sweating.
Figuring out how to stop sweaty hands looks different for each person, but there are some relaxing activities that can either prevent sweat or help control it once it’s begun. Some possible activities to reduce your stress include listening to your favorite music, getting enough sleep, and exercising daily. Other helpful techniques include deep breathing and stretching. Everyone is different, so try some of these other tips to find what works best for you.
2. Try (the right) antiperspirant
You’re relaxed, but maybe you’re still trying to work out how to stop having sweaty hands? While reducing stress is a beneficial home remedy, it should be combined with other easy-to-use remedies. Some home remedies, such as baking soda or apple cider vinegar, may help with hyperhidrosis, but the next best step is over-the-counter antiperspirant.
Antiperspirants are great at preventing clam hands and often work better than deodorants to stop excessive sweating. Antiperspirants for hands are especially important in how to stop sweaty hands. Others prefer anti sweat wipes. Finding the right hand antiperspirant is an important step to combat sweaty hands.
Hate needles? Need to figure out how to stop sweaty hands? Iontophoresis may be for you. This method uses mild electrical currents to treat your hands while they’re submerged in water. And although iontophoresis sessions may be performed at a doctor’s office, some people choose to purchase their own iontophoresis machines for at-home treatment .
While this method can be a bit harder on the wallet, if you can pay upfront for a machine, you may save by avoiding paying for every visit to the doctors. However, if you don’t see progress after a few weeks, talk to your doctor to discuss how to stop your sweaty hands from affecting your daily life.
4. Check with your doctor about underlying conditions
It can be easy to write off sweaty hands as a reaction to anxiety or nervousness. But sometimes sweaty hands can be caused by underlying conditions. These conditions might include diabetes, low blood sugar, overactive thyroid, infections, and other issues. To learn more on how to stop sweaty hands that may be connected to underlying conditions, it is best to talk to a medical professional about your hyperhidrosis needs.
In addition to talking about your underlying conditions, a medical professional may also suggest a prescription to help with sweaty hands. More specifically, your dermatologist may prescribe an oral medication for hyperhidrosis like a series of pills known as anticholinergics, which help your body produce less sweat. Like pills, topical creams may also be prescribed to help reduce excessive sweating. These creams are made up of solutions that will decrease the amount of sweat released, including hand sweat. If medications don’t cut it for you, you may need to take one of the two steps below.
6. Give botox a shot
You may be thinking, I’m not sure how to stop sweaty hands, so why are you recommending botox? While many may not associate botox with hyperhidrosis, it can significantly reduce excessive sweating, including in your hands  . While botox may solve how to stop having sweaty hands, this method can cause temporary pain or weakness of the hands, so it is crucial that you consult a medical professional for appropriate botox delivery.
7. Take a more surgical approach. This one is only for serious sweaters who have tried everything else.
If you can’t figure out how to stop having sweaty hands after trying these first six tips, you might consider surgical treatment for primary focal hyperhidrosis. While botox is a less invasive surgery, significantly more invasive procedures include endoscopic thoracic sympathectomy or an endoscopic lumbar sympathectomy. These names may be hard to pronounce, but these surgeries can provide significant relief for people with certain kinds of severe hyperhidrosis. Of course, try less invasive options first, and talk to a medical professional before deciding to take a more surgical approach.
- Huddle, J. R. (2014). Hyperhidrosis: Causes, Treatment Options and Outcomes. New York, NY: Nova Science.
- Pariser, D. M. (2014). Hyperhidrosis (4th ed., Vol. 32). Amsterdam: Elsevier Pub. Co., 2014. Retrieved from <a href=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</a>
- Lakraj, A. A., Moghimi, N., & Jabbari, B. (2013). Hyperhidrosis: anatomy, pathophysiology and treatment with emphasis on the role of botulinum toxins. Toxins, 5(4), 821–840. https://doi.org/10.3390/toxins5040821
What Is Hyperhidrosis?
Hyperhidrosis, or excessive sweating, is characterized by sweat that is produced in excess of what is necessary for thermoregulation (the ability to maintain a healthy temperature). Sweating is a perfectly natural and necessary function the body uses to cool itself down. However, if you have hyperhidrosis, you’ll start sweating even when your body isn’t overheating. Sweating that has no apparent cause is known to doctors as diaphoresis.
If you have hyperhidrosis, you can experience sweating on several parts of the body, including in the hands, underarms, face, scalp, and feet. Some people even experience excessive groin sweat and sweating under the breasts. The type of hyperhidrosis you have will determine whether you experience sweating all over your body or if it is just in specific areas. Some people with hyperhidrosis sweat in several different areas simultaneously, while others only experience excessive sweating at one location - it is a highly individualized condition. Hands, feet, and underarms are the parts of the body that are most likely to be affected by hyperhidrosis.
People who suffer from hyperhidrosis have the same number and size of sweat glands as people who don’t have the condition. Their sweat glands are just overactive, compared to what they would normally be.
What Are the Symptoms of Hyperhidrosis?
If you’re wondering how to tell whether you have hyperhidrosis , here is a checklist of symptoms for you to review.
- Noticeable sweat:Even when you’re sitting down and taking it easy, you’ll notice your clothes are wet. On your bare skin, you’ll often see beads of sweat.
- You leave a trail in your wake:You might not just see sweat on your clothes and skin. You might be transferring it to everything you touch, including door knobs, keyboards, and papers that you touch.
- Your skin is white and peeling:You might notice white and peeling skin from the constant moisture.
- You have skin infections:Skin infections can happen to people who don’t have hyperhidrosis. However, if you have repeated skin infections due to constant moisture, like athlete’s foot, you might suspect hyperhidrosis.
Different dermatologists characterize hyperhidrosis in various ways. What’s important is the fact that if you are uncomfortable with the level of sweat that your body produces (wherever it’s being produced), there are solutions that are available. You have access to over-the-counter topical treatments, prescription options, and medical procedures that can help. If you are interested in medical solutions, you can book an appointment with your dermatologist and learn how to manage hyperhidrosis with a dermatologist.
Now that we’ve answered the question “what is hyperhidrosis?”, It’s important to understand the different types of hyperhidrosis. The approaches used to understand and treat hyperhidrosis are very different depending on the type you have.
The Two Main Types of Hyperhidrosis
There are two main types of hyperhidrosis. There are a few other types that are much less common, but the vast majority of people will either have primary focal hyperhidrosis or secondary generalized hyperhidrosis. Let’s look at each type of hyperhidrosis and what they entail.
Primary Focal Hyperhidrosis
Primary Focal Hyperhidrosis (PFH) is by far the most common type, affecting up to 90 percent of people who have hyperhidrosis. The cause is not well understood, but it is thought to have a genetic component.
People with primary focal hyperhidrosis only sweat in particular areas like the hands, feet, armpits, face, and groin. Sweat will occur on both sides of the body in the same place. For example, if someone has one sweaty hand it is likely their other hand will also be sweaty. Additionally, the sweat will usually occur in more than one area — one common problem with PFH is that the sweating occurs on hands and feet simultaneously. It can also affect other body parts individually or simultaneously, it just depends on a person’s specific situation.
Symptoms usually begin in childhood or adolescence and tend to last for a person’s entire lifetime. There is evidence that primary focal hyperhidrosis is hereditary, meaning it has a genetic component and often runs in families.
Secondary Generalized Hyperhidrosis
While primary focal hyperhidrosis appears to be something you’re born with,secondary generalized hyperhidrosis (SGH) is a condition that shows up during adulthood. Think of SGH as an uninvited guest who arrives on your doorstep with no warning. Unfortunately, it may be a little harder to get rid of than an uninvited guest.
You might suddenly wonder why you’ve been so sweaty lately. And you’d be right to wonder, because this type of hyperhidrosis can point to an underlying problem.
When someone has secondary hyperhidrosis the biggest problem isn’t the hyperhidrosis – it’s the disease or condition that might be causing it. That’s why it’s known as secondary hyperhidrosis. The true cause may be a medical condition and the symptom of that condition is hyperhidrosis.
Before you panic that you’re suffering from a mysterious disease, keep in mind the source of this type of hyperhidrosis can also be a medication. Many common medications can cause hyperhidrosis as a side effect.
Unlike primary focal hyperhidrosis, the sweating from secondary hyperhidrosis tends to occur all over the body. This is a telltale sign of the condition.
Unlike primary hyperhidrosis, this condition doesn’t have to be permanent. If the instigating condition is found and treated, it can fix the hyperhidrosis. It may take a little work, but you CAN kick this guest off your porch.
If you are concerned that your hyperhidrosis might have an underlying cause, schedule an appointment to talk to your doctor and find out.
The Impact of Hyperhidrosis
While hyperhidrosis isn’t particularly dangerous physically, it can be embarrassing for those who suffer from it. It won’t just give you clammy skin – the sweat can literally drip off. That can cause a great deal of anxiety for those who experience it.
Shaking hands can become a nightmare because you may be so self-conscious about how sweaty your palms are. Your socks can become wet even if you don’t do any exercise. It can make basic human experiences extremely stressful.
Unfortunately, hyperhidrosis is more serious than just uncomfortable sweating. Up to a third of people who deal with excessive sweating from hyperhidrosis say that they are constantly bothered by their sweating. One study done in the US found that 75% of respondents reported that hyperhidrosis negatively impacted their social, emotional, and mental health. That’s a lot of people who are suffering! Due to these issues, hyperhidrosis and anxiety often go hand in hand. Many people find it helpful to utilize anxiety reduction methods that are known to lessen excessive sweating.
Hyperhidrosis is hard for adults to deal with, so it is especially important to find help for kids with hyperhidrosis.
Some people refer to hyperhidrosis as a silent handicap because of the impact it has upon the lives of those who live with it. It can deeply impact their confidence and hyperhidrosis can even keep people from doing the things they love most.
Is Hyperhidrosis Common?
It is thought that about 3% of the US population struggles with hyperhidrosis. In other countries the percentage of the population that has it is even higher. Other sources have stated that up to 5% of the population might even have it! This means that hyperhidrosis is a very common issue.
While most doctor’s offices are familiar with managing hyperhidrosis, they generally don’t see a lot of patients who suffer from it. However, because hyperhidrosis is such an embarrassing and overlooked condition, many individuals avoid reporting the issue to their doctor. This means that the number of people who have hyperhidrosis might even be higher than we currently think.
Those with family members who have this ailment are more likely to get it – making it an inherited condition. If you have a family member teased for their sweaty hands constantly, there could be a chance they have hyperhidrosis. 
What Causes Hyperhidrosis?
Doctors don’t truly understand what causes primary focal hyperhidrosis yet. One theory is that particular nerves that control the amount of sweat overreact or malfunction. That malfunction can cause the excessive sweating that can be life-changing for those who suffer from it.
Since hyperhidrosis affects so many people, researchers are now shifting into full gear to discover the causes of excessive sweating so they can develop better treatments. Future treatments and research for hyperhidrosis are being developed more rapidly than ever before.
What Conditions Can Cause Secondary Generalized Hyperhidrosis?
Many diseases and medical conditions can cause hyperhidrosis. However, just because you have one of the conditions listed below this paragraph doesn’t mean you’ll develop hyperhidrosis.
Here are some of the more common conditions that may be causing the hyperhidrosis you have developed as an adult.
- A febrile illness
- Heart failure
- Alcoholism - Alcohol can cause excessive sweating when someone is intoxicated, withdrawing, or in someone with an intolerance.
- Lymphoma and some other cancers and tumors.
- Parkinson’s disease
- Rheumatoid arthritis
There are also several types of common medications that cause hyperhidrosis as a side effect. So, if you are on medication and you begin experiencing new or increased amounts of sweating mention it to your doctor. Some of these medications include antidepressants, painkillers, blood pressure medications and many others.a 
If you think you might have secondary generalized hyperhidrosis it is very important that you speak to a doctor. Many of the things that cause it can be resolved, and it could be a sign of a more serious problem. Don’t panic, but it is wise to look into the reason you are sweating more.
What Are the Treatments for Primary Focal Hyperhidrosis?
If you are diagnosed with primary focal hyperhidrosis, there are many things you can do.These are the existing treatments for hyperhidrosis, but new treatments are currently being explored by scientists:
- Antiperspirants:There are many over-the-counter antiperspirants that can be very useful when trying to curb sweat. If a regular antiperspirant isn’t cutting it for you, ask your doctor to write a prescription for a stronger one. You can apply antiperspirant to places other than just your underarms. Use it on your hands, hairline, or feet as well. There are even antiperspirants for the face and groin that are made specifically for sensitive areas.
- An Iontophoresis machine:This medical device sends low-voltage currents into a pan of water where your hands or feet are sitting. The electricity can lessen the activity of your sweat glands, at least for a while. However, it can take up to 10 sessions with the iontophoresis machine to deactivate your sweat glands. You may need to use this machine up to three times a week in the beginning and one treatment can take up to 40 minutes. Although iontophoresis as a treatment for palmar and plantar hyperhidrosis may give your hands and feet a much needed break, the iontophoresis machine is anything but convenient. Iontophoresis really does work, but patients have to be willing to keep up with a regular treatment regimen for it to work successfully.
- Botox:If other treatments aren’t enough in your, you might need Botox injections. Botox can be particularly useful for axillary hyperhidrosis, but botox can also be a treatment for palmar and plantar hyperhidrosis. Botox can provide up to 6 months of reduced sweating. If you’re going to pursue this route, you should look for someone who is experienced at doing Botox injections in the underarms to ensure the right area is targeted.
- Anticholinergics:A few oral medications can for hyperhidrosis can reduce the amount of sweat you produce by stopping your sweat glands from working. Most commonly patients are prescribed anticholinergics like glycopyrrolate or oxybutynin as a treatment for hyperhidrosis. These medications also have several side effects, including heart palpitations, blurry vision, and dry mouth.
- ETS Surgery:An endoscopic thoracic sympathectomy (ETS) is a surgical treatment for primary focal hyperhidrosis. It is an operation where an individual actually has the nerve endings that transfer sensory information to the sweat glands destroyed. Since no known successful reversal of an ETS surgery has ever been recorded, this option isn’t usually on the table unless the other treatments have failed. As with any surgery, it can be risky. There is also a type of surgery called an endoscopic lumbar sympathectomy which is used to treat plantar hyperhidrosis, but this surgery can be very dangerous and is almost never recommended.
Undoubtedly, hyperhidrosis can be a hard condition to cope with. Until recently, the lack of research into hyperhidrosis had made hyperhidrosis difficult to manage. Thankfully, however, new treatments and awareness has made hyperhidrosis much easier to handle. Keep trying treatments until you find what works for you and remember that you are not alone in suffering with this condition. It’s just a matter of figuring out what you can do to control your sweat instead of your sweat controlling you!
- MedicineNet Medical Journal. (2016, May 13). Definition of Hyperhidrosis. Retrieved May 14, 2018, from https://www.medicinenet.com/script/main/art.asp?articlekey=16272
- Diaphoresis: What causes excessive sweating? (n.d.). Retrieved May 20, 2020, from https://www.medicalnewstoday.com/articles/321663#overview
- 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
- Lenefsky, M., & Rice, Z. P. (2018). Hyperhidrosis and Its Impact on Those Living With It. AJMC. Retrieved from https://www.ajmc.com/journals/supplement/2018/hyperhidrosis-managed-markets-update-treatments/hyperhidrosis-and-its-impact--on-those-living-with-it
Nordqvist, C. (2017, December 21). Hyperhidrosis: Symptoms, causes, diagnosis, and treatment. Retrieved May 14, 2018, from https://www.medicalnewstoday.com/articles/182130.php
Doolittle, James, et al. “Hyperhidrosis: an Update on Prevalence and Severity in the United States.” Archives of Dermatological Research, vol. 308, no. 10, 2016, pp. 743–749., doi:10.1007/s00403-016-1697-9. Retrieved from https://pubmed.ncbi.nlm.nih.gov/27744497/
Huddle, J. R. (2014). Hyperhidrosis: Causes, Treatment Options and Outcomes. New York, NY: Nova Science. Retrieved from https://www.bookdepository.com/Hyperhidrosis-Janine-R-Huddle/9781633215160
Glycopyrrolate and Oxybutynin are both anticholinergic medicines used to treat hyperhidrosis, a skin condition that causes excessive sweating. A patient must be actively managing their hyperhidrosis with a doctor in order to obtain these types of medications, as they are only available by prescription. Both Glycopyrrolate and Oxybutynin are most often used as oral medications to treat hyperhidrosis, although they can be given in other forms. Neither drug is specifically approved by the FDA for use in the treatment of hyperhidrosis, but they are commonly used off-label for this purpose.
Anticholinergics agents comprise a group of medications that work by affecting how the body is able to use the neurotransmitter acetylcholine. Specifically, anticholinergics interrupt acetylcholine from being used at muscarinic receptors throughout the body by binding with it. This action is called competitive inhibition. Muscarinic receptors are located throughout the autonomic nervous system, and spread out over the whole body, which is why anticholinergics are responsible for such widespread effects. The autonomic nervous system is the part of the nervous system that governs involuntary actions, like the movement of smooth muscle, breathing, heart rate, and many other functions. It is also responsible for regulating sweat production, which is why anticholinergic medications can be useful in the treatment of hyperhidrosis.
There are several types of anticholinergics, although most are not used in the treatment of hyperhidrosis. Glycopyrrolate and Oxybutynin are the two most common anticholinergic medications used to treat excessive sweating. Other types of anticholinergic medicines, like scopolamine and atropine, can cross the blood-brain barrier and cause more unwanted neurological side effects than glycopyrrolate. While there are other anticholinergics that can be used to treat hyperhidrosis, they are not available in the United States. The most studied anticholinergic agent, other than glycopyrrolate and oxybutynin, is called methantheline bromide, and it has had some promising results in Germany.
The Specifics of Each Medication
Glycopyrrolate (sold under the brand name Robinul) is one of the anticholinergics used most often in the treatment of hyperhidrosis, although this varies widely between doctors and studies. Patients are usually given glycopyrrolate in pill form and instructed to take 1 to 2 mg twice a day. If needed, patients can increase the dose by 1 mg per day at two-week intervals until the therapeutic dose is reached. The normal dosage range is usually between one and eight mgs per day. Many times patients are limited in the amount of glycopyrrolate they are able to take due to side effects that increase as the dose increases. There are several possible side effects, but the most common is dry mouth. This is because glycopyrrolate dries up bodily secretions, which is beneficial when attempting to reduce sweat production but can lead to aggravating side effects. Glycopyrrolate can also cause dry eyes, constipation, nausea and several other issues. Patients can drink more water, use mints, take eye-drops and increase fiber consumption to fight address side effects. Another limiting factor for the use of glycopyrrolate is its high cost.
The effectiveness of glycopyrrolate is often related to the dose a patient is able to handle. One study on the effectiveness of glycopyrrolate found that out of 19 patients 80% responded to treatment. However, one third of the patients had to stop treatment due to side effects. Other studies have found that the drug is effective in reducing sweating but that side effects often hinder treatment. Glycopyrrolate is often chosen as a second, or third line therapy for hyperhidrosis that causes excessive sweating of the palms, soles, and armpits. It is one of the first line treatments for craniofacial hyperhidrosis. Many times, using glycopyrrolate in conjunction with other therapies increases patient satisfaction.
Oxybutynin (brand name Ditropan) is the other most commonly used anticholinergic used in the treatment of hyperhidrosis. When being used orally to treat hyperhidrosis, oxybutynin is typically prescribed in 5 to 10 mg doses and taken daily. It can be used in amounts of 15 to 20 mgs a day if needed. It is also available as a topical gel, slow-release tablet, and as a transdermal patch. Oxybutynin has similar side effects when compared to glycopyrrolate. However, it is able to penetrate into the central nervous system (CNS) more easily so it can also have some added CNS side effects. These include dry mouth, constipation, somnolence, confusion and other potential effects. Oxybutynin is a relatively inexpensive drug so that can sometimes make it more accessible to patients.
Oxybutynin is found to be effective in treating the symptoms of hyperhidrosis but, like other anticholinergic drugs, it is limited by side effects. One study of 50 patients using oxybutynin to treat palmar and axillary hyperhidrosis found that 70% of patients reported improvements in those areas. Interestingly, 90% of the patients also reported improvement of plantar sweating. Side effects were noted as moderate to severe in 35% of the patients by the six week mark of the study. This indicates that oxybutynin is effective in reducing sweat production, but that, when used orally it can be limited by the side effects it can cause. Another study found that 60% of their patients showed improvement in their quality of life compared to only 27% in the placebo group, when low doses of oxybutynin were given. If patients can find relief at lower doses than this can mitigate the drawbacks caused by side effects.
Local Treatments that Use Glycopyrrolate and Oxybutynin
All oral medications for hyperhidrosis will cause systemic side effects throughout the body because of how they work. This can often make them less desirable treatment options. Sometimes, this is necessary, like in the case of a patient who has generalized all-over sweating instigated by a medication that causes hyperhidrosis as a side effect. However, both glycopyrrolate and oxybutynin are available in other forms that allow them to be used locally. Both drugs are available to be used in conjunction with an iontophoresis machine when being used to treat palmar and plantar hyperhidrosis. The electrical current from the iontophoresis machine aids the skin in absorbing the medications locally. Topical creams are available containing both medications but their effectiveness is currently unclear as the medications may have trouble penetrating the skin barrier in this form. A new product called Qbrexza uses glycopyrrolate on a medicated wipe that can be used once a day to prevent sweating.
Future Uses in the Treatment of Hyperhidrosis
There are various future treatments and research for hyperhidrosis that involve the use of both glycopyrrolate and oxybutynin. The most notable of these future treatments is the use of glycopyrrolate in a topical form which would be able to penetrate into eccrine glands. The cream would contain 1% or 2% glycopyrrolate. Oxybutynin is also being studied and potentially developed into a topical cream. Researchers are also looking into developing a glycopyrrolate pad to relieve sweating symptoms.
Recently, a product called Qbrexza (created by Dermira) was released and it uses Glycopyrronium Tosylate, a topical form of anticholinergic medication, on a wipe to reduce sweating. It is only marketed for underarm use, but it may have interesting implications for the future of hyperhidrosis treatment. For those who are interested in medicated antiperspirant wipes, but who don’t want to deal with prescription medications like Qbrexza, there are now over-the-counter antiperspirant wipes available from brands like Carpe.
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