Hyperhidrosis affects upwards of 3% of the population, making it a very common medical condition. This means that there are many people seeking treatment for their excessive sweating. While there are several effective treatments for people with hyperhidrosis, there are some pitfalls that people need to be aware of. All of the medically recommended treatments for hyperhidrosis have been tested by the medical community but it doesn’t mean that they don’t come with their own risks. For those that suffer from primary focal hyperhidrosis proper treatment can make an immense difference in their quality of life. Here is what people with hyperhidrosis need to watch out for as they figure out which treatments work best for them:
The first line treatment that dermatologists will recommend for hyperhidrosis is the use of antiperspirant. Antiperspirant is a type of topical treatment for hyperhidrosis that prevents skin from producing sweat. It is considered to be a drug by the FDA due to the fact that it changes the function of skin. Most antiperspirants, even powerful ones, can be found over-the-counter and are quite effective at stopping a person from producing excessive sweat. Typically, antiperspirant is used for axillary sweating although it has been used on other parts of the body more frequently as time goes on. One of the most bothersome side effects of antiperspirant is the irritation it can cause. When used on the less sensitive skin of the armpit this is not as big of an issue, but it is a problem when antiperspirant needs to be used on other, more sensitive, areas of the body.
The reason that antiperspirant can be so irritating is because of its active ingredient. Most antiperspirants use aluminum chloride, aluminum chloride hexahydrate, or a newer generation ingredient, like aluminum zirconium trichlorohydrex. These products can easily irritate skin. One study published in the journal of Dermatologic Clinics found that 26% of patients being treated with aluminum chloride antiperspirant reported stinging and itching sensations after use. If you are struggling to use antiperspirant because of skin irritation there are things you can do. Using antiperspirant consistently over a period of time seems to reduce skin irritation. You can also apply 1% hydrocortisone cream the morning after applying antiperspirant to clear up irritation. If you are sensitive to irritation then you may benefit from trying a newer generation antiperspirant with aluminum zirconium hexahydrate as the active ingredient. Studies have found that these antiperspirants tend to cause less irritation. There are also specific antiperspirants that are made for sensitive skin that you can try. Ultimately, you shouldn’t have to put up with skin irritation to talk to your doctor and see if you can find the antiperspirant that works best for your skin.
Antiperspirants can be extremely helpful for those with excessive sweating, but they come with another major downfall - they stain clothing. Unfortunately, antiperspirant can leave a yellowish stain on clothing, especially when it is mixed with sweat. One study showed that up to 70% of people with axillary hyperhidrosis reported having to change their clothes at least two times a day. If a person is regularly sweating through their clothes it is safe to assume that they are also getting antiperspirant residue on their clothing. Antiperspirant is usually worth the inconvenience, and thankfully, there are effective ways to get antiperspirant out of clothes.
Medication Side Effects
Doctors often treat hyperhidrosis with oral medications when other, more conservative, therapies have failed to work. Most of the time patients are prescribed a type of medication that falls into the class of anticholinergics. Anticholinergics work on the part of the nervous system that innervates sweat glands and stops the body from producing as much sweat. Unfortunately, they can also act on other parts of the body as well and cause unintended and unwanted side effects. The side effects a person will experience depend on their individual biological makeup and the specific medication they use. Some of the side effects of anticholinergics include dry mouth, constipation, nausea, vomiting, and many other possibilities. If you are planning to try oral medications for your hyperhidrosis, make sure that you work closely with your doctor to make sure that you aren’t suffering from intolerable side effects so that you can find the best medication for your body.
Not Trying Less Invasive Therapies First
Almost all doctors that treat hyperhidrosis will recommend that patients begin trialing the most conservative treatments first before they move on to more invasive options. Sometimes, however, patients are exasperated with their condition and want to move on to more extensive options before trying all of the more conservative treatments. This is a big mistake because some of the most effective options are local therapies which are less invasive. For example, a patient with palmar hyperhidrosis who didn’t respond well to an antiperspirant may try iontophoresis, but be inconsistent with their routine and fail to see a benefit. They may want to move on to botox injections, or even surgery, when iontophoresis may have worked if they had given it a proper chance. This would require them to take less risk and cost them less money. However, this isn’t the case for everyone and sometimes patients decide to go with more invasive treatments first for a variety of legitimate reasons. The most important thing is that you communicate openly with your doctor to find the treatment that is most effective for you.
Sometimes, despite their best efforts, patients can’t find an effective treatment for their hyperhidrosis. This can be extremely frustrating and disheartening because hyperhidrosis is a condition that negatively impacts quality of life. However, it is important that patients continue to try new treatments as they come out and that they remain open to using the treatment options they do have. Even if your hyperhidrosis symptoms are not completely under control, most people find at least some relief from treatment. There are new treatments coming out every year and as awareness grows the future continues to look brighter for those with hyperhidrosis.
- Pariser, D. M. (2014). Hyperhidrosis (4th ed., Vol. 32). Philadelphia, PA: Elsevier.
- Zirwas, M. J., & Moennich, J. (2008). Antiperspirant and Deodorant Allergy Diagnosis and Management. The Journal of Clinical and Aesthetic Dermatology, 1(3), 38-43. Retrieved August 22, 2019, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3013594/