Ask Your Pharmacist Hyperhidrosis (Heavy Sweating) (Part 2)

 

This is a follow on to last week’s article, this week I discuss treatment.

 

Aluminium chloride antiperspirants

Strong aluminium chloride antiperspirants are often first choice to tackle hyperhidrosis. They work by plugging or blocking sweat glands.Aluminium chloride antiperspirant needs to be applied at night just before bed (as sweat glands are less active at night). Wash the aluminium chloride off the next morning. Mild skin irritation, itching and tingling in the areas where applied are the most common side effects of aluminium chloride. Brands available in pharmacies include Anhydrol Forte^® and Driclor^®. When it comes to using aluminium chloride antiperspirants, less is more; they are less effective if too much is used at each application. It should be used once every one to three weeks for best effect. It can take a few weeks initially to build up its effect.

 

When to refer to a dermatologist

If the above techniques do not work, your GP may consider referral to a dermatologist (skin specialist) for more specialist treatment options including:

 

Iontophoresis

Iontophoresis is considered a good option for excessive sweating of the hands and feet. The way it works is that the hand and feet are placed in water and weak electric current passes through the water under specialist supervision. The electric current has the effect of helping block the sweat glands. Iontophoresis is not painful but the electric current can cause a slightly uncomfortable sensation and skin irritation. Each treatment of iontophoresis takes about 20 to 40 minutes and person normally gets two to four treatments each week. You will normally notice improvement after about two weeks and treatments is usually lasts up to a month after improvement in symptoms is seen. 80 to 90% of people notice improvement in symptoms due to iontophoresis.

Botulinum toxin

Botulinum toxin (botox for short) may be tried if other options fail. Up to 20 injections of botulinum toxin is injected to areas that sweat heavily like the armpits, hands, feet or face. Botox blocks signals from the brain to sweat glands thus reducing sweating. Botox injections work particularly well for armpit sweating. It is not recommended for sweating of the palms and face due to the risk that botox may block nearby small muscles. Costs of this treatment depend on the part of the body being treated. Treatment needs to be repeated every 4 to six months. Botox is only effective for between two and twelve months so treatment must continually be repeated.

 

Anti-cholinergic drugs

Anticholinergic drugs include prescription drugs such as oxybutynin hydrochloride and glycopyrronium bromide. They only control generalised hyperhidrosis or compensatory sweating which can occur after endoscopic thoracic sympathectomy (VATs) (see next week). Their success is variable so they are not used very often. Side effects can include drowsiness, dry mouth, dry eyes, blurred vision and constipation.

 

To be continued….next week I discuss surgical options if above are not successful.

This article is shortened to fit within Newspaper space limits. More detailed information and leaflets is available in Whelehans