Hyperhidrosis (Excessive Sweating) Treatment

Hyperhidrosis (Excessive Sweating) Treatment

It’s the time of year that we tend to think the warm, sweaty months have left us behind – not so for those with hyperhidrosis.  There is normal sweating, and there is abnormal sweating. Simply put, hyperhidrosis is abnormal sweating.  Our bodies sweat as part of our normal thermoregulatory control.  This is because sweating is necessary in many circumstances to help us dissipate heat energy and therefore reduce our body temperature when we are overheated in environments such as being outdoors on a very hot day.

Hyperhidrosis (Excessive Sweating)

Hyperhidrosis is sweating beyond what is normal or expected for basic body temperature control. The problem is common with nearly 5% of people having hyperhidrosis. Two main types of hyperhidrosis are recognized—primary and secondary.

Primary hyperhidrosis

This is the most common one we see in dermatology. It usually begins between puberty to early adulthood and often affects localized areas of the body. Generally the:

  • armpits
  • palms
  • soles of the feet

This condition may often run in families as well. In contrast, secondary hyperhidrosis can begin at any time in life and rather than being familial it is usually due to an underlying medical condition which causes the sweating.

Secondary hyperhidrosis

Secondary hyperhidrosis does not follow a specific pattern. It may be on just one side of the body or affect the entire body. In cases where we suspect secondary hyperhidrosis, additional testing may be recommended to try to determine the underlying cause. Causes can include medications or other diseases. In cases where we suspect secondary hyperhidrosis, additional testing may be recommended to try to identify the underlying trigger.

Hyperhidrosis (Excessive Sweating) Conditions

At Advanced Dermatology of the Midlands we manage all types of hyperhidrosis and see a wide spectrum when it comes to the severity of how our patients may be affected by this condition.  Those of us who have the worst of the worst when it comes to hyperhidrosis may have profuse sweating all day long.  No matter the severity, the condition can cause several problems.

First and foremost, hyperhidrosis can be embarrassing.  Having to shake someone’s hand when your hands are damp or wet or even just having wet spots in your armpits can be extremely embarrassing.  School-age individuals may have issues with smudging of their schoolwork.  The same problem can happen with paperwork at work.  It may be difficult to grip items at work or at school due to sweatiness on the hands.  Hyperhidrosis in the armpits can cause staining and damage to clothing.  It may also trigger irritation in that area and a rash.

Hyperhidrosis Treatments (Excessive Sweating)

The good news is that despite all the potential complications from this common condition, there are treatments available and the array of choices for treating excessive sweating is ever expanding in the field of dermatology. The best dermatologists in Omaha know that the single key piece of information in determining how to treat someone with hyperhidrosis is where on the body the sweating is occurring.

In most cases, the sweating is localized and one of the most common areas with localized hyperhidrosis is the armpits.  The palms and soles are the next most common area for localized hyperhidrosis to occur, with the head and neck region being the least common.

Iocalized Hyperhidrosis Treatments

For localized hyperhidrosis, we often start out with localized treatments.  The first line treatment is generally an over the counter or prescription strength antiperspirant containing aluminum chloride. An over-the-counter version of this is known as Maxim. The prescription version is called Drysol which has a higher percentage of the active ingredient aluminum chloride. The key with the use of these medicated antiperspirants is that the areas must be completely dry for them to work effectively when they are applied.  They may be used on the armpits, palms, or soles at bedtime.

A medicine known as glycopyrrolate (Robinul) may also be helpful for treating hyperhidrosis. Traditionally this medicine has been taken as a pill which works especially well for patients who have hyperhidrosis that is widespread or in the head and neck region.

However, a new topical (applied to the skin) version has come to market recently and is known as Qbrexza. Qbrexza is a cloth that contains glycopyrrolate and can be applied to the areas of intense sweating in the armpits daily. A few other treatments and measures can help for hyperhidrosis, including some types of specialized surgery. However, for localized hyperhidrosis one of the very best treatments is Botox.

Botox Hyperhidrosis Treatments

Botox, otherwise known as botulinum toxin injections, is a medication that can disrupt the nerve transmission apparatus which triggers the sweat glands to function. This apparatus is hyperactive in individuals with hyperhidrosis. At Advanced Dermatology of the Midlands we have extensive experience using Botox injections to treat primary hyperhidrosis, especially in the armpit region.  This medicine requires administration with injections into the affected area, and the effects can last three months or longer.  Many insurances will cover this treatment for individuals with hyperhidrosis.


Iontophoresis is another treatment that may be used for localized hyperhidrosis on the hands and feet.  With this treatment, a specialized device uses an electric current to reduce the sweating.  In some cases, the treatment may be quite helpful long-term. Both prescription and over-the-counter devices are available.

Advanced Dermatology of the Midlands | Best Dermatologist Omaha & Council Bluffs, IA | Board Certified Dermatologists

One of the things we see time and time again in our clinics at Advanced Dermatology of the Midlands is that hyperhidrosis is incredibly common. Numerous different things can contribute to hyperhidrosis. However, for virtually all cases there are effective treatment options available.  We hope this information is helpful if you or someone you know has hyperhidrosis. If we may be of any further assistance, please reach out to us and schedule a consultation in any of our clinics in Nebraska or Iowa.

For any information or to make an appointment please contact us today.