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In my previous entry, we talked about the condition Primary Focal Hyperhidrosis, or basically, excessive sweating.  The 2 major misconceptions about this condition is that, first, it isn’t a real medical problem (fact: even insurance companies recognize this as a real disease), and, second, most people don’t realize just how many great treatments exist.  Here I discuss the major treatments for Primary Axillary Hyperhidrosis, or excessive underarm sweating:

1) Anti-perspirants: with an active ingredient of aluminum salt, these topical deodorants are considered “first line” up front therapy, meaning you should try them first; there are both over-the-counter and also prescription deodorants and both are affordable

How deodorant works

2) Oral medication: the main class of medication for treating hyperhidrosis are the “anti-cholinergics” and include glycopyrrolate, oxybutynin, and others.  These drugs block acetylcholine from reaching receptors on the sweat glands, which normally directs the glands to sweat.  Because acetylcholine receptors are located in other areas on the body, there can be a range of side effects.  Therefore, these drugs are generally reserved for young, healthy patients with either generalized sweating in many areas of the body, or patients who already tried other therapies and failed.

Several new topical anti-cholinergics are in development, and thus far show great promise.  Notable among them is DRM04 (Dermira, Inc., Menlo Park, Calif.).

3) Botox: injections into the armpit or hands is performed every 3-6 months, depending on the patient and very well tolerated.  Downside is that the injections may be a bit painful, however this is really very temporary, and the results, while great, eventually wear off.  Prior to injections, we do a Starch Iodine Test, which tells us where the sweating is!

Starch iodine test (purple=sweat)

4) miraDry: a 90 minute office procedure that uses microwave energy to permanently shut down the sweat glands.  Overall one can expect 65-80% reduction in sweat, and approximately 20% reduction in odor (from experience).  Results are obvious after even 1 single session.  The device is FDA approved in adults age 18 and up, however there is good precedent for treating certain teenagers “off label” in my opinion.  More about miraDry in my next post!

****Other cool stuff: for more information on specialty garments, bedding, and even shoes for people who sweat a lot, see the Fan Faves section on the International Hyperhidrosis Society website