Hyperhidrosis Treatment – Mr. Adrian Richards, of Aurora Clinics  explains Excessive Sweating and treatment options,the advantage of each treatment and the body areas they are suitable for. For more information or should you wish to book a FREE Consultation with our specialist plastic surgeon, please call us on 01844 214362.

Hyperhidrosis – Treatment Options

Hello. My name is Adrian Richards, and I’m the Surgical Director of Aurora Skin Clinics. Today I’m going to be talking about the treatment options for hyperhidrosis. I’ve explained in a previous video that hyperhidrosis is a condition which affects a significant amount of the population and really causes excess sweating from the eccrine sweat glands, which produce the thin, watery sweat.

The options for treatment range from antiperspirants to surgery. I’m going to work through those from the simplest, antiperspirants, through to surgery. The simplest option is antiperspirant. Antiperspirants differ from deodorants. Deodorants neutralise the odour from the armpit. Antiperspirants usually contain some sort form of aluminium chloride and actually stop the sweating. The way they do this is the aluminium chloride crystals coat the skin, and then when the sweat glands sweat, they actually draw, by osmosis, the aluminium crystals into the sweat gland, and they form a plug which typically lasts about 24 hours or until they’re washed off. This plug in the opening, the mouth of the sweat gland, actually prevents sweat escaping. Normal deodorants should be used first. An interesting point is you shouldn’t just use deodorant in the morning. You should use it morning and evening, because remember we’ve got a 24 hour effect here and it’s beneficial to use them in the evening as well to really try and keep those sweat glands plugged off. Start off with the normal proprietary antiperspirants, which you can buy over the counter. If that doesn’t work, you can then go to some of the aluminium chloride based, stronger antiperspirants. The best known of these in the UK is called Driclor, which you can discuss with your doctor. That works well. The downside of it can be quite irritable on the skin. Some of my patients have mentioned that they have quite a lot of irritation on the skin. But it’s certainly a good way to start.

If that doesn’t work for you, the next option is called iontophoresis, and this is basically a technique normally used for the hands and feet. You can buy kits for this, but basically the hands and the feet are placed in a bowl of water and an electrical current is passed across the water and this, no one really knows how it works actually, but it does tend to block the sweat glands and can produce a reduction in sweat. It’s very good for the hands, good for the feet, but not so good for the underarm area because it’s technically difficult to submerge that area in a bowl of water, as you’ll understand. Iontophoresis is a good option if you’re bothered by hands and feet hyperhidrosis.

The next option which has proved very, very successful is Botox therapy. Botox essentially blocks any nerve fibres which secrete acetylcholine as their neurotransmitters, so this is muscle fibres, that’s why Botox relaxes muscles and also eccrine sweat glands. The normal nerve impulses from the glands are blocked by the Botox injections. This treatment typically lasts six months, slightly longer than the muscle activity interestingly, and essentially stops the nerve impulses to the gland and reduces sweating during that time. It’s very good for the underarm area. It can be used on the hands, can be used on the feet, but these are very tender areas, much more tender than the underarm area, and injections in there we need some form of nerve block or some sort of numbing cream for the treatment.

The final solution, which is really a bit of a last gasp, is a surgical treatment called endoscopic sympathectomy. It’s the sympathetic nerves which cause innervation to the sweat glands. Vascular surgeons, surgeons who normally deal with blood vessels, can in a technique using telescopes and small incisions divide the nerve trunks which supply the impulses to the glands. This is a treatment that works very well. It is an operation, and it’s really normally reserved for very severe sweating principally of the hands and arms. If you’ve got very severe sweating in both areas and none of these other treatments are giving you a solution, it is worth considering sympathectomy.

I hope that’s clarified some of the treatment options for hyperhidrosis. If you suffer from this and would like any more information about the treatment, please don’t hesitate to contact us either via our website or by ringing us on our office number, which is 01844 214362. We’ll be happy to discuss the options with you. Thank you.