Hyperhidrosis: Excessive Sweating
While it’s perfectly normal to sweat in hot weather, during strenuous activities, and in response to certain situations, it’s not normal to sweat excessively for no apparent reason. Approximately 2 – 3% of Americans suffer from excessive sweating, which is known as hyperhidrosis. These individuals are most likely to experience excessive wetness in the underarms, palms of their hands, and/or soles of their feet.
Hyperhidrosis can be extremely inconvenient and embarrassing. It can impact self-esteem and affect professional performance and romantic relationships. Those who suffer from sweating on their palms may find it difficult to grip objects and feel embarrassed to offer a handshake when meeting new people.
With a variety of treatments available, there is no reason to continue suffering from excessive sweating. Our New York dermatologist, Dr. Paul Jarrod Frank, specializes in the treatment of excessive sweating and offers the most cutting-edge options to his NYC patients.
Causes of Hyperhidrosis
Most cases of hyperhidrosis occur in patients who are otherwise healthy. In some cases, it can be linked to other diseases and occasionally, heat and emotions are the cause. Most people who suffer from hyperhidrosis sweat heavily at all times, regardless of activity level, emotions, or the weather.
Doctors and scientists have yet to uncover the cause of hyperhidrosis. They are aware that certain factors, including diet, caffeine, emotional state, and substance abuse, can trigger or worsen hyperhidrosis, but it has been difficult to identify the originating cause of the condition.
When assessing patients for treatment, our team will first review the medical history to eliminate the possibility that any systemic diseases or conditions are causing hyperhidrosis. Next, we will assess the amount of sweat that is produced and determine if it is considered normal or excessive. This is done by examining the areas of the body that sweat excessively. In some cases, additional tests are needed to determine the amount of sweat produced. Then, we will recommend the best course of treatment for you, along with any modifications to diet or behavior that may help improve hyperhidrosis.
Treatments for Excessive Sweating
Traditionally, topical or oral prescription medications are the go-to treatment for hyperhidrosis. In less severe cases, medication can be used to control hyperhidrosis, but it may not work for all individuals. Many of these medications also cause skin irritation and cannot be used long term as a result.
When recommending treatment for hyperhidrosis to his NYC patients, Dr. Frank prefers to identify solutions that will provide long-term results with few side effects. Among these, he has identified VASER® hyperhidrosis therapy, neuromodulator injections, and certain anticholinergic oral medications as the best treatments for excessive sweating.
VASER® Hyperhidrosis Therapy
VASER® is a treatment for underarm hyperhidrosis that uses ultrasonic energy to alter the activity of sweat glands beneath the skin’s surface. The treatment is performed in our state-of-the-art New York City facility using only a local anesthetic. Dr. Frank makes a tiny incision in the underarm skin and then inserts a thin wand through the incision to target the axillary sweat glands. The results of VASER® therapy for hyperhidrosis are long lasting. The patient is able to resume normal activities after 24 hours.
Before the development of VASER® Hyperhidrosis Therapy, Dr. Frank frequently recommended Botox to treat excessive sweating. Botox, however, requires ongoing treatment – if the patient stops receiving injections, the sweating will return.
Botox for Hyperhidrosis
For individuals who cannot undergo VASER® or would prefer something less invasive, Dr. Frank may recommend Botox or another neuromodulator product. We regularly use Botox, Dysport, Jeuveau, and Xeomin treatments to reduce hyperhidrosis.
The active ingredient in these neuromodulators is botulinum toxin type A. It inhibits the release of sweat in the treatment area by blocking nerve signals to the targeted sweat glands. It can be used locally to stop sweating in the underarms, palms, or soles of the feet without affecting sweat glands anywhere else on the body.
Neuromodulator injections are very quick and easy to perform and requires no downtime or recovery time afterwards. Dr. Frank simply injects the chosen neuromodulator in a specific pattern to the targeted area. To maintain results, neuromodulator injections are required every 6 months.
Anticholinergic Oral Medications
Anticholinergic oral medications, like glycopyrrolate and oxybutynin, are a completely non-invasive option for treating hyperhidrosis. They are often combined with other methods of hyperhidrosis management.
These medications prevent nerve signals from reaching overactive sweat glands. As a result, sweating is greatly decreased in the soles, palms, underarms, and anywhere else experiencing excessive sweating. Both primary and secondary hyperhidrosis can be addressed using anticholinergic medications.
Patients experience results over time, and it will be necessary to continue taking the chosen medication in order to maintain results.
Normally, these medications are used for issues like peptic ulcer disease and an overactive bladder. Using them to treat hyperhidrosis is an off-label use that has proven to be quite effective in numerous cases.
It is important to remember that anticholinergic oral medications may increase a person’s chance of overheating, since sweating is greatly reduced. Because of this, it is best to stay well hydrated while taking these medications and to avoid sun overexposure and overexertion.