People diagnosed with hyperhidrosis know that excessive sweating can interrupt their daily life. The good news is that there are more treatments for hyperhidrosis than ever before.

If you’re wondering how to sweat less with hyperhidrosis, there’s a range of treatments to try, including antiperspirants, topical medications, oral medications, and medical procedures. No one treatment is effective for everyone with hyperhidrosis, and you might need to try a few before finding one that works for your symptoms. Your healthcare team will help you find the best remedy for your hyperhidrosis.

Hyperhidrosis Types and Treatment Options

There are two types of hyperhidrosis:

• Primary focal hyperhidrosis
• Secondary generalized hyperhidrosis

In primary focal hyperhidrosis, there’s no underlying cause for the condition. In secondary generalized hyperhidrosis, sweating is caused by another health condition or a medication.

Treatment usually differs between the two types of hyperhidrosis. Secondary hyperhidrosis may require treating the underlying condition or discontinuing the medication that’s causing excessive sweating. In primary focal hyperhidrosis, the sweating itself is the condition, so treatment is focused on directly reducing excessive sweating.

1. Antiperspirants

Antiperspirants are typically the first line of treatment for hyperhidrosis. They are a good option to try first, because they are typically inexpensive, less invasive than other treatment options, and easy to use. Antiperspirants work by forming temporary plugs at the opening of sweat ducts in the skin.

If you have hyperhidrosis, you might need something stronger than a normal over-the-counter (OTC) antiperspirant deodorant. Many brands offer “clinical strength” versions of their OTC antiperspirant deodorants, which include higher concentrations of active ingredients. The most common active ingredients of OTC antiperspirants are:

• Aluminum chlorohydrate
• Aluminum zirconium trichlorohydrex
• Aluminum chloride hexahydrate

Prescription antiperspirants might also be an option. These typically contain aluminum chloride. To use a prescription antiperspirant, apply it to dry skin at bedtime and wash it off in the morning. If you experience results, you may be able to scale back the application to a few times a week to reduce skin irritation.

Side effects to look out for with prescription antiperspirants are skin or eye irritation. Be careful to wash your hands thoroughly after applying so as not to get any in your eyes.

2. Topical Creams and Gels

In addition to antiperspirants, there are creams, wipes, and gels that your doctor might prescribe. These include glycopyrronium (Qbrexza) and sofpironium (Sofdra).

Glycopyrronium is usually applied with a wipe and can be used on the hands, feet, and underarms. Possible side effects include skin irritation and dry mouth.

Sofpironium is usually applied in gel form to the underarm area, and works by preventing the activation of receptors that cause excessive sweating. Common side effects include dry mouth, vision changes, and pain, discoloration, or swelling in the underarm area.

3. Pills

Hyperhidrosis can be treated with pills or oral medications in addition to gels and creams. Several options are available. Some medications work by blocking the nerve activity that triggers sweat glands. These are called anticholinergic medications.

Antisweat medications include:

• Glycopyrrolate (Cuvposa and Robinul)
• Oxybutynin
• Propantheline

These medications are often prescribed off-label for hyperhidrosis, meaning they are not specifically approved by the U.S. Food and Drug Administration (FDA) to treat the condition but are commonly used by doctors based on clinical experience.

Common side effects of anticholinergics are headaches, dry mouth, blurred vision, and bladder problems.

Some doctors recommend medications that are used to treat depression or anxiety for the management of hyperhidrosis that is associated with stress or anxiety. These can include beta-blockers like propranolol or benzodiazepines like diazepam (Valium), although these might not be a first choice, since they carry a risk of addiction or dependence.

4. Procedures

In cases where antiperspirants and medications do not work well enough to stop excessive sweating, there are several medical procedures that can be effective in treating hyperhidrosis.

Iontophoresis

Iontophoresis is a procedure used to treat some types of hyperhidrosis, especially on the hands and feet.

During iontophoresis, hands and feet are submerged in shallow containers of water. An iontophoresis device generates a mild electrical current through the water that then enters skin, reducing the amount of sweat that the treated area produces.

To achieve effectiveness, iontophoresis generally needs to be performed three times a week for 20 to 30 minutes each time. Once sweating is reduced, one treatment per week is usually sufficient to maintain improvement.

Botulinum Toxin Injections

In cases of severe sweating in adults, botulinum toxin (Botox) may be injected into the underarms, hands, feet, or face to reduce sweating, and can last between three and 10 months, depending on the treatment area.

5. Hyperhidrosis Surgeries

Several types of surgery might also be considered if other treatments are not effective.

MiraDry

A type of noninvasive outpatient surgery called miraDry is approved by the FDA to treat axillary (underarm) hyperhidrosis. It uses microwave energy to permanently destroy sweat glands under the arms and decrease sweating.

Sweat Gland Removal

Sweat gland removal may be considered for individuals who have localized underarm sweating and other treatments have proven ineffective. During sweat gland excision surgery, sweat glands under the arms are surgically removed and/or damaged. Techniques for sweat gland excision include liposuction and curettage.

Sympathectomy Nerve Surgery

Sympathectomy (nerve surgery) may be used to treat severe hyperhidrosis of the hands. After this surgery, other large areas of the body may become excessively sweaty to compensate. Due to the risk of side effects and complications, this surgery is rarely recommended.

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