Question:  Is there such a thing as sweating too much? What can I do about it if I’m constantly soaking through my clothes? It’s so embarrassing, especially at work!

shutterstock_155697284Answer:   Yes, the condition definitely heats up during the summer months but can plague sufferers all year long with overly sweaty armpits, palms and even on soles of the feet. It  is called hyperhidrosis which just means “excessive sweating.”

Hyperhidrosis is simply abnormally heavy perspiration. Sweating is a normal bodily function, but some people may have overactive sweat glands that produce more sweat beyond what is required for regulation of body temperature. It can be most noticeable at the armpits because sweat can soak through clothing and become obviously embarrassing. Or you may also be aware your palms are often sweaty so you avoid shaking hands with others.  Hyperhidrosis can occur  in many parts of the body whether exposed to triggers such as heat, physical activity or exertion, embarrassment, stress or not.

How do we treat excessive sweating?

First, we’ll evaluate your excessive sweating for any potential causes of secondary hyperhidrosis (for example, an underlying disease that causes excessive sweating such as hyperthyroidism).

To gauge your sweating problem, we will try you on stronger prescription-grade antiperspirants which can also help block sweat glands to reduce sweating. Typical over-the-counter antiperspirants are 1-2% aluminum chloride but prescription products can contain up to a 20% solution of aluminum chloride hexahydrate or similar aluminum salts. While these can be irritating in those with sensitive skin and sweat glands, they do reduce perspiration, however they require continuous usage.

After a few weeks of trial, if the prescription products do not reduce your sweating problem well enough, we can now use Botox® (onabotulinumtoxinA), which is FDA approved for the treatment of excessive sweating of armpits. We also use Myobloc® (rimabotulinumtoxinB) or Dysport® (abobotulinumtoxinA) off-label as an alternative, especially for those who have excessive sweating on palms and soles of feet.

These injections work to temporarily de-nerve the sweat gland and results in a local reduction in sweating where injections have been administered for up 5 months. Injections must be repeated at regular intervals to keep excessive sweating at bay and you may still need to use an antiperspirant.

-Jodi