Topical medication (Antiperspirants):
Aluminum chloride, potassium permanganate, formalin, glutaraldehyde, and various topical anticholinergic compounds can be very helpful. However, these products can sometimes cause cosmetically offensive staining of the skin. Drysol, a prescription antiperspirant containing 20% aluminum chloride hexahydrate, is useful for some patients with axillary hyperhidrosis that does not respond to over-the-counter antiperspirants, and may be effective in mild cases of palmar and plantar hyperhidrosis. Drysol is reported to work in 80 per cent of the people who use it for excessive sweating.
Surgical resection:
Surgical resection is effective for axillary hyperhidrosis. Surgical resection of the axillary sweat glands helps to stop excessive sweating.
Surgical sympathectomy:
Surgical sympathectomy is an effective treatment for palmar hyperhidrosis, horner syndrome, and neurologic lesions. Different levels of the sympathetic nerve are cut, which corresponds to where excessive sweating occurs. The most common side effect of sympathectomy is called compensatory sweating or compensatory hyperhidrosis. Cutting the sympathetic nerve to stop sweating in one area of the body causes it to shift to another location. Therefore, it is better to try some medications before going for sympathectomy surgery.
Endoscopic thoracic sympathectomy (ETS):
ETS is carried out with the use of a video camera. The video camera through three 1/8 incisions on each side of the chest locates the sympathetic nerve in the chest along the spinal cord. After locating, the nerve is cut at the level that corresponds to the patients sweating.
Iontophoresis:
Its regular application can decrease or temporarily resolve hyperhidrosis. Iontophoresis involves the administration of direct current via tap-water baths to the skin of the palms, or soles, or both by using devices such as Drionics device or Fischer galvanic unit. The success rate is 85%.
Botox®:
Botox® injections are directly injected to the effected areas. Botulinum-A toxin blocks axillary hyperhidrosis and effective for palmar & facial hyperhidrosis. Botulinum-A toxin has proven to be a long-lasting treatment for Frey syndrome, a form of gustatory hyperhidrosis related to parotid gland surgery.
