Botox, creams and surgery
Some people sweat so excessively that good hygiene and clean clothing no longer offer a solution. We call that hyperhidrosis. Sometimes doctors prescribe medication, but there are also other options.
Aluminum-containing creams
Topical treatment with an aluminum chloride solution can be helpful in reducing excessive perspiration on the hands, feet and armpits. By applying the cream or solution to the skin, the drainage ducts of the sweat glands become blocked. This treatment is simple, but the effect is highly variable. The treatment may cause skin irritation.
The solution or cream should be applied to clean, dry skin overnight. After application, blow dry the skin so that the aluminum chloride does not sweat off the skin. The next morning, the same areas of skin should be washed again. If the sweating stops, you can switch to maintenance treatment.
iontophoresis
Iontophoresis can also give good results in hyperhidrosis. In this method, the hands and feet are immersed in water, through which a weak electrical charge is passed. The treatment lasts 15 to 20 minutes and should be performed 3 times a week, until the excessive perspiration has stopped.
You can then switch to a less frequent maintenance treatment, ranging from once a week to once every four weeks. Treatment is sometimes started under the supervision of a physiotherapist. With a good effect, you can then also get started at home.
The way iontophoresis works is not well known. Sweat production may be inhibited by disrupting the transport of ions in the sweat glands. It is especially suitable for hands and feet. However, for severe cases, this therapy is not always adequate. Treatment with iontophoresis is harmless, but side effects can cause skin irritation and pain.
Botulinum Injections
A treatment with botulinum toxin is a relatively new therapy. By injecting small amounts of botulinum toxin into the skin, the sweat secretion is blocked. The effect is often extremely good, but the blockage is only temporary. After 3 to 6 months, nerve impulse conduction recovers and the hyperhidrosis returns. The treatment will therefore have to be repeated regularly.
Botulinum toxin injections are painful, especially to the hands. The hands can only be treated with botulinum toxin under a regional anaesthetic. On the hands, there is a risk that the hand muscles will become paralyzed for several weeks to months.
Operation
The only definitive solution is an operation that cuts nerves to the sweat glands: a sympathectomy. Often the nerves are blocked first, but this only has a temporary effect of one to two years. If the result is good, the nerves can then really be cut.
The effect is greatest for the hands and armpits. There is a risk of complications as a result of the treatment. In addition, an increase in perspiration can occur in other parts of the body.
Another possibility is that an area of skin with the sweat glands is cut out in the armpits or that the sweat glands are suctioned out (liposuction). The cutting can have side effects, such as painful and unsightly scars. Liposuction of the armpits gives good results, but the long-term effects are not yet known.
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