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Hyperhidrosis is excessive sweating that is not due to heat or exercise. The most common forms are underarm (axillary) and palms/soles (palmoplantar). There are several treatments that are available to help hyperhidrosis as it can impact a patient’s quality of life.
Excessive sweating, often through shirts regardless of the temperature or exercise, is noted. The sweating is symmetric on both sides of the body and not due to heat or exercise.

The most common cause of hyperhidrosis is primary focal hyperhidrosis which is due to overactive sweat glands. This may run in families. If the excessive sweating is due to underlying conditions or medications, it is referred to as secondary hyperhidrosis.


  • Antiperspirants: Certain deodorants, often containing aluminum chloride, can help with sweating. They are found over the counter or are prescription strength. They are often used nightly. These can sometimes be irritating; if so, decrease the frequency of the application.
  • Topical and oral glycopyrrolate: This medication can help to block the signals that may lead to sweating. The topical formulation comes as a wipe (Qbrexa) that is used daily to the affected area. It is very important to wash your hands after use. The oral medication comes as 1 mg tablet and dosing can range from 1 mg daily to 2 mg twice daily. Side effects include dry eyes, dry mouth, urinary retention and constipation.
  • Botulinum A toxin (Botox®):  injections are very effective, and work for 3-4 months when injected into the affected areas by blocking the nerve signaling that leads to sweating. Insurance does not cover this option.
  • Tap water iontophoresis: This method uses electrical currents with minimal discomfort to decrease sweating. Information is available at, including order forms for the Drionic brand, and your insurance may cover the unit with a prescription. An underarm unit and a hand/foot unit are available. Another company that sells iontophoresis device is Hidrex USA.

For more information about hyperhidrosis, treatment options and recommended products, please visit

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