How can I stop excessive sweating?

Daniel P. O'Hair, MD
Thoracic Surgery (Cardiothoracic Vascular)

Palmar hyperhidrosis (excessive sweating of the hands) can be treated by a variety of methods, most of which are of limited long-term value. Topical drying agents, aquapheresis machines and botox injection provide either no substantial benefit or are limited by pain and excessive cost and provide only temporary relief. When these methods fail, endoscopic thoracic sympathectomy (ETS) provides patients with a minimally invasive, scope-based procedure that gives instant and permanent relief in more than 95% of patients.

The procedure involves a general anesthetic and then a single 12-mm incision under each arm. About 30 minutes is needed on each side to identify the proper segment of the sympathetic chain of the autonomic nervous system. The nerve is divided and the scope is removed. The results are instantaneous. Patients emerge from anesthesia with dry hands. Most cases are performed as an outpatient, and the person can go home the same day. Alternatively, some patients stay overnight as comfort and safety would indicate.

There can be minor side effects including compensatory truncal sweating but this is uncommon and may occur in 10% of patients. Patient satisfaction with this procedure is very high and the results are dramatic.

Dr. Michael Roizen, MD
Internal Medicine

Though sweat is a natural bodily process, about one percent of all Americans suffer from hyperhidrosis (loosely translates as "sweats like a tripped-up witness"). This is a condition that affects hands, feet, and armpits because the nerves to those areas relax the arteries and turn on extra sweat glands just beneath the skin and allow excessive moisture to escape. While an appearance issue, it's also a function issue - excess sweat makes it more difficult to drive, work, or simply grab a can of beans off the pantry shelf. And that's not even mentioning the anxiety that can come from meeting people, going on job interviews, or needing to change outfits more often than a Friday night stripper.

While we don't favor the average person using antiperspirants (deodorant will do just fine), if you really suffer from the embarrassment of hyperhidrosis, you might want to try a boric acid or tannic acid solution as a first step. If you're still dripping, give 20 percent aluminum chloride a whirl. Put it on at night and wash it off in the morning. If this fails, you could try Botox every six to 12 months. It's the pits thinking about shots right there in the pits, but it might be better than a surgical procedure. There's one such procedure that cuts the nerves that cause sweaty hands (fixes the problem in nearly all cases). That's a pretty big procedure, so you need to sweat an awful lot to justify it. In Germany, sage has traditionally been used to treat excessive sweating and night sweats caused by menopause or tuberculosis. It can be taken as a tea or in capsule form daily and is reported anecdotally to reduce sweating by 50 percent or more.

For the groin, a new technique called sweat-gland suction may be an option. Similar to liposuction, this procedure works by suctioning the sweat glands permanently out of the area. Not many plastic surgeons do this one, however. Other options: Cut nicotine and caffeine to reduce anxiety associated with the condition. Botox injected directly into the area can also help.

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Dr. Mehmet Oz, MD
Cardiology (Cardiovascular Disease)
Your primary care physician or dermatologist can work with you to control excessive sweating. The first step is to determine the cause. If excessive sweating is caused by an underlying medical condition such as an overactive thyroid or a metabolic disorder, the first priority will be to treat the underlying cause. In many cases, however, excessive sweating is not caused by a medical condition.

If frequent bathing, wearing loose clothing, and using antiperspirants doesn't help, your dermatologist can suggest a number of treatments. Among others, these include Botox, especially when excessive sweat only affects some parts of your body, such as your underarms. Oral medications are also available, but they can have unpleasant side effects. In severe cases, surgery can be used to sever the nerves that are linked to sweat glands. Talk to your doctor about ways to control excessive sweating.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.