HYPERHIDROSIS

At Midlothian Dermatology, we understand how challenging hyperhidrosis can be. Approximately 15.3 million Americans, or around 4.8% of the population, have been diagnosed with this condition, with two-thirds experiencing excessive sweating in the underarm area. However, due to the stigma often associated with hyperhidrosis, the International Hyperhidrosis Society believes the actual number may be much higher, estimating that as many as one in three Americans struggle with excessive sweating.

What is Hyperhidrosis?

Sweating is normal. Excessive underarm sweating is not. Signs of excessive underarm sweating include sweating even when you're not physically active or in a warm environment. This type of sweating may be so severe that it ruins your clothing, forces you to carry extra clothes, increases your dry cleaning costs or leaves stains from antiperspirants and deodorants. You may find yourself changing your routine, avoiding certain social situations, or limiting work activities — even refraining from raising your arms in public — due to anxiety about noticeable sweat. Excessive sweating can also lead to feelings of embarrassment and frustration, impacting your daily life and confidence. 

Types of Hyperhidrosis

General Hyperhidrosis

Patients with general hyperhidrosis often experience excessive sweating around the head and chest, typically beginning after the age of 50. This form of hyperhidrosis is commonly seen in post-menopausal women due to hormonal changes and is often triggered by heat or physical activity rather than stress. While some may find that the condition improves over time, for many, it can persist for years.

Focal Hyperhidrosis

On the other hand, focal hyperhidrosis usually starts during the teenage years and affects the palms, feet, and underarms. Unlike general hyperhidrosis, this type is primarily triggered by stress and secondarily by heat or exertion. Though many believe stress or anxiety causes hyperhidrosis, it is due to an inherited dysfunction of the sympathetic nervous system. However, stress and anxiety can worsen its effects. Those with focal hyperhidrosis often have perpetually damp or drenched hands, feet, and underarms, regardless of their environment or activity level.

Is Hyperhidrosis Genetic?

One of the two types of excessive sweating, primary hyperhidrosis, is believed to have a genetic link, meaning that you may have family members who experience similar symptoms. The other type, secondary hyperhidrosis, is usually associated with underlying medical conditions like neurologic disorders or spine injuries.

Can Hyperhidrosis be Prevented?

Preventing hyperhidrosis depends on its cause. Identifying triggers, such as excessive caffeine or untreated anxiety, may help reduce episodes. If certain medications are the culprit, consulting your doctor about alternatives might help manage the condition. While most cases of hyperhidrosis can't be fully prevented, they can be effectively managed. Midlothian Dermatology has several treatment options for those coping with hyperhidrosis.  

Am I a Candidate for Hyperhidrosis Treatment?

Hyperhidrosis can impact men and women of any age. While the severity of symptoms varies, if excessive sweating affects your quality of life, you are a suitable candidate for treatment.

Treatments for Hyperhidrosis

There are a few options for treating hyperhidrosis. Some treatment options include:

Clinical strength Antiperspirants

Over-the-counter antiperspirants and prescription formulas work similarly by forming "plugs" in the sweat glands, but they differ in the percentage of active ingredients. The International Hyperhidrosis Society (www.sweathelp.org) recommends popular brands like Sweatblock and DuraDry .

For the best results, ensure your skin is completely clean and dry before applying, ideally at bedtime to allow the product time to work. You can use a cool hairdryer or fan to help dry the area first. Applying antiperspirant only in the morning may reduce its effectiveness.

Most people with hyperhidrosis experience little to no side effects when using clinical-strength antiperspirants, if they follow the instructions carefully to maximize effectiveness and minimize irritation. The most common side effects are irritation and a burning sensation upon application. To avoid this, do not shave before applying or using the product on irritated skin.

While some concerns have been raised about links between antiperspirants and breast cancer or Alzheimer's disease, current research shows no significant evidence of such associations. If you have concerns, feel free to discuss them with one of our medical professionals.

Use – applied directly to the area that sweats.

How Clinical Strength Antiperspirants Work:

As they lie on your skin, tiny crystals plug up the glands. They are meant to trick your body into stopping producing sweat.

Clinical Strength Antiperspirant Side Effects – Possible irritation or burning sensation

Prescription Medication

Glycopyrrolate and oxybutynin are prescription medications that can be used to temporarily block the body from sweating. This approach does not target a single area, but rather the entire body. However, the FDA just granted approval to a topical version of glycopyrrolate, which could relieve sweating of the underarms in the form of towelettes, Qbrexza.

Use – The entire body, and women from post-menopausal who suffer from heavy head sweating.

How Prescription Medications for Excessive Sweating Work—These medications block all body secretions (sweat, urine, stool, saliva, tears). They are not recommended for those who need to sweat to cool down, such as athletes, people in warmer climates, or working in a hot setting. The body needs to be able to cool itself. They are also not recommended for people with baseline constipation or heart disease.

Prescription Medication Side Effects include dry mouth, skin, and eyes, as well as blurred vision and heart palpitations. The higher the dose, the higher the risk for side effects.

What Some Non-Oral Treatments for Hyperhidrosis?

Botox and the Brella SweatControl Patch are two effective treatments for hyperhidrosis. Botox, an injectable treatment containing the neurotoxin onabotulinum toxin type A, acts as a neuromodulator when injected, blocking nerve endings at the treatment site to prevent sweat gland activity. This highly effective treatment has shown impressive results; in one randomized placebo-controlled study, 94% of patients saw a 50% or greater reduction in sweating, with over 80% still experiencing reduced sweating four months later. While the effects of Botox are temporary, repeat treatments can effectively manage hyperhidrosis and significantly enhance quality of life. Dr. Adams offers incobotulinum toxin (Xeomin) as an alternative to traditional Botox.  She has extensive experience treating hyperhidrosis and is an expert in Botox injections, ensuring safe and effective results.

Botox for Excessive Sweating

Use –Underarms, head, feet, and hands.

How Botox for Excessive Sweating Works

Neurotoxin can be injected into the underarm area, palms, and soles of the feet. The injection is intended to chemically block the interaction between the nerves and the sweat glands. On average, patients notice results about 5 days after treatment. The effects can last up to 12 months, but patients usually need to get re-treatment every 4–6 months. 

Neurotoxins available at Midlothian Dermatology: 

• Xeomin

• Daxxify

• Dysport

What is Botox Treatment for Excessive Sweating Like?

A Botox treatment at Midlothian Dermatology is quick, minimally invasive, and takes less than 15 minutes, making it easy to fit into your busy schedule. The process starts with a consultation to discuss your goals and determine the best injection sites. After cleaning the treatment area, a topical numbing cream may be applied, but most patients find the procedure manageable due to the fine needles used. Afterward, you can resume your day without downtime.

Recovery After Botox for Excessive Sweating Treatment

Botox treatment for hyperhidrosis may require multiple sessions. Some tenderness or soreness in the treated areas is normal but typically subsides quickly. Because the procedure is quick, simple, and requires no downtime, many patients opt for regular Botox treatments to enjoy a sweat-free lifestyle.

Botox for Excessive Sweating Results

Neurotoxins effectively begin halting sweat gland activity within a week of your appointment. Studies show that Botox treatment for hyperhidrosis results in a 75% reduction in sweating, improved emotional and physical well-being, and fewer social limitations. While not permanent, the benefits of Botox can last six months or more.

Neurotoxin injections will reduce hyperhidrosis for about 4-6 months, sometimes a little longer, but you will need re-treatment to maintain the effect. As you receive successive injections, you may find that the results begin to last longer and that more time can pass between appointments.

Botox for Excessive Sweating Side Effects

Normally, there are none, but a person might feel temporary muscle weakness.

Is Botox Safe?

Botox has been approved by the U.S. Food and Drug Administration (FDA) for cosmetic use since 2002, making it one of the most trusted and widely used treatments for wrinkles and fine lines. Before its cosmetic approval, Botox was used for decades to treat medical conditions such as muscle spasms and excessive sweating.

Xeomin is an acceptable alternative to Botox for treatment of hyperhidrosis.  It was initially approved for human use in 2010.

Xeomin is considered very safe and is administered by our board-certified dermatologist, Dr. Adams. She has extensive experience performing these treatments and ensures that each patient receives precise and effective care. While all Botox products have an excellent safety profile, choosing a qualified injector like Dr. Adams is important to minimize the risk of side effects. 

When Body Odor is the Main Problem

If sweat isn't the primary concern but odor is, you're not alone. The deodorant market is massive, and most products combine deodorants with antiperspirants to tackle both sweat and smell. But if you prefer to avoid the active ingredient in antiperspirants (aluminum) or if you're seeking odor control without sweat reduction, there are other options.

Newer deodorants, especially those containing AHAs like mandelic acid, can be more effective for some people when traditional deodorants fall short. While these products won't stop sweating, they can help prevent the odor that develops when you sweat by altering your skin's pH. This odor control may even reduce anxiety-related sweating. Look for ingredients like mandelic or salicylic acid to help inhibit odor naturally.

Antibacterial cleanser and possibly a topical antibiotic may also be recommended at a medical consultation.

Dr. Adams’ Personal Recommendations

Over the counter antiperspirant: Right Guard Xtreme Defense 72h

“Natural” Deodorant: PiperWai Natural Deodorant with activated charcoal or Lavilin Roll On Deodorant-72h

For Sensitive Skin-Vanicream Antiperspirant and Deodorant

Learn More About Hyperhidrosis

For more information, we recommend visiting the International Hyperhidrosis Society website (www.sweathelp.org), which offers valuable resources on managing excessive sweating.

Schedule Hyperhidrosis Treatment at Midlothian Dermatology

If you are struggling with excessive sweating and are interested in hyperhidrosis treatment in the Midlothian, Virginia area, call our office at 804-378-3048 to book a consultation.