Several ways to treat excessive sweating

DEAR DOCTOR K: I sweat a lot, mostly my underarms and palms. Is it possible to sweat too much? What can I do about it?

Dear Reader: Excessive sweating is called hyperhidrosis. This condition isn’t usually dangerous, but it can be embarrassing and inconvenient.

As in your case, it’s the underarms and palms where the sweating is most prominent. Excess sweating also can occur in the feet and groin.

Why do some people sweat too much? In fact, why do we sweat at all? Sweat cools the body as it evaporates. It helps us to cool off when our body temperature is too high. When we exercise, for example, the heat produced by our working muscles heats up the body too much.

Most people with hyperhidrosis are extra-sensitive to the acetylcholine signal. They produce several times more sweat than average. They’ve been sweating too much most of their lives.

Topical antiperspirants are the first choice for underarm sweating. They are also effective on hands and feet. Look for a preparation containing 10 percent to 20 percent of an aluminum salt such as aluminum chloride. Prescription-strength antiperspirants are also available. For most of my patients with hyperhidrosis, this fixes the problem.

A procedure called iontophoresis treats excessive sweating on the hands, feet and underarms. The affected body parts are submerged in water for 20 to 30 minutes while a mild electric current passes through the water. Iontophoresis appears to temporarily block sweat glands.

Botulinum toxin A (Botox) injections treat underarm hyperhidrosis by blocking acetylcholine. They are also effective for hands and feet. Multiple injections are required, but the effect lasts up to 10 months.

When I was in medical school, antiperspirants were the only solution for sweating too much – and they didn’t always work. Today, we are fortunate to have more treatment options.