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Need More Than a Roll-On? Treatment Options for Excessive Sweating

Sep 06, 2017 02:00PM ● By Becca Newell

Sweating—The Details

By Becca Newell

Exercising, heat, and anxiety are all major triggers of sweat. There are two types of sweat glands: eccrine and apocrine. The former are located all over the body whereas the latter are concentrated in areas with hair follicles, like the armpits and chest. Both sets of glands are odorless, but when the oily substance from apocrine glands mixes with the bacteria existing on the skin, an odor can form.

For most of us frequent showers and daily deodorant application is enough to keep us feeling—and smelling—fresh. But what if store-bought antiperspirant isn’t enough? We looked into other treatment options to help lessen heavy sweating.

Excessive Sweating

Abnormally excessive sweating, also known as hyperhidrosis, affects either the entire body or certain parts, like palms, underarms, or face. Almost 3 percent of the United States’ population suffers from this condition. Primary hyperhidrosis, according to the Mayo Clinic, “occurs when the nerves responsible for triggering your sweat glands become overactive and call for more perspiration even when it’s not needed.” There are certain health conditions, like diabetes, menopause, and leukemia, that cause excessive sweating—also known as secondary hyperhidrosis.

Botulinum Toxin

In 2004, the U.S. Food and Drug Administration approved Botox for the treatment of severe primary hyperhidrosis. Injections of botulinum toxins block the nerves that trigger sweat glands, according to the Mayo Clinic. Affected areas require several injections per session and treatment is repeated once symptoms return. A 2014 study considered botulinum toxin as a “very effective and safe therapy” for hyperhidrosis with a “fast onset of action, high rate of patient satisfaction, and relatively few side effects.” “Off-label” uses include injections to the palms of hands and soles of feet. Currently, data on duration and frequency of application is inconsistent. Studies suggest that one injection session provides relief from symptoms for three to nine months; the Mayo Clinic reports effects lasting up to a year.

Surgical Procedures

Removal of the sweat glands located in the armpit might be an option if sweating only occurs in that region. One technique involves removal through curettage—extracting the tissue by scraping—via small incisions in the armpit. According to a 2014 study, suction-curettage is a minimally invasive surgery with high success rates. Patients, the study reports, tolerate the surgery well without needing much downtime. Similarly, another option is liposuction of the sweat glands, often referred to as “sweat gland suction.” This technique only removes the subcutaneous tissue—or hypodermis, the innermost layer of the skin—however, and, according to the study, shows a less significant reduction in sweat rates than suction-curettage. For those with palmar hyperhidrosis—uncontrollable sweating of the palms or hands—nerve surgery may be an option. The procedure involves the cutting, burning, or clamping of sympathetic nerves that control sweating. While successful in reducing clammy hands, more than 50 percent of patients who undergo treatment, experience compensatory sweating, ranging from mild and manageable to excessive, in other areas of the body.

Aluminum in Deodorant

The link between breast cancer and antiperspirants containing aluminum was suggested in clinical studies, published in 2004 that reported an increase of genomic instability in the upper outer quadrants of historically normal breast tissue from exposure to genotoxic chemicals. According to the study, “instability of the genome is an important contributor to genetic changes that drive carcinogenic processes, and in accordance with the cancer field theory could provide a milieu where genetically altered cells would be more susceptible to the development of cancer.” A later study published similar findings, suggesting aluminum can interfere with certain cells, within the breast. The study concluded that further research is necessary to determine the long-term effects of aluminum exposure and whether low-level absorption plays a role in breast cancer development.

Laser Treatments

According to a 2014 review of ongoing and future therapies, the use of lasers for glandular disruption to treat primary hyperhidrosis “may provide a promising option for patients” in which other treatments failed. The American Society for Laser Medicine & Surgery, Inc., reports that laser wavelengths that treat fat have been successful in treating overactive sweat glands. One to two treatments are necessary and side effects include mild swelling and bruising following the procedure, with the treated area returning to normal after a few days. The organization also lists microwave devices, like miraDry, as another option in energy-based devices. The procedure destroys sweat glands, located in the hypodermis, with heat. Studies suggest significant post-procedure swelling. Though more data is necessary, both techniques “have shown 90 percent patient satisfaction after 12 months,” according to the American Society for Laser Medicine & Surgery, Inc.

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