Hyperhidrosis (Excessive Sweating)

A woman putting on deodorant

Hyperhidrosis means excessive sweating. This condition most often affects the underarms, palms, and soles, causing embarrassment, staining clothing, and complicating social interactions. In some cases, hyperhidrosis can affect a person’s ability to perform simple tasks such as holding a pen, gripping a steering wheel, or shaking hands. It is estimated that over half of sufferers of hyperhidrosis do not seek treatment, in some cases because they do not realize it is available. Fortunately, there is hope. If treated properly, the symptoms of hyperhidrosis can be eliminated entirely for most patients.


There are two types of hyperhidrosis, primary and secondary. In primary hyperhidrosis, emotional stimuli are believed to trigger excessive sweating. It is unknown why this occurs. Secondary hyperhidrosis is associated with an underlying medical condition. Conditions triggering excessive sweating may include: infection, malignancy, spinal cord injury, and neurologic or endocrine disorders. Because the sweating is caused by these disorders, treatment for secondary hyperhidrosis focuses on determining and resolving the underlying condition.


There are many treatment options for sufferers of hyperhidrosis. Dr. Katsnelson will help you determine what method is best for you.

  • Antiperspirants:

    For mild to moderate cases of hyperhidrosis, a clinical strength, over-the-counter antiperspirant applied to affected areas, is usually recommended. If this treatment does not succeed in reducing symptoms, the next step is a prescription antiperspirant containing aluminum chloride. Possible side effects include red, swollen, and itchy skin where applied.

  • Oral Medications:

    There are several types of oral medications used to control hyperhidrosis. Anticholinergics, for example, block nerve impulses to sweat glands, thereby blocking sweat output. Some types of antidepressants or anti-anxiety medication may also control excessive sweating.  The right choice should be determined by your Dermatologist.

  • Iontophoresis:

    Iontophoresis is a procedure that uses a battery-operated device to deliver electricity to the hands, feet, and sometimes armpits, through water-saturated pads. This alters the outer surface layers of the skin to prevent sweat from coming to the surface. The process of iontophoresis must be performed twice daily for 3-4 weeks. The results will last for several weeks before the procedure needs to be repeated. With the proper device, you can complete the treatment at home.

  • Botulinum toxin (Botox):

    Botulinum toxin is a protein produced by the bacterium clostridium botulinum, and when injected into the problem areas, most commonly armpits and palms, temporarily blocks the nerves that trigger your sweat glands. The treatment can last for up to four to six months before needing to be repeated.

  • Surgery:

    There are two approaches of hyperhidrosis surgery.  Surgery is generally considered for extremely severe cases of hyperhidrosis, and only after all other treatment options have failed.