The body’s nervous system tells the body when to sweat. Hyperhidrosis is caused by dysregulation of the nervous system or by abnormal glands that produce sweat. Dysregulation refers to an impairment or abnormality in the regulation of a body process. There are many underlying causes of excessive sweating. The leading causes are:

• Hereditary causes
• Underlying medical conditions
• Side effects of medications
• Anxiety disorders
• Unknown causes

The treatment options for hyperhidrosis are varied and are prescribed based on the severity of the condition, the areas of the body affected, and your personal preferences. Current treatment options consist of:

• Antiperspirants: Over-the-counter or prescription-strength antiperspirants containing aluminum chloride can be effective. They are usually the first line of treatment and are applied to the affected areas.
• Topical agents: Other topical agents, such as glycopyrrolate, an oral medication that slows the nervous system triggers for sweating, can be used, especially for facial sweating.
• Oral medications: Anticholinergic drugs, or medications that slow sweating by calming the nervous system can reduce sweating but may have side effects like dry mouth, blurred vision, and bladder problems.
• Iontophoresis: This treatment involves placing the hands or feet in a water tray while a gentle electrical current is passed through the water. It’s more suitable for palmoplantar hyperhidrosis (affecting hands and feet).
• BOTOX® injections (Botulinum Toxin Type A): FDA-approved for underarm sweating, BOTOX® can also be used off-label for other areas. It temporarily blocks the nerves that stimulate sweating.
• Microwave therapy: A new treatment device that uses microwave energy to destroy sweat glands in the underarms.
• Laser therapy: Lasers can target and destroy the underarm sweat glands.
• Surgery: Options include thoracic sympathectomy, which involves cutting or destroying part of the sympathetic nerve pathway responsible for excessive sweating. This is usually considered only in severe cases due to potential side effects.
• Lifestyle changes and home remedies: Wearing breathable fabrics, avoiding certain foods and drinks that trigger sweating, and using absorbent powders can also help manage your symptoms.

Each treatment option has its advantages, limitations, and potential side effects. You should discuss these with your healthcare provider to determine the most suitable and personalized approach. Sometimes, a combination of therapies may be recommended for optimal results.