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Raj Singh MD
August 27, 2023

Hyperhidrosis Diagnosis and Treatments

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Today’s video is about excessive sweating or hyperhidrosis

We all produce sweat as a way of regulating our body temperature, however sometimes excessive amount of sweat is produced independent of body temperature. At this point it becomes extremely uncomfortable and unpleasant for the individual

Hyperhidrosis is a common medical condition and up to 5% of the population may suffer from this condition.

Diagnostic criteria

In order to diagnose hyperhidrosis we need to have a certain criteria

Generally starts before the age of 25

Visible sweating for at least 6 months.

Sweating is bilateral so under both armpits or in the palms, or soles of the feet

What causes hyperhidrosis?

We have sweat glands throughout the body, they help in controlling body temperature, removing excessive amounts of electrolytes or fluids. The sweat glands are linked to our sympathetic nervous system. Although the sweat glands are normal in number and size ,they are just overly sensitive to signals from the brain and produce excessive amounts of sweat.

Certain medications are linked to producing excessive amounts of sweat, certain antidepressants, anti diabetic medications, estrogen blockers, etc. if you suffer from accessory of sweating it is a good idea to review the list of medications with your doctor as modification in some of these medication may improve symptoms

If it is mild to moderate hyperhidrosis, this can be effectively managed with prescription antiperspirants such as Drysol or Xerac. These are available by prescription only, similar alternatives available online on Amazon and other web sites are counterfeit and not effective.

This new medication, as seen here qbrexa is topical glycopyrronium 2.4% is applied once daily to the axillae using a premoistened cloth.When wiped once under the arm, the solution enters the affected area to inhibit neurotransmitters on the sweat glands, reducing the amount of sweat produced.

If the above options are not effective then the next option would be to use Neurotoxin such as Botox. Recommended dose is 50 units in each armpit. Typically 10 to 20 injections spaced 1 cm apart are performed in each armpit. Response is seen within 2 weeks. Let us watch a video of this simple procedure

Microwave thermolysis

Miradry is a new treatment approved recently for hyperhidrosis, microwaves are used which destroys sweat glands in the axilla. Typically 2-3 sessions are required.


is effective for hyperhidrosis that affects the palms and the soles of the feet. n general, patients sit with both hands or both feet, immersed in shallow trays filled with tap water for a short period of time (15 to 40 minutes depending on the device) while the device sends a small electrical current through the water.

Oral medications

also that can be used to reduce the amount of sweating produced, oral glycopyrrolate and oxybutynin are 2 of such medications, however they have significant side effects and are generally not recommended for treatment of hyperhidrosis when so many other safer therapies are available

In summary, hyperhidrosis is a common condition, with many effective treatments available.

Schedule a visit to see your doctor to discuss these different options

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