By Dr. Indu Ballani, Dermatologist, Delhi

The days of sweltering heat are here and we are already running for cover. One of the most significant problems associated with summers is sweating. Apart from the discomfort it causes, body odor is something that can put off anybody. As if the summer heat is not enough, some people are unfortunate to have overactive sweat glands, a syndrome known as hyperhidrosis.

The uncontrollable sweating can lead to significant discomfort, both physical and emotional. When excessive sweating affects the hands, feet, and armpits, it’s called primary or focal hyperhidrosis. Primary hyperhidrosis affects 2 – 3% of the population, yet less than 40% of patients with this condition seek medical advice. In the majority of primary hyperhidrosis cases, no cause can be found. It seems to run in families. If the sweating occurs as a result of another medical condition, it is called secondary hyperhidrosis. The sweating may be all over the body, or it may be in one area. In fact, people with hyperhidrosis may sweat even when the temperature is cool or when they are at rest.

When administered under the arms, Botulinum toxin type A, popularly known as Botox, can help affected people keep sweating at bay. It works at the nerves of overactive sweat glands and relaxes them, significantly cutting down on sweat.

Botox is FDA approved for the treatment of severe underarm sweating, a condition called primary axillary hyperhidrosis. Small doses of purified botulinum toxin injected into the underarm temporarily block the nerves that stimulate sweating. For axillary hyperhidrosis, this is the best option as relief lasts 4 – 6 months and helps control body odor.

Also for focal hyperhidrosis, like excessive sweating on forehead area or face, Meso Botox is the best solution. Here diluted botox is injected into the dermis to decrease sweating.

Some other options are:

Antiperspirants:  Excessive sweating may be controlled with strong anti-perspirants, which plug the sweat ducts. Products containing 10% to 20% aluminum chloride hexahydrate are the first line of treatment for underarm sweating. Some patients may be prescribed a product containing a higher dose of aluminum chloride, which is applied nightly onto the affected areas. Antiperspirants can cause skin irritation, and large doses of aluminum chloride can damage clothing. Note: Deodorants do not prevent sweating, but are helpful in reducing body odor.

Medication: Anticholinergics drugs, such as glycopyrrolate (Robinul, Robinul-Forte), help to prevent the stimulation of sweat glands. Although effective for some patients, these drugs have not been studied as well as other treatments. Side effects include dry mouth, dizziness, and problems with urination. Beta-blockers or benzodiazepines may help reduce stress-related sweating.

Endoscopic thoracic sympathectomy (ETS): In severe cases, a minimally-invasive surgical procedure called sympathectomy may be recommended when other treatments fail. The procedure turns off the signal that tells the body to sweat excessively. It is usually done on patients whose palms sweat much more heavily than normal. It may also be used to treat extreme sweating of the face. ETS does not work as well for those with excessive armpit sweating.