Hyperhidrosis treatment: get relief from excessive sweating

Several oral and topical prescription medications are available to help manage excessive sweating, either on their own or in combination with other treatments. These medications work by preventing the stimulation of sweat glands to limit sweating.  

Several of these medications are offered in cost-effective, generic forms easily accessible with a prescription. However, experts emphasize that these medications should not be used as standalone treatments but rather in combination with other therapies to maximize their benefits and minimize potential side effects. 

Aluminum Chloride (also known as Drysol, Hypercare, or Xerac AC) is the preferred first line of treatment, if over the counter antiperspirants such as Certain Dri are not enough to reduce sweating. This is a topical medication applied to the affected area as directed by a healthcare professional3, typically at bedtime. Keeping the skin dry before application and avoiding contact with broken or irritated skin is essential.  

This medicine may cause a decrease in sweating and can discolor fabrics and harm certain metals. Common side effects include mild irritation. Allergic reactions and excessive irritation should be reported to a doctor. 

This form of the medication glycopyrronium is prescribed to treat excessive sweating from the underarms.⁴ The medication is provided in a pre-moistened cloth for easy application to the skin. It effectively reduces sweat by targeting the sweat glands.  

Glycopyrronium belongs to a class of drugs called anticholinergics. The towelettes are easy to use:  

• Apply it only to clean and dry the skin of the underarms, avoiding broken skin. 

• Using the same cloth, wipe it once across each underarm once each day.  

• Avoid covering the treated area(s) with a plastic dressing or bandage.  

• Do not reuse the cloth; dispose of the used cloth in the trash.  

• Remember to wash your hands immediately after using the cloth to prevent accidental contact with your eyes or other areas.  

• For the best results, use this product consistently at the same time every day. 

Glycopyrrolate is FDA-approved to treat peptic ulcer disease and reduce excessive saliva production. It can also be prescribed off-label for hyperhidrosis. The medication is available in small pills, allowing patients to adjust the dose as directed for maximum benefits and minimal side effects.  

Common side effects include dry mouth, while other potential side effects may include difficulty with urination, confusion, dizziness, constipation, and rapid heartbeat. Significant side effects should be reported to your doctor. Glycopyrrolate is not recommended for patients with liver, kidney, or unstable heart disease, gastrointestinal disorders, eye diseases, urinary retention, prostate enlargement, or myasthenia gravis. 

Prescription medications like beta-blockers (propranolol) and benzodiazepines can effectively address excessive sweating triggered by anxiety-provoking situations, such as public speaking engagements. These oral medications are specifically designed to alleviate symptoms and provide relief in such circumstances. Please note that our doctors do not prescribe controlled substances like benzodiazepines. 

Propranolol is commonly used to treat high blood pressure, angina, irregular heartbeats, and hand tremors and prevent migraine headaches. It can also help with performance anxiety and reduce excessive sweating in individuals with hyperhidrosis.5  

When using propranolol, start with a small dose taken 30-60 minutes before the anxiety-provoking situation and adjust as needed, with the guidance of your doctor. Avoid repeating the dose within 24 hours. Common side effects of this medication include fatigue, dizziness, slow heart rate, lowered blood pressure, constipation, and depression.  

Other possible adverse reactions of propranolol may include insomnia, weakness, disorientation, nausea, diarrhea, allergic reactions, worsening of psoriasis, hair loss, and impotence. Rare severe reactions can include congestive heart failure, very slow heartbeat, severe skin rash, and asthma/shortness of breath. 

These side effects are unlikely to occur with the recommended low dose of the medication. However, if you have a heart condition or asthma, it is essential to consult your primary care physician before taking this medication.  

Oxybutynin is primarily used to treat overactive bladder problems. Consult your physician for specific prescription recommendations. For hyperhidrosis, clinicians prescribe a large quantity of small pills to allow careful adjustment of the dose for maximum benefits and minimal side effects.  

Side effects may limit the number of tablets needed to impact sweating. Determine the appropriate dose to improve excessive sweating with mild or tolerable side effects. Decrease the dose to reduce mild side effects. 

This medicine may cause dry mouth and has other potential side effects. These include difficulty with urination, confusion, dizziness, drowsiness, blurred vision, increased bloating, constipation or diarrhea, dry skin, and rapid heartbeat. It can also lead to overheating if unable to sweat.  

Adjust the dosage to manage excessive sweating with mild side effects. Seek medical attention for severe side effects. Avoid use in patients with certain medical conditions. Discuss usage during pregnancy or breastfeeding with your obstetrician. 

Excessive sweating can be a symptom of various conditions, but it doesn't automatically indicate a severe health problem. In most cases, it is caused by emotional stress, exercise, hormonal changes, medications, and spicy foods, and in most cases, doesn’t require immediate medical attention. On the other hand, conditions linked to excessive sweating such as diabetes, thyroid problems, heart problems and infections may need medical attention.  Speak with your doctor if you experience sweating accompanied by other symptoms, sudden onset of excessive sweating, or if it interferes with your daily activities.