Sweat Reduction Treatment

Hyperhidrosis can generalised (affecting the whole body), or focal (affecting certain areas only). Type of focal hyperhidrosis include axillary (underarms), palmar/plantar (palms and/or soles), craniofacial (face, crown on head), and inguinal (groin).

Hyperhidrosis can be primary (no underlying disease or disorder), or secondary (occurring as a result of an underlying medical condition, injury, or certain medications). The majority of cases are primary, and have onset in childhood, adolescents or young adulthood. Cases presenting in later life are more likely to be secondary.

There are millions of people around the world that suffer from hyperhidrosis and it can be an isolating, chronic condition. Due to the embarrassing nature of the condition, more than half of the people with it are never diagnosed or treated for their symptoms. Severe primary axillary hyperhidrosis can affect people physically, psychologically, and emotionally. Some of the issues that these people face are:

• Social embarrassment and difficulty being in public situations.
• Impact on their ability to perform at work.
• Difficulty meeting people and developing personal relationships.
• Needing to change clothes multiple times a day and not being able to wear certain colours/particular materials.
• Time and energy looking after personal hygiene.

Different treatments are more suitable for different sorts of hyperhidrosis.

• Generalized hyperhidrosis.
• Axillary hyperhidrosis (armpit sweating)
• Palmar hyperhidrosis
• Plantar hyperhidrosis
• Craniofacial hyperhidrosis

Most over-the-counter antiperspirants contain metallic salts. These salts have been found to block sweat ducts, reducing the amount of perspiration that reaches the skin. Deodorants are often combined (deodorants are not designed to control sweating; they mask the odour usually associated with it). Regular antiperspirants are usually insufficient for severe axillary hyperhidrosis.

Clinical strength antiperspirants contain more concentrated antiperspirants, and can be effective for many cases of severe axillary hyperhidrosis. However, these often cause irritation, especially if not used correctly.

These work by temporarily blocking the chemical signals from the nerves that stimulate the sweat glands. As a result, sweating is usually greatly reduced in the area injected for a period of 4-12 months.

The procedure involves a short office visit. Each axilla receives approximately 25 injections via a very fine needle. Discomfort is usually minor, and can be further reduce by first applying local anaesthetic cream (numbing cream) and the application of ice. The procedure is over in under 10 minutes.

The main limitation of this treatment previously was the cost of the medication. However, now that the PBS has subsidized the treatment, the out-of-pocket cost is now minimized (see below).

People with severe primary axillary hyperhidrosis are eligible for treatment under the Pharmaceutical Benefits Scheme (PBS) if they are:

• Are over 12 years of age.
• Are intolerant to topical aluminium chloride hexahydrate (found in antiperspirants such as Driclor™) after one or two months of treatment.
• Are treated by a PBS-registered dermatologist or neurologist.

A variety of surgical approaches have been used to treat severe underarm sweating but they are usually reserved for the most extreme cases that do not respond to other treatments. Surgical methods used include removal of axillary sweat glands, endoscopic thoracic sympathectomy and other techniques.

Download Severe Primary Axillary Hyperhidrosis Fact Sheet.