Alternative Treatment for Hyperhidrosis

My son who is 17 years old and has palmer hyperhidrosis. What are some treatment options besides Botox?

Doctor Answers 4

Treatment options for Palmar hyperhidrosis

Treatment for hyperhidrosis includes use of anticholinergic medication, Botox injection, iontophoresis and sympathectomy.

Anticholinergic medication by mouth can be tried for several weeks to see if it is efficacious and discontinued thereafter. It has some side effects which his doctor can tell you about. It is not frequently effective in eliminating hyperhidrosis.

Iontophoresis devices are cumbersome to use, painful and require frequent treatment - they 'shock' the sweat glands and stop eccrine sweating.

Botox injections are performed and can be effective for 3-6 months and have some untoward consequences if inexperienced providers do it such as weakness of the hand muscles. Make sure that someone who has done lots of these does it.

Sympathectomy is the best option. It works best and is effective in more than 98% of the time. You MUST have it done by someone who has done over 500 of these, in my opinion. I recommend clips and not cutting or destroying the nerve.

Hyperhidrosis surgery should be done by a board certified thoracic surgeon. Hyperhidrosis care, in my opinion, is best provided by someone who does ALL of the above, so a treatment algorythm can be made, and followed, for insurance purposes. Otherwise, you will have to pay out of pocket to many different providers who don't make the effort to run these through your insurance company.

Buffalo Phlebologist
4.8 out of 5 stars 41 reviews

Botox to hands

Using botox for palmar hyperhidrosis is an effective way to decrease sweating. The botox prevents the nerves from telling the sweat glands to secrete sweat.
Each palm will need 50 to 100 units depending on the size. The cost depends on the cost per unit in each office. Botox ranges from 10-15 dollars per unit in my area.

There are surgeries for this as well: sympathatectomy.

Sheila S. Nazarian, MD
Beverly Hills Plastic Surgeon
4.8 out of 5 stars 56 reviews

Options besides botox include things that don't work well and others that are expensive

and may cause other issues...there's always topical antiperspirants that should be used at night or medicines like drysol that must be applied correctly to avoid burning and irritation...these options sometimes work...and there are pills that are in the glycopyrrolate family may help but they often cause dry mouth and difficulty urinating...then there are the laser or surgical options...but surgery may lead to its own complications and often triggers excessive sweating from the chest down...and laser is more involved, may burn the tissues and may be painful...botox and similar products address the problem with little fanfare, little problem, and proven results...if you want to try the topicals or pills as a starter, that's okay...then I'd move on to botox...

Ken Landow, MD
Las Vegas Dermatologist
4.6 out of 5 stars 9 reviews

Palmar hyperhidrosis

Aluminum chloride anti-perspirants, iontophoresis, surgical clipping of nerves, glycopyrrolate orally or topically, and Botox Therapeutic injections are all treatments for palmar hyperhidrosis.  Your son should consult a dermatologist for advice.

Martie Gidon, MD, FRCPC
Toronto Dermatologist
5.0 out of 5 stars 22 reviews

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