Horrible head and facial sweating.

Question

I have been suffering from horrible head and facial sweating for years ( 'straight outta shower' severity level). I have already tried multiple deodorants (eg. odaban) and have had botox injected all over my head. Sadly nothing seems to help. My health seems to be good (according to my doctor , blood tests etc). Sweating usually appears at the smallest amount of exertion and/or temperature change and/or anxiety. Are there any treatments apart from botox available that can be used on the head ?

Aldo Guerra, MD · Answer

I believe like the other doctors on this forum that you will be well served by Botox to reduce your sweating. Best wishes, Dr. ALDO

Anil R. Shah, MD · Answer

Craniofacial hyperhidrosis typically involves several treatment options:
Botox- The standard for hyperhidrosis with local side effects only.  May require a larger dose for the scalp.
Oral medications- Typically involve anticholinergic medications such as glycopyrrolate and are not well tolerated.
Topical medications- Usually not advisable to put drysol on the scalp
Surgery- May be last resort for some patients but hyperhidrosis treatments tend to be moving away from this
LASERS/Miradry/ Radiofrequency- Very effective in other parts of the body.  Not ideal for scalp as some hair loss can be seen.

Hratch Karamanoukian, MD, FACS · Answer

Generally, reserve sympathectomy for the most severe cases after all else fails to reduce hyperhidrosis (2017 update).
Algorhythm is: natural supplements, oral prescription medication or Botox.
I have used Botox effectively for these areas: face, scalp, neck, underarms, back, groin, feet, chest. 
Botox is safe and very rarely causes compensatory sweating.
Once it's effect wears off, compensatory sweating goes away (my experience). 
It is very unpredictable who will get compensatory sweating with Botox as it is a rare side effect. 
H Karamanoukian MD FACS
Center for Excessive Sweating, established 1999

Derek Norcom, MD · Answer

Botox is likely your best option. Make sure you see someone who has several years of experience injecting Botox as injections for sweating must be placed directly in the dermis, not the muscle. There are also areas of the face to avoid due to chance of affecting the muscles.

Harry Sharata, MD · Answer

Have you tried a medication called glycopyrrolate? It is usually given in pill form, and now they have new topical formulations. Glycopyrrolate is an anti-cholinergic medication that essentially helps to "dry out" the sweat glands. The pills can be very effective in minimizing sweat for some people. Botox is one of the better options, but I would talk to a Dermatologist to see if the oral medication would be worth a try. Take care!

Horrible head and facial sweating.

Answers (6)