What Treatments Are Available for Hyperhidrosis of the Scalp?

Question

I have excessive sweating on my scalp, in a zone that starts about an inch above each ear and wraps all the way around the back of my head. BELOW this line (not above), my hair gets soaking, wringing wet with perspiration whenever I'm outside on a hot day, or if I start to heat up from exercise or exertion. What treatments are available for this? Is there anything I can do on my own? If I decide to seek medical help, what kind of doctor should I see? A dermatologist?

Young R. Cho, MD, PhD · Answer

Botox is an excellent option for sweating of the scalp. It can provide anywhere from 3-6 months of relief depending on dosage. It would involve a series of small injections. The surface area of the sweaty scalp will determine how much you use, but a safe starting dose would be 50 units.

Anil R. Shah, MD · Answer

Sweating is not a bad thing and on a hot day helps to serve to cool you down.  If this only occurs with exercise, you should see if a simple solution such as a headband can help control sweating.

If the sweating occurs outside a normal context of exercise, other options include the use of antiperspirants (not great on scalp or for hair though) or botox.  
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.

Ken Landow, MD · Answer

since your problem seems related to getting too hot, it's really not a medical disease but just an overactive response to increased body temperature...the way your body cools itself...evaporative cooling...since it seems to bother you, you're a candidate for botox...in this area topical agents are messy and ineffective and oral products have too many side effects and generally don't even work...botox injections placed superficially into the skin generally will alleviate the problem for about 6-12 months after a single session...sounds like a perfect solution to an uncomfortable problem...

Hratch Karamanoukian, MD, FACS · Answer

Botox works very well in the scalp and will change your life to the better almost immediately. I have injected Botox in the scalp for years and recommend it highly for those with craniofacial type sweating.You should find someone who has done a lot of these and who has experience in injecting Botox in the scalp.

There are needlesticks involved but they are small (30G) and there will be minimal bruising and pain. Back to work the same day. You can shower the following day. You can exercise the same day. No limitations on activity following Botox injections. You will need 100 - 200 units of Botox which is quite expensive.Read my free ebook about craniofacial hyperhidrosis on the link below.

Benjamin Barankin, MD, FRCPC · Answer

There are several options for treating hyperhidrosis of the scalp. Firstly, one can apply an aluminum chloride solution at nighttime of which there are several brands on the market. Secondly, Botox can be injected into the scalp and works quite well to reduce sweating in this location. Finally, in some cases, an oral medication can be prescribed to reduce sweating. Best to speak to a dermatologist, the experts in treating excessive sweating/hyperhidrosis. We'd be happy to assess you at Toronto Dermatology Centre, phone: 416-633-0001.

What Treatments Are Available for Hyperhidrosis of the Scalp?

Answers (6)