8 Best Hyperhidrosis Treatments To Help People Who Sweat Excessively

Treatment for hyperhidrosis, or excessive sweating, depends on where on your body you're sweating. Also, you may need to try different approaches, or a combination, to find relief.

Options may include antiperspirants, Botox injections, or medications for excessive sweating. In some cases, you may use medical devices, or a healthcare provider may recommend surgical procedures.

"For complex conditions, you need to be mindful that just because something isn't working, that doesn't mean it doesn't work. It just might not be enough," Adam Friedman, MD, a professor of dermatology at the George Washington School of Medicine and Health Sciences, told Health. "You might have to compound multiple treatments to get it under control."

Here's a breakdown of the best hyperhidrosis treatments and what type of hyperhidrosis you may use them for.

What Is Hyperhidrosis?

Hyperhidrosis is a condition that causes excessive sweating. "Hyper" means "too much," and "hidrosis" means "sweating." People with hyperhidrosis sweat more than what the body needs for cooling.

"Many people have multiple areas of sweating. Oftentimes, hands and feet go together. Some of my patients have [sweating on the] underarms, hands, and feet," Dee Glaser, MD, a dermatologist based in St. Louis, told Health. "The groin and buttocks are not uncommon either, as well as under the breasts or back."

Types of Hyperhidrosis

There are two types of hyperhidrosis: primary and secondary hyperhidrosis.

Primary hyperhidrosis is not the result of another health condition. Usually, primary hyperhidrosis begins in childhood or adolescence. Excessive sweating occurs in one or a few areas of the body. People with a family history of excessive sweating are most at risk for primary hyperhidrosis.

Secondary hyperhidrosis results from another medical condition, like:

• Diabetes
• Gout
• Frostbite
• Head injury
• Tumor
• Overactive thyroid
• Obesity 
• Menopause

The condition can also be a side effect of a medication or supplement. With secondary hyperhidrosis, excessive sweating may affect the whole body or only parts of the body.

Hyperhidrosis Symptoms

Signs and symptoms of hyperhidrosis may include:

• Visible sweating even when you aren't hot or nervous
• Sweating interferes with everyday activities, such as holding a pen or using a computer
• The skin turns soft and white and peels in certain areas
• Skin infections in areas of your body that sweat heavily
  

Treatments for Hyperhidrosis

Treatment options depend on the affected body part and the severity of the excessive sweating. What works best can also vary between people.

A healthcare provider may recommend several treatments for excessive sweating for people with sweating in multiple body parts.

Antiperspirants

Best treatment for: underarms, hands, feet, and sometimes face 

Antiperspirants temporarily plug up sweat ducts, which reduces sweating. People often use antiperspirants to treat hyperhidrosis since they're not invasive or costly.

There are over-the-counter (OTC) and prescription options to treat hyperhidrosis. In addition to regular antiperspirants, Certain Dri is an extra-strength option. Some extra-strength options, like Drysol, require a prescription.

Applying antiperspirants to the underarms at night can help block sweating, advised Dr. Friedman. For mild hyperhidrosis, use an antiperspirant every night for three weeks, gradually decreasing to three times a week.

Keep in mind: some high-strength OTC and prescription antiperspirants can cause itching and burning if used incorrectly. To avoid skin irritation, wipe off antiperspirants first thing in the morning, said Dr. Friedman. However, talk to a healthcare provider about the best plan for you.

Topical Wipes

Best treatment for: underarms 

In 2018, the Food and Drug Administration approved Qbrexza (glycopyrronium) for primary hyperhidrosis on the underarms in adults and children ages 9 and older.

"When used properly, Qbrexza cloths are quite effective," said Dr. Glaser.

Qbrexza is a topical "anticholinergic" medicine available by prescription. Anticholinergic medicines block the nerve signals that activate sweating.

Botox

Best treatment for:  for underarms, hands, feet, face, groin, and more

In 2004, the Food and Drug Administration approved Botox (onabotulinumtoxinA) to treat severe primary hyperhidrosis on the underarms. Typically, healthcare providers recommend Botox when topical treatments are ineffective. Botox can temporarily block the release of the chemical that activates sweat glands.

A healthcare provider injects Botox right below the skin's surface. According to the International Hyperhidrosis Society (IHS), Botox "turns off" sweating in the injection area.

Besides the underarms, as of 2023, the Food and Drug Administration has not approved Botox for use on other body parts. Still, in severe cases, dermatologists may treat the hands, feet, face, groin, and other body parts with caution. However, healthcare providers may only recommend doing so when no other treatments work. 

For instance, using Botox in the hands can be difficult because the skin on the palms is thick, said Dr. Friedman. The skin's thickness makes it hard for the medicine to penetrate. 

"Also, there are a lot of nerve endings in the fingers and hands, and Botox injections can hurt there," added Dr. Friedman. Additionally, muscle wasting may occur if a healthcare provider administers Botox incorrectly. 

Typically, people get Botox injections every four to six months, explained Dr. Friedman. Some people use Botox alongside a topical treatment. 

Laser

Best treatment for: underarms

Most studies involving laser treatment for underarm sweating are merely case reports. Researchers do not control case reports, which often involve few people.

So, there's no definitive evidence that lasers are an effective treatment. However, some healthcare providers provide the option.

Laser procedures typically take less than an hour to complete. Healthcare providers use lasers to target and destroy sweat glands in the underarm via small incisions.

Iontophoresis

Best treatment for: hands and feet 

Since the 1940s, iontophoresis has treated hyperhidrosis of the feet and hands. Typically, people who use iontophoresis get weekly treatments.

An iontophoresis device is a machine that generates a low-voltage current. The device temporarily shuts down sweat glands. 

You'll immerse your hands or feet in a pan of shallow water through which the current passes. For other body parts requiring treatment, a healthcare provider will place pads that connect to the machine on your skin.

You'll see your dermatologist for initial treatments. However, you can later perform the procedure at home.

Iontophoresis can provide long-term benefits. In contrast, side effects may include dry or irritated skin or discomfort during treatment.

miraDry

Best treatment for: underarms

In 2011, the Food and Drug Administration approved miraDry to treat underarm sweating. miraDry involves a handheld device that directs microwave energy to sweat glands on the skin. The device generates heat that eliminates or damages sweat glands in the underarm.

The effects are almost immediate. In some cases, one treatment is enough. However, some people benefit from a second procedure three months after the first.

Oral Medications

Best treatment for: underarms, hands, feet, face, groin, and more

Prescription oral medications help stop sweat glands from producing sweat. Anticholinergics are some of the most common medications for hyperhidrosis. Those medications include:

• Glycopyrrolate
• Oxybutynin
• Benztropine
• Propantheline

However, as of 2023, researchers have not studied those drugs in controlled clinical trials specifically for hyperhidrosis. Still, the Food and Drug Administration has approved them for other medical conditions. So, healthcare providers use them "off-label."

"For example, the most common medication we give orally would be oxybutynin, which stops sweating as a side effect," said Dr. Glaser. "But [oxybutynin] is FDA-approved to treat bladder problems. So, it dries out your mouth and eyes and can constipate you."

Beta-blockers (propranolol) and benzodiazepines are other oral medications that treat excessive sweating in anxiety-inducing situations, like giving a presentation. Those medications "block" the physical side effects of anxiety.

Surgery

Best treatment for: underarms

The following procedures, per the IHS, treat hyperhidrosis of the underarms:

• Excision: Cuts out sweat glands
• Curettage: Scrapes out sweat glands
• Liposuction: Suctions out sweat glands

In some cases, healthcare providers use a combination of those surgeries. 

Keep in mind that those treatments remove or damage sweat glands. So, they can have permanent effects. Also, healthcare providers might not know how effective the surgeries will be. Sweat glands are very small and often undetectable with instruments.

Also, endoscopic thoracic sympathectomy (ETS) can treat hyperhidrosis. With ETS, a healthcare provider inserts a camera under the armpit to cut or destroy nerve paths connected to overactive sweat glands.

However, healthcare providers rarely perform ETS on the underarms and hands. Per the IHS, healthcare providers should consider ETS as a last resort when all other treatments fail. ETS may be the final option when hyperhidrosis severely affects a person's quality of life.

ETS is not reversible and can cause compensatory hyperhidrosis anywhere from six months to 10 years after the procedure. Compensatory hyperhidrosis happens when other body parts start excessively sweating after the affected body parts get better. 

ETS can cause extremely low blood pressure, arrhythmia (irregular heartbeat), and heat intolerance.

A Quick Review

Hyperhidrosis is sweating more than the body needs to cool itself. The condition tends to occur early in life in people with a family history of excessive sweating. However, hyperhidrosis can also result from a health condition or the side effect of a medication or supplement.

Treatment options may include topical or oral medications, Botox injections, or laser or surgical procedures. The best options depend on the affected body parts, the severity, and how well you've responded to noninvasive options.