Treatment Options for Excessive Sweating

Treatment Options for Excessive Sweating

Excessive sweating, also known as hyperhidrosis, is a condition that affects millions of people worldwide. It can be embarrassing and inconvenient, impacting an individual’s daily activities and quality of life. However, there are treatment options available to manage excessive sweating effectively. This blog will explore different treatment options for excessive sweating, including medical, surgical, and lifestyle interventions, and discuss their benefits and limitations.

Topical Antiperspirants

Topical antiperspirants are the first line of treatment for excessive sweating. These products contain aluminum chloride or other aluminum salts blocking sweat ducts and reducing sweat production. Topical antiperspirants are available over-the-counter or with a prescription, and they can be applied to the affected areas, such as the underarms, palms, and soles.

One of the most commonly used topical antiperspirants is aluminum chloride hexahydrate, available in different strengths. It is applied at night to clean and dry skin and washed off in the morning. Regularly using topical antiperspirants can significantly reduce sweating and improve the quality of life for individuals with hyperhidrosis.

Botulinum Toxin Injections

Botulinum toxin injections, commonly known as Botox, are another effective treatment option for excessive sweating. Botox is a neurotoxin that blocks the nerve signals that stimulate sweat glands, thus reducing sweat production. It is FDA-approved for treating axillary hyperhidrosis, which is excessive sweating in the underarms.

Botox is injected into the affected areas using a thin needle during the procedure. The effects of Botox injections usually last for several months, and repeat treatments may be necessary to maintain the results. Botox injections are relatively safe and have minimal side effects, making them a popular option for managing excessive sweating.

Oral Medications

Oral medications can also be prescribed for individuals with excessive sweating. One common group of medications used for hyperhidrosis is anticholinergics, which block the action of acetylcholine, a neurotransmitter that stimulates sweat glands. Anticholinergics can help reduce sweat production but may cause side effects such as dry mouth, blurred vision, and constipation.

Another group of medications used for hyperhidrosis is antiperspirant pills, which contain compounds that reduce sweat production systemically. These medications are less commonly prescribed due to their potential side effects, including gastrointestinal issues, urinary retention, and dry mouth.


Iontophoresis is a non-invasive treatment option for excessive sweating that involves using a small electrical device to deliver a low-level electric current to the affected areas. The electric current helps to block the sweat ducts, reducing sweat production temporarily. Iontophoresis is commonly used for treating palmoplantar hyperhidrosis, which is excessive sweating of the palms and soles.

Iontophoresis is usually performed in a healthcare provider’s office, and the affected areas are soaked in water while a weak electric current is applied. The treatment typically requires several sessions to achieve optimal results, and maintenance treatments may be necessary to maintain the effects. Iontophoresis is generally safe but may cause minor skin irritation or tingling during treatment.

Surgical Interventions

Surgical interventions may be considered in severe cases of hyperhidrosis that do not respond to conservative treatments. There are different surgical options available for excessive sweating, including:

a) Sweat gland removal: Also known as sweat gland excision, this surgical procedure involves removing sweat glands from the affected areas, such as the underarms or palms. This can be done using various techniques, including excision, liposuction, or laser-assisted methods. Sweat gland removal can significantly reduce sweat production in the treated areas but may also cause scarring or changes in skin sensation.

b) Sympathectomy: Sympathectomy is a surgical procedure that involves cutting or blocking the sympathetic nerves responsible for activating sweat glands. This procedure is usually performed using minimally invasive techniques, such as thoracic sympathectomy, which involves making small incisions and using a thoracoscope to visualize and cut the sympathetic nerves. Sympathectomy is typically reserved for severe cases of hyperhidrosis that do not respond to other treatments, and it may cause compensatory sweating in other areas of the body.

c) Laser ablation: Laser ablation is a newer surgical technique using laser energy to destroy sweat glands selectively. This procedure is less invasive than traditional surgery and may offer more precise and targeted treatment for excessive sweating. However, laser ablation’s long-term safety and effectiveness for hyperhidrosis are still being studied, and it may only be widely available in some healthcare settings.

Lifestyle Interventions

In addition to medical and surgical treatments, specific lifestyle changes can help manage excessive sweating. These may include:

a) Clothing choices: Wearing loose-fitting, breathable clothing made of natural fibers, such as cotton or linen, can help reduce sweating and allow better air circulation around the skin, which can help prevent sweat buildup and odor.

b) Avoiding triggers: Identifying and avoiding triggers that worsen excessive sweating, such as spicy foods, hot beverages, or stressful situations, can help manage symptoms. Keeping a diary of triggers and avoiding them can be an effective self-care strategy for individuals with hyperhidrosis.

c) Stress management: Stress and anxiety can trigger excessive sweating in some individuals. Practicing stress management, such as deep breathing, meditation, or yoga, can help reduce stress levels and potentially decrease sweat production.

d) Personal hygiene: Maintaining good personal hygiene, including regular showers, using antibacterial soaps, and applying antiperspirants, can help reduce sweat and odor associated with hyperhidrosis.

Complementary and Alternative Therapies

Some complementary and alternative therapies have been suggested as potential treatments for excessive sweating. However, it’s important to note that the evidence supporting their effectiveness is limited, and they should be used with caution and under the guidance of a healthcare provider. Some examples of complementary and alternative therapies for hyperhidrosis include:

a) Herbal remedies: Certain herbs, such as sage, witch hazel, and tea tree oil, have been suggested to have antiperspirant properties and may help reduce excessive sweating. However, more research is needed to determine their safety and effectiveness for hyperhidrosis.

b) Acupuncture: Acupuncture, a traditional Chinese medicine practice, involves inserting thin needles into specific points on the body to balance the body’s energy flow. Some studies suggest acupuncture may help reduce sweat production in individuals with hyperhidrosis, but more research is needed to confirm its effectiveness.

c) Biofeedback: Biofeedback is a technique that involves using electronic devices to monitor and control physiological responses, such as sweating. Biofeedback training may help individuals with hyperhidrosis learn to control their sweat production by becoming more aware of their body’s signals and using relaxation techniques to manage stress-induced sweating.


In conclusion, excessive sweating, or hyperhidrosis, can significantly impact a person’s quality of life. However, there are numerous treatment options available to manage its symptoms effectively. From topical antiperspirants to advanced procedures like botulinum toxin injections and surgical interventions, individuals with hyperhidrosis have a range of choices to find the best treatment. Lifestyle changes, such as clothing choices and stress management, can also effectively reduce excessive sweating. Additionally, complementary and alternative therapies like acupuncture and biofeedback may provide additional relief for some individuals.

If you’re struggling with excessive sweating and seeking professional help, consider consulting with Sheperd Integrative Dermatology. As a leading dermatology clinic, Sheperd Integrative Dermatology offers comprehensive and integrative approaches to skin health, including hyperhidrosis treatment. With their expertise in dermatology and integrative medicine, the team at Sheperd Integrative Dermatology can provide personalized treatment plans tailored to your unique needs, combining conventional treatments with complementary and alternative therapies to achieve optimal results. Don’t let excessive sweating hold you back – schedule a consultation with Sheperd Integrative Dermatology today and take the first step towards finding relief from hyperhidrosis.

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Rebecca Repaire


Becky is a board- certified Physician Assistant and has practiced Dermatology for over 18 years. She graduated magna cum laude from her undergraduate degree at the University of Georgia, then completed her Physician Assistant studies at the Medical University of South Carolina. She now practices medical, surgical and cosmetic dermatology. She has done extensive training in the use of a dermatoscope and equally extensive training in surgical techniques for the removal of skin cancers. As her practice and skill have continued to grow, cosmetic dermatology has become a passion of hers and she devotes herself enthusiastically to continuing training to ensure she remains at the forefront of innovations with Botox, fillers, threads, and other techniques. She believes that our skin is a reflection of our overall emotional and physical well-being, and she delights in helping patients find their inner beauty.

Amy Jetter


Amy brings her whole heart to her role on the Sheperd cosmetic team.  A graduate of Elon College and the Medical College of Virginia, Amy has been a board-certified nurse for over 30 years.  Bringing her skills as an ICU nurse into her role in cosmetic patient care, Amy provides a warm, reassuring presence to all her clients, listening to their concerns and collaborating with them in a plan to bring forth and enhance their natural beauty.  A standing member of the American Association of Plastic Surgery Nurses and a past RN trainer in cosmetic and aesthetic procedures, Amy offers all types of laser treatments, botox and dermal filler injections, and chemical peels.

Melissa Mancuso

Body Contouring Specialist

Melissa has six years of experience in body contouring, beginning with her role as the CoolSculpting representative for Maryland, Virginia, and the District of Columbia. Since joining the Sheperd team, she has received additional training and now offers chemical peels, Vivace micro-needling, and Diamond Glow dermal infusion. She loves helping patients feel good about their bodies and teaching them about how the various cosmetic procedures can help them achieve the results they are seeking.

Margaret Gierhart


Margaret, a South Carolina native, is a Licensed Esthetician and makeup artist with over 20 years of experience in the beauty industry. She earned a BA in Psychology from the University of South Carolina. She began her career in beauty as the resident makeup artist for Bobbie Brown cosmetics at Saks Fifth Avenue in Charleston. In order to expand her knowledge, she earned her degree in esthetics from Trident Technical College, graduating with honors. She joined the Sheperd Integrative Dermatology staff in 2014 and is certified in a wide array of cosmetic procedures and skin care products. Her offerings include laser skin resurfacing, IPL, micro-needling, chemical peels, radio frequency, laser hair removal, and body contouring. Her background in both psychology and artistry gives her a deep capacity to care for patients and understand what makes them feel beautiful. A mother of two daughters, Margaret understands beauty as not only external appearance, but also as a manifestation of the inner qualities of kindness, generosity, and well-being.

Madeline Anderson


Maddie is a board-certified Physician Assistant and a Lowcountry native. She obtained her undergraduate degree from Clemson University and then went on to earn a Master of Science in Physician Assistant Studies from the Medical University of South Carolina, graduating with highest honors. While in PA school, Maddie served as a Student Representative for the SC Society of Dermatology Physician Assistants. After graduation, she completed a six-month advanced dermatology internship here at Sheperd Integrative Dermatology. She also completed the Diplomate Fellowship with the Society of Dermatology Physician Assistants. Maddie has a heart for medical missions and is passionate about patient education. Her free time is shared with her family, her friends, and her two fur babies!

AnnaKathryn Keiper


AnnaKathryn completed her Doctorate degree at the Medical University of South Carolina and has seven years of experience in dermatology. She has completed additional training in medical dermatology, cosmetic dermatology, and functional medicine. She provides skin cancer screenings, surgical removal of skin cancers, treatment of precancerous lesions, extractions of cysts, and the treatment of acne. In the cosmetic domain, she provides laser, filler, and neurotoxin treatments. Certified through the Institute of Functional Medicine, AnnaKathryn has a special focus on wellness, including weight loss and diet consulting. She uses her expertise in this field to create an individualized program to help each of her patients achieve optimal wellness supporting them in maintaining vibrancy and vitality throughout their lifespan.

Allyson Harrell-Garrison


Ally is a board-certified Physician Assistant and a Diplomate of the Society of Dermatology Physician Assistants, their highest rating. She is a graduate of Clemson University and earned her Master’s degree in Physicians Assistant studies at the University of Alabama; additionally, she completed a dermatology fellowship at Charlotte Dermatology in North Carolina. For more than ten years, her focus on both medical and surgical dermatology has included identifying and treating skin cancers as well as managing biologic medications for psoriasis and atopic dermatitis. Ally has a strong love of surgical dermatology and she performs surgeries every day in the clinic, including excisions of cysts and skin cancers. She also loves the challenge of a difficult case! On the cosmetic side, Ally is a skilled injector of both Botox and Dysport. She sees compassion and empathy as vital qualities that she brings to all her patient interactions. She is mindful that skin cancer screenings can be frightening or overwhelming; her warm, calm manner and her focus on patient education throughout each appointment make her an outstanding clinician.
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