Conservative (non-surgical)
and drug treatments for excessive sweating and hyperhidrosis:
Changing behaviour
Many people can control very
mild hyperhidrosis by altering their normal behaviour. Such methods
include wearing lighter clothes, perhaps drinking less (but only if over
drinking), reducing the amount of caffeine or alcohol, less rushing about
and avoiding stressful situations.
By identifying when excess
sweating occurs many people are able to identify what causes their problem
(if mild) and can think out ways to avoid the problem by making relevant
changes.
Antiperspirants
Useful antiperspirants can
range from simple talcum powders that soak up mild sweat, through some of
the spray-on antiperspirants that reduce the amount of sweat to the very
strongest Aluminium solutions that dry out the skin.
Most people with normal
sweating or very mild hyperhidrosis can find an antiperspirant that suits
them, and most people never need more help than this.
Pads
Some people find using
absorbent pads to protect their clothes to be very useful. Some of these
stick to the clothes - others stick to the skin. Once they become
saturated they need to be changed.
Again these may be useful
for people with mild to moderate hyperhidrosis if well managed. However
they can occasionally mark the skin, and can restrict the sorts of clothes
that can be worn so that they don't show.
Drug treatments for
hyperhidrosis
Some doctors use drug to
treat hyperhidrosis. Commonly a Beta blocker such as Propranolol can be
used. This drug calms the heart down and reduces the effect of Adrenaline
and Noradrenaline. Therefore the usual "Stress" response that starts
sweating off is also clamed down.
Other doctors use a variety
of other medications.
My experience with drugs for
hyperhidrosis has led me to shy away from all drugs bar one. I do not use
beta blockers such as propranolol, as there is a risk of impotency in
young men if this is taken for a long period of time. It also removes a
lot of the excitement out of life, by blocking the adrenaline - a life
without sweating but also without excitement isn't really worth living.
The one drug that I have
found to be very useful in people with severe hyperhidrosis that affects
several areas of the body, is Glycopyrolate (also called Robinul®).
It is not licensed in the UK but can be prescribed by specialists under
certain conditions.
Counselling,
Cognitive Behavioural Therapy (CBT) or Hypnotherapy
If sweating comes on due to
stressful situations, and then worsens when the patient worries about the
sweating, a "vicious circle" starts.
By knowing you sweat, you
become anxious - this causes more sweating which causes more anxiety - and
so on.
Counselling or hypnotherapy
can be very useful for some people in overcoming these stresses - meaning
that they can go into situations that would normally make them sweat - and
control it themselves.
I have found that a few
patients with generalised sweating in stressful situations, of facial
flushing can get some improvement over a long time with these methods.
However, for severe and localised hyperhidrosis, I have found most of my
patients need something a bit more directed.
Summary of Conservative Methods of Treating
Excessive Sweating and Hyperhidrosis:
One of the basic principles
of medicine is "do no harm". Therefore anyone with hyperhidrosis should
consider these conservative measures before embarking on any medical or
surgical treatments.
Most people with very mild
hyperhidrosis will be able to find that one of these methods will work for
them. However, people with moderate or severe hyperhidrosis that is
causing a major problem for them will probably need to go on to other
treatment methods. |
