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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.