Although iontophoresis is generally safe, because it uses an electrical current it's not recommended for women who are pregnant and people who have pacemakers or metal implants (including joint replacements), cardiac conditions, or epilepsy.
2. Botulinum toxin: Another treatment option for heavy sweating is injections of botulinum toxin A (Botox), the same medicine used for wrinkles. Botox is FDA-approved for treating excessive sweating of the underarms, but some doctors may also use it on the palms of the hands and soles of the feet.
Botox works by preventing the release of a chemical that signals the sweat glands to activate. You may need to have several Botox injections, but the results can last for almost a year.
3. Anticholinergic drugs: When you've tried antiperspirants and treatments like iontophoresis and Botox and they haven't worked, your doctor might recommend a prescription medicine such as anticholinergic drugs. Oral anticholinergic drugs stop the activation of the sweat glands, but they aren't for everyone because they can have side effects such as blurred vision, heart palpitations, and urinary problems.
4. Surgery: You may have seen plastic surgeons advertising surgical procedures for excessive sweating. Surgery is only recommended for people with severe hyperhidrosis that hasn't responded to other treatments. During surgery, the doctor may cut, scrape, or suction out the sweat glands.
Another surgical option is endoscopic thoracic sympathectomy (ETS), in which the surgeon makes very small incisions and cuts the nerves in your armpit that normally activate the sweat glands. This procedure is very effective, but it's used only as a last resort on people who have tried every other treatment. ETS can't be reversed, and it can leave scars. One side effect almost everyone who gets ETS has to deal with is compensatory sweating, which is when your body stops sweating in one area, but starts sweating in another (such as the face or chest) to compensate.
4 Steps You Can Take at Home to Control Heavy Sweating
While you're trying out different antiperspirants, or whatever other treatment your doctor recommends, you can also incorporate some of these at-home solutions to help reduce sweating.
- Don't wear heavy clothes that will trap sweat. Instead, wear light, breathable fabrics such as cotton and silk. Bring along an extra shirt when you know you'll be exercising or outdoors in the heat. Your feet can sweat too, so wear socks that wick moisture away from them (merino wool and polypro are good choices).
- Shower or bathe every day using an antibacterial soap to control the bacteria that can inhabit your sweaty skin and cause odors. Dry yourself completely afterward, and before applying antiperspirant.
- Use underarm liners and shoe inserts to absorb sweat so it doesn't ruin your clothes or start to smell.
- Don't order a double jalapeno burrito with a margarita at your favorite Mexican restaurant. Spicy foods and alcohol can both make you sweat, as can hot drinks like tea and coffee.