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Excessive Sweating: Embarrassing, Treatable

Nearly 8 Million Americans Affected, but Help Is Available
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The 'Home-Run' Treatment

Botox, is derived from the bacterium Clostridium botulinum. It blocks nerves that trigger the sweat glands. Despite the recent FDA approval, Botox injections have been used by dermatologists for about 10 years -- not only to treat underarm hyperhidrosis, but also that of the palms, soles, and face.

Other available treatments include:

  • Prescription antiperspirants, the typical first-line treatment. "They work but can cause skin irritation, redness, and stinging," says Glaser.
  • Medications such as antidepressants, tranquilizers, and a type of high blood pressure medication known as calcium channel blockers. These drugs, which have a "drying" effect, are primarily used to control sweating caused by stressful situations.

  • Surgery to either remove the sweat glands or sever nerves leading to them. But in the procedure to remove underarm sweat glands, range of motion problems of the arm are a common side effect, says Glaser.

"But with Botox, you hit a home run every time," says Glaser, vice chairwoman of the department of dermatology at Saint Louis University School of Medicine.

Waldorf agrees and tells WebMD that Botox injections are even used "cosmetically" in people who don't have hyperhidrosis but want to ensure they don't sweat during special occasions.

"Let's say you're making an important presentation or it's your wedding and you are concerned about sweating too much. You get an injection," she says. "Even celebrities are getting Botox injection in the weeks before the Academy Awards because they know they'll be on stage in expensive dresses."

Are You at Risk?

The exact cause of hyperhidrosis is not completely understood. "We've determined that these patients have sweat glands that are normal in size, number, and function," Glaser tells WebMD. "What seems to be driving this is that signals from the brain cause these people to sweat excessively, not because of heat or from exercise, when it's not necessary to control that much to maintain normal body temperature."

The condition affects men and women equally and has no geographic influence -- those in colder climates are as prone as those in hotter areas. It does seem to run in families, with about half of patients reporting a similarly afflicted relative, says Glaser. It typically first appears following puberty and rarely affects infants.

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