The drugs, application agents and surgical procedures listed below show an exemplary extract of the current therapeutic options against hyperhidrosis / bromhidrosis. Mode of action and side effects of these preparations and surgical procedures are individual. Self-medication without medical supervision is not recommended (except for commercially available antiperspirants, deodorants or homeopathics).
treatment options for excessive sweating
therapy with botulinum toxin-A
As an alternative to surgical procedures with potential and not infrequently severe side effects, treatment with botolinum toxin to combat excessive sweating can be considered. This agent is injected / injected directly into the skin of the increased sweating area . The procedure is considered to be extremely effective, scientifically proven and can be used not only under the armpits, but even in the head and neck area, hands and feet. However, the disadvantage is that the effect is limited in time. A repetition would be necessary.
The physical therapy method of iontophoresis refers to the introduction of ionized substances into the body through the skin or mucous membrane by means of an electric current. The current flow promotes the penetration of a substance through the skin. The amount of substance introduced by iontophoresis depends on the strength and duration of exposure to the electric current.
Skin resistance is lowest within the sweat gland excretory ducts, therefore ion flow is greatest within the ducti.
The technique of iontophoresis was first described in the 18th century. In dermatology, the application of iontophoresis reached its greatest popularity in the treatment of hyperhidrosis. In experimental works it was proved that by ordinary tap water it is possible to achieve reduction of sweat secretion.
In the pharmaceutical sector, herbal antihidrotics are offered to combat increased perspiration. These products contain sage or camphor and are available in various forms of preparation (tea, cream, powder, etc.). There are no scientifically based studies on the quality of their antihidrotic effect, possibly they can contribute to the relief of hyperhidrosis. Since the eccrine sweat glands are supplied by cholinergic sympathetic nerve fibers, anticholinergics have been used in hyperhidrosis therapy (especially Sormodren and Vagantin). Anticholinergics act by blocking the neuroglandular transmitter acetylcholine. They can be applied systemically or locally (with or without occlusion), and as an adjunct to iontophoresis treatment.
It has been shown that anticholinergics can reduce but not satisfactorily inhibit sweat secretion. The considerable disadvantage of anticholinergics, which ultimately limits their usefulness, is that they lead to side effects on the autonomic nervous system when used systemically. Even at low doses, visual disturbances, tachycardia, or dry mouth may result.
Endoscopic transthoracic sympathectomy is a surgical procedure to interrupt nerves in the circulation of sweating, which are responsible for the impulse to secrete sweat. This endoscopic procedure is preferred for the treatment of extreme hyperhidrosis of the face or hands. In the case of foot sweat, a special feature arises due to the difficult-to-access localization of the sweat-stimulating nerves, so that a much more complex intervention in the form of open abdominal surgery is necessary here.
In addition to the chemical substances already presented, which develop their sweat-reducing effect inside the body, there are also those substances which, when applied externally, are able to drastically inhibit the excess secretion of sweat. These include primarily metal compounds, especially the combination of aluminum and chlorine, which belong to the main group of antiperspirants.
Aluminum chloride and also sulfate, as well as zinc and magnesium, have been successfully used as metal agents in antiperspirant and hydrosis therapy for many years. These compounds have an astringent effect, they hinder and impede the secretion discharge, and can also be administered in a very treatment-friendly manner in a wide variety of application modifications.
More information about antiperspirants - external applications
In the fight against ugly sweat stains in clothing, in addition to the applications of aluminum chlorides as a pharmacy mixture or industrial products, there are also completely natural aids such as underarm pads or functional shirts. This is not a specific form of therapy but rather the concealment of axillary sweating, but with a result that is often just as positive as the medical, cosmetic or even surgical applications. Primarily, this is a "treatment or better application" without any intervention in the body. The anti-sweat shirts are an undershirt of high quality with a built-in pocket for normal paper tissues to absorb the underarm sweat and a liquid barrier in the underarm area.