Hyperhidrosis Care & Treatment Options

Hyperhidrosis is a condition of excessive sweating. This is a medical condition caused by an overactivity of the sympathetic nervous system of the sweat glands. The only effective medical treatment for severe hyperhidrosis is a surgical procedure called Endoscopic Thoracic Sympathectomy or, ETS.

This operation can now be performed safely as an outpatient, same-day procedure. There is very little bleeding involved, which reduces recovery time, minimizes scarring, and contributes to less post-operative pain. Patients enjoy quality results, immediately!

People come from around the world to the Hyperhidrosis Center to consult with experts in the cure of hyperhidrosis. There are four major types of hyperhidrosis: palmar hyperhidrosis (sweaty palms), axillary hyperhidrosis (sweaty underarms), facial hyperhidrosis (facial sweating), and plantar hyperhidrosis (sweaty feet).

Where Does Hyperhidrosis Occur?

Palmar Hyperhidrosis

Palmar Hyperhidrosis is a condition marked by excessive perspiration of the palms beyond physiological necessity. It is caused by hyperactivity of the sympathetic nervous system of sweat glands. It is a hereditary sweating disorder, which can sometimes develop in early childhood, or appear at a later age.

Click here to read more about Palmar Hyperhidrosis (Sweaty Hands)

Axillary Hyperhidrosis

Axillary Hyperhidrosis involves extreme, dripping sweat in the armpits, with constant odor that is usually resistant to all deodorants. Axillary sweating may be present, alone, or in conjunction with any or all other types of hyperhidrosis.

Click here to read more about Axillary Hyperhidrosis (Sweaty Underarms)

Plantar Hyperhidrosis

Plantar Hyperhidrosis, severe sweating of the feet, usually occurs in conjunction with Palmar Hyperhidrosis, hand sweating, as a result of an overactive sympathetic nervous system. People with Plantar Hyperhidrosis complain of bad foot odor.

Click here to read more about Plantar Hyperhidrosis (Sweaty Feet)

Facial Hyperhidrosis

Slight increases in temperature and humidity are the stimuli for facial hyperhidrosis/sweating. The sweating usually involves the entire scalp and face. It affects both men and women. They find themselves soaking with sweat on the face and scalp, while doing the most minimal of activities.

Click here to read more about Facial Hyperhidrosis (Sweaty Face)

What Are The Symptoms of Hyperhidrosis?

Having palmar hyperhidrosis, axillary hyperhidrosis, plantar hyperhidrosis, and/or facial hyperhidrosis is a profound and dramatic experience. It affects all aspects of life, including work and related professional activities, the activities of daily living and normal, interpersonal social actions.

Sweaty hands can occur while meeting someone for the first time, through nervousness or emotional distress. Even rubbing on a small amount of lotion can trigger palmar hyperhidrosis.

In severe palmar hyperhidrosis cases, sweat is seen to drip literally down from the hands. This is a condition which can be detected in early childhood. Patients with palmar hyperhidrosis disorder are constantly aware of their condition and think they have to live with it. Usually, the sweating of the hands is the most distressing manifestation of primary hyperhidrosis. The amount of sweating varies from moisture to actual dripping. Many patients report, also, that their hands feel cold and clammy.

Because hands are exposed in social and professional settings, many patients with Hyperhidrosis are self-conscious and may avoid social contact. They may be reluctant to shake hands or handle paperwork. Patients have even been embarrassed to hold the hands of those they love.

Axillary Hyperhidrosis, excessive sweating in the armpits, can cause embarrassing wet marks on shirts. People with this condition avoid many colors and fabrics which could show the sweat marks.

Plantar Hyperhidrosis refers to excessive sweating of the feet. It is a known cause of foot odor and athlete's feet. The combination of palmar and plantar hyperhidrosis can create a problem for a driver because the moisture of the hands and feet can build up to make the steering wheel and foot pedals slippery; this, in turn, can cause a lack of control of the vehicle.

Facial Hyperhidrosis, sweating of the face, may be so profuse that it causes the person to be insecure, appearing overly-anxious, when this is not really the case. Along with facial sweating, someone could experience facial blushing, another embarrassing manifestation of the activity of the sympathetic nervous system.

What Are The Alternative Treatments for Hyperhidrosis?

Ointments or Antiperspirants

This is the initial treatment for moderate or light hyperhidrosis. A product such as Drysol® is recommended. Doctors generally recommend applying it to problem areas after drying the skin completely.

Wearing it only at bedtime and then washing it off in the morning with plain water reduces the chance of skin irritation. It is somewhat irritating and will stain clothing. Do not use a regular deodorant afterwards.

Repeat the treatment, nightly, until the sweating is under control. After it begins to work, use once or twice, weekly, to maintain the effect, and use a regular deodorant on the other days. The medication is less effective on the thick skin of the palms and soles.

Click here to read our detailed guide on antiperspirants.

Oral Anticholinergic Medication

Certain prescription oral medications can prevent the release of Acetylcholine, the neurotransmitter responsible for causing the eccrine sweat gland to go into overdrive. Robinul® is frequently recommended and easy to take, once per day.

The negative side to this medicine is the list of potential side effects including dry mouth, blurred vision, constipation, urinary retention and palpitations.


This treatment consists of electrical stimulation of the affected areas. The site of choice is submerged in water and electricity is emitted by the device. The intensity is gradually increased until the patient notices a tingling feeling, which some people find unpleasant.

After several uses, the person will sweat less for four to six weeks. To really get it to work, it needs to be used one half hour every night, per site. Treatment is repeated until sweating is under control. Drionic® is the product recommended.

The results may vary: in cases of light hyperhidrosis, some patients are happy, but others may consider the treatment too time-consuming and expensive.


Another treatment is the injection of BOTOX® into the area of excessive sweating. People who find no relief from conventional drug treatment for the persistent problem of sweaty palms or underarms may get short-term improvement from injections of a potent bacterial toxin.

Botulinum toxin type A is a powerful chemical that, in its diluted prescription form, BOTOX®, has been used safely in treating eye muscle disorders, wrinkles and other conditions. BOTOX® is nothing more than a protein that acts on the junction of the nerve and the muscle, making the muscle less active.

It reduces sweating by blocking release of the chemical acetylcholine, which stimulates secretion of the sweat glands. When a small amount of BOTOX® is injected into the armpits or palms, it stops those areas from getting clammy and sweaty.

BOTOX® injections, however, are only temporary and have to be repeated two to three times a year. In addition, they are painful and expensive. Some BOTOX® patients say the treatment has given them renewed self-confidence, while others think the whole process is not worth the trouble.

Generally, BOTOX® injections are ineffective in cases of severe palmar or facial hyperhidrosis.

Is There a Surgical Treament for Hyperhidrosis?

Although alternative treatments such as oral medication, BOTOX®, Drysol® and Drionic® are available, the only long-lasting, effective treatment is to surgically stop the signal transmissions of the sympathetic nerve impulse to sweat glands.

Basically, this can be achieved for all locations in the body such as palms, face, armpits, and feet. This procedure is known as Endoscopic Thoracoscopic Sympathectomy (ETS).

Endoscopic Thoracoscopic Sympathectomy (ETS)

The best person to perform Endoscopic Thoracic Sympathectomy (ETS) is a highly trained, experienced, thoracic surgeon.

The operation is performed on an outpatient basis while patient is under general anesthesia administered by a board-certified or board-eligible anesthesiologist. The sympathetic nerves are located along the back, just behind the ribs. The surgeon uses a scope with magnification and illumination provided by the camera to view the sympathetic nerves.

The vascular surgeon cuts or clamps the sympathetic nerves of the  ganglion through two small incisions (5 to 10 mm) below the armpit area on each side of the chest. In the cutting method, the nerve is simply cut.

These nerves are cut to stop or reduce the body's ability to produce sweat in those identified problem areas. Our surgeons prefer this method over the clamping method. In the clamping method, metal clamps are applied on the nerve to stop the sweating from a particular section of the nerve; the success rate for this method is low.

The procedure is performed bilaterally in the same session. After patients wake up from the anesthesia, they are moved to a recovery room, where they are carefully monitored, before being discharged to go home.

Patients can return to work or school within several days. The procedure is extremely effective for palmar and axillary hyperhidrosis. The endoscopic technique is very safe and is curative in 98% of patients.

Hyperhidrosis Treatment Testimonials

It's so awesome! I'm really glad I went to cure my hyperhidrosis. It's great to be able to go to the gym and not sweat on my hands, face, head, or feet. Thank you so much!"

As a little boy, I already had sweaty palms. I was miserable because this condition had been with me all my life. I dreaded attending church or social gatherings because it meant I had to face others. Also, I had difficulty handling tools at work because everything I touched became wet. I am very happy with the result of my surgery. Thanks for curing my hyperhidrosis. I feel years younger. I highly recommend the surgery to anyone who is suffering from palmar hyperhidrosis.

I tried medicines-- from Beta Blockers-- to lotions-- to anti-psychotics, but to no avail. I was using Drysol. At the beginning, it was great. I had dry hands for two weeks in-between doses. Then slowly, the medication started to lose its affect on me. Instead of applying once every two weeks, it was once every two days. I started to look on the Internet for other alternatives and found the website for treating hyperhidrosis.

I strongly suggest that anyone suffering from palmar hyperhidrosis should consult the doctor, to have the surgery. I suffered from this problem for more than 20 years, and now there is no more hyperhidrosis.

Thank you for taking care of my hyperhidrosis. Your staff was compassionate, caring, and very professional. You made me feel like family. I was attended to in a prompt and hospitable manner. Everything was thoroughly explained in detail to me. I can't wait to tell everyone how successful my surgery was!