About Your Diagnosis

Hyperhidrosis or excessive sweat production is a relatively common problem that can also be associated with abnormal sweat odor called bromhidrosis. Hyperhidrosis frequently affects the feet but can also involve the hands and armpits. The cause of hyperhidrosis is not known but may be related to stress in some individuals. Other less common causes include certain types of arthritis, nervous system diseases and trauma to the spinal cord, disorders of the blood system, and certain medications. Diagnosis is made based on the history and physical examination. It is usually not curable but it is treatable.

Living With Your Diagnosis
Patients with hyperhidrosis have excess sweating of the feet, hands, or armpits, or sometimes a combination of all three. Occasionally other areas of the body are affected. The sweating can cause embarrassment and sometimes foul odor. Shirt, socks, and shoes can become stained.

Treatment
Hyperhidrosis of the feet, hands, and armpits is frequently treated with Drysol (20% aluminum chloride hexahydrate). Before bedtime, wash and dry affected areas and apply a small amount of Drysol. Wash off in the morning. Repeat nightly for 1–2 weeks, then once per week or as needed. For sensitive skin apply less frequently. Once symptoms are under control, apply Drysol as infrequently as possible, especially in the armpit area to keep symptoms under control. Other medications to apply to the affected areas may also be prescribed if Drysol is not effective. Occasionally oral medications called anticholinergics are prescribed, but these may cause side effects such as dry mouth, blurred vision, and dizziness. Iontophoresis–application of a mild electric current in tap water–is used in some cases for about 30 minutes a day.

The DOs
• During initial use of Drysol for armpit sweating, do not use other commercial deodorants or antiperspirants. Dry the armpit with a hairdryer first, apply Drysol, then dry with hairdryer immediately after application. Once you decrease Drysol treatments to once or twice a week, it is O.K. to use other antiperspirants and deodorants during the day.
• Drink plenty of water to avoid dehydration. Increase fluid intake during hot summer months to 8–10 glasses (8 ounces per glass) of water per day. Drink more if in hot sun.
• Wear cotton clothing that absorbs sweat, and change clothing and socks frequently.
• Take a bath or shower every day, more often if necessary.
• If stress is a major cause of sweating, consider stress reduction counseling.
• It is O.K. to shave armpit hair.

The DON’Ts
• Don’t wear nylon or man-made fabrics.
• Avoid applying deodorants and antiperspirants to the armpits during the initial 1–2 weeks of Drysol therapy. Baking soda can be used instead. Avoid stressful situations that worsen the sweating.

When to Call Your Doctor
• If redness, swelling, or any pus drainage occurs.
• If symptoms are not improved in 3–4 weeks of treatment.