Excessive Sweating

Excessive Sweating is called hyperhidrosis. People with hyperhidrosis seem to have overactive sweat glands, which can be embarrassing and frustrating, and in severe cases can affect their quality of life in a big way! When someone has sweaty palms, they may avoid shaking other people's hands or it may be difficult to complete schoolwork or paperwork. When hyperhidrosis involves the armpits, sweat marks can be visually embarrassing and sweat stains can ruin clothing. When feet are involved, people can go through multiple pairs of socks per day and easily get skin irritation and athlete's foot.


Sometimes hyperhidrosis over the entire body is due to an underlying medical problem or medication, for example an overactive thyroid, a stroke, or blood pressure pills. Rarely, sweating over the entire body is idiopathic, meaning no cause can be found, and is best treated with an oral medicine.

Most often however, hyperhidrosis is localized to problem areas such as the underarms, feet, hands, head, and face and has no explainable underlying cause. This is called Primary Hyperhidrosis. It usually affects both sides of the body equally. It often begins in childhood when it affects the hands and feet, and it starts during puberty when it affects the underarms. Possibly, people inherit this trait.



Available with or without a prescription, antiperspirants decrease sweating because when applied to the skin, they plug up the sweat duct openings, so that sweat cannot physically come out of the skin. The most common ingredient in antiperspirants that plugs the sweat ducts is called aluminum chloride. Now there are "clinical-strength" antiperspirants available with higher concentrations of active ingredients to more effectively plug the sweat ducts.

Did you know that the best time of day to apply antiperspirant is at bedtime? At bedtime you are relaxed and your sweat glands are the least active. When antiperspirant is applied at bedtime, the antiperspirant is able to plug up the sweat ducts more effectively. In contrast in the morning when you are rushing to get ready for work or school, you are already actively sweating, the sweat ducts are actively pumping out sweat, and it is harder for the antiperspirant to adhere and work.


This is a treatment for sweaty hands and feet that requires the patient to immerse the hands or feet in a shallow pan filled with water. A medical device sends a low-voltage current through the water, and this process temporarily shuts off the sweat glands. When used every other day, it takes 6 to 10 treatments for sweating to decrease, and treatment must be repeated to maintain results. An iontophoresis machine is available by prescription only, must be purchased by the patient, and treatments are self-administered at home. Many health insurance plans will help cover the cost of the machine.


Though it may sound odd, Botox can be injected into the armpits, palms, or soles to block sweating. Botox works by blocking the release of acetylcholine which normally stimulates the sweat glands. Most patients say that the Botox wears off over an 8-month period, at which time it needs to be re-administered. Call our office to ask how much Botox costs for your problem area. In some cases your insurance may help cover the cost of your treatment, but in most cases it will not. As a rule, the hands or feet require twice as much Botox to be injected as the underarms in order to block sweating. Dr. Downes uses special techniques that makes treatment of these areas as painless as possible.

Laser & Microwave Treatments

New in 2011, the MiraDry System permanently kills targeted sweat glands with microwave energy. And new in 2012, the AxiLase Laser also permanently destroys sweat glands. Both procedures have been shown to decrease sweating by 80- 90 percent. These treatments work by sparing the upper skin layers and focusing energy in the deep dermis and fat to destroy sweat glands. Local anesthesia is required to numb the skin first and swelling may occur after both procedures. Neither MiraDry nor AxiLase are currently covered by insurance.