Hyperhidrosis treatment

sandra eriksson mirkovic hyperhidrosis

Written by: Sandra Eriksson Mirkovic, licensed MD

Hyperhidrosis is a medical condition that results in excessive sweating. Choosing the right hyperhidrosis treatment depends on the type of hyperhidrosis and where excessive sweating occurs on the body. It may affect the whole body or just specific areas such as for example the hands, feet, underarms or face.

Dealing with excessive sweating on a daily basis can be extremely difficult. It often has a huge impact on the quality of life, and often prevents those who suffer from it, from carrying out everyday tasks


Our doctor Sandra will help you with medical assessment, advice and information on possible treatment about any sweat related issues. Schedule an online appointment with a licensed physician from anywhere within minutes.

Read more

Hyperhidrosis causes

The cause of hyperhidrosis is not fully understood but it seems people with hyperhidrosis require less stimuli like heat or movement to start sweating a lot.

Commonly affected areas include:

  • Face
  • Underarms
  • Palms of your hands
  • Groin/Genitals
  • Feet

If excessive sweating has no other underlying medical cause or other reason, it's called primary hyperhidrosis. There are two types of primary hyperhidrosis: Focal and generalized. It happens when excessive sweating occurs due to a slight raise/change in temperature, when a person is focusing or maybe watching/reading something interesting, walking or due to no reason at all.

It can either affect one area of the body and is then called focal, most often hands, feet, underarms or the groin area. Or it can affect several areas of the body/the whole body and then is called generalized hyperhidrosis. The other main type of hyperhidrosis is referred to as secondary hyperhidrosis. It is caused by an underlying medical condition or as a side effect of medications. That's how it got its name - secondary. People with secondary hyperhidrosis usually experience sweating over large areas of their body.

With primary generalized hyperhidrosis, excessive sweating usually begins in adulthood, whereas primary focal hyperhidrosis often begins in adolescence or during childhood. Also, people with generalized hyperhidrosis may often experience their sweating symptoms at night while sleeping which is not so common in primary focal hyperhidrosis. Hyperhidrosis can be uncomfortable and at the same time challenging to treat. What works for one person will not necessarily work for another, so it can take some time until you find the right treatment.

sweaty underarms

In some cases, excessive sweating can be caused by other medical conditions such as menopause or hyperthyroidism, or even some types of cancer. Certain medications also can lead to excessive sweating. To make sure your hyperhidrosis is not due to another underlying condition, please consult a doctor to get your diagnosis. Once the diagnosis is made, various forms of hyperhidrosis treatment are available to control this condition and improve quality of life.

Hyperhidrosis treatment options

Antiperspirants (Topical Aluminum chloride)

It's usually recommended to start with the least invasive treatment such as antiperspirants. These come in many different forms such as sprays, roll-ons or lotions. The active ingredient (aluminum chloride) in antiperspirant is designed to block sweat glands. They can be bought at pharmacies without a prescription. While aluminum chloride can be found in OTC antiperspirants, your doctor can prescribe a higher percentage. These antiperspirants are often used to treat mild cases of hyperhidrosis. Aluminium chloride can also be combined with other treatments for a better effect.


How does it work?

The so-called Drysol or STOP 24 (it has different names in different countries) is usually applied before bedtime, 2 to 3 nights in a row, then roughly once a week thereafter to maintain results (apply it to dry skin and wash it off in the morning). Use as directed by your doctor.


Which body parts are suitable?

Armpits, but other areas can also be considered.


What are the side effects?

Skin irritation

Home remedies

Lifestyle changes may also help, including wearing loose and light clothes or avoiding triggers, such as alcohol and spicy food.

You can also try to reduce sweating by:

  • Bathing daily to get rid of bacteria
  • Wearing shoes and socks made from natural materials
  • Letting your feet breathe although many experience that they sweat less if they wear socks.
  • Changing your socks frequently
  • Using over-the-counter antiperspirants on the affected area


Iontophoresis is often recommended to people who have tried prescription antiperspirants but need stronger treatment. It’s a medical device that delivers a mild electrical current which passes through water and into the skin’s surface while your affected body part is submerged in water. There are special pads available that can be used for other areas of the body such as underarms and face. It’s the most common treatment for hyperhidrosis of the hands and feet.

iontophoresis treatment

The method has been around for decades and, if used correctly, it can provide outstanding results.

The main advantages of iontophoresis machine are:
  • The noticeable reduction of the excessive sweating and dryness that can last up to 4 weeks
  • It is a non-invasive, needle-free, drug-free method
  • The treatment is painless but patients may feel a slight tingling sensation on the skin during the treatment
  • The efficiency of iontophoresis treatment for hyperhidrosis generally ranges between 85%-95% of people treated

How does it work?

To perform the treatment, the hands or feet are placed in two tubs with tap water, each containing an electrode. According to your preferences, the current can be adjusted while for example, with Hidroxa SE 20 ionotphoresis machine, you get to choose between constant and pulsed current. However, iontophoresis is not a cure. The treatment must initially be performed several times a week, and in case you get satisfactory results, maintenance treatment will follow, most often one to a couple of times per week.

If you are experiencing excessive sweating, contact us today to schedule a consultation and to see which treatment might be the perfect solution for you!


Which body parts are suitable?

Hands, feet, underarms, face


What are the side effects?

There are no significant or serious side effects, and the benefits are long-term when you maintain your treatments regularly. The most common side effect is dry skin, which is nothing compared to the results you might get with this method. This can be easily solved by applying a moisturizer to the skin after each session.


One of the possible treatments of hyperhidrosis can be injections given into the affected area. The method has been used for a couple of decades to treat excessive underarm sweating and it can help reduce sweat up to one year depending on the sweating level, the amount injected, and location.


How does it work?

This is a safe treatment with very good effect in 90% of the cases but regretfully the effect is not permanent but lasts for 3-12 months. One should always demand enough anaesthetics for the pain. This treatment is not supposed to be very painful even though the number of injections are quite high. The injections can be combined with aluminium chloride as well as anticholinergic medication.


Which body parts are suitable?

Although the best effect is seen for axillary hyperhidrosis, it can be used to treat almost any body parts such as hands, feet, back, chest, groin and face. However, please be aware of the pain during the injections.


What are the side effects?

Most common side effects are: dry mouth, headache, fatigue, pain in the treated area after the injections and so on. Serious side effects are rare, but possible such as muscle weakness.


Sometimes a person has hyperhidrosis on such a large area of the body that injections are not enough. It is then possible​ to combine the injections with pills (glycopyrrolate, oxybutynin, robinul, etc). Referred to as anticholinergics, they are widely used as the first-line therapy for axillary hyperhidrosis. The pills can also be combined with other treatment methods.

Remember you need to speak with your doctor to make sure you have the right diagnosis.


anticholinergics pills

How does it work?

You take a pill and it will have an effect within hours to days depending on what pill it is. They temporarily block the nerve signals to the sweat glands and a reduction in sweat production is seen. When used correctly and after being given all necessary information, even despite the side effects, these pills help a lot of people. It is recommended to take them as seldom as possible.


Which body parts are suitable?

When the whole body is affected.


What are the side effects?

Side effects can include dry mouth, headache, constipation, dizziness, loss of taste which can be regulated by adjusting the dose. Impact on cognitive functions and even dementia in the older population has been seen after long term use.


If you experience unwanted excessive underarm sweating (primary axillary hyperhidrosis) or sweat stains on your clothing, then you may be a good candidate for the miraDry procedure. It is an FDA-approved treatment which eliminates sweat and odor-producing glands in the armpit area.


How does it work?

A handheld device used for excessive underarm sweating by delivering precisely controlled electromagnetic energy under the skin that destroys the sweat glands through the process of thermolysis. Once treated, these sweat glands, in most cases, do not regenerate, making Miradry a lasting solution to underarm sweating.


Which body parts are suitable?



What are the side effects?

Common and so to speak, minor side effects of miraDry include swelling under the armpits, redness, and tenderness that lasts for several days. Temporary tingling or numbness in the upper arm or armpit may also occur, but this usually resolves within 5 weeks of treatment. The treatment seems to not be permanent for everyone.


Surgery is not a first treatment to try, but may be considered for a very select group of patients.

There are two types of surgery:

  • Surgically remove sweat glands
  • ETS (endoscopic thoracic sympathectomy)

How does it work?

A surgeon can surgically remove sweat glands from the underarms. Not often performed.

Sympathectomy is another surgery where the surgeon cuts or destroys the nerves connected to the sweat glands. The surgery is usually performed to treat hyperhidrosis (excessive sweating) and/or face blushing. In order to find these nerves, the surgeon inserts a mini surgical camera into the patient’s chest just below the underarm. The fact that the patient's lungs must temporarily be deflated in order for the surgeon to cut or destroy the nerves confirms how invasive this method is. For some it is successful but for a lot of people it can lead to bad side effects, severe compensatory sweating being one of them.


Which body parts are suitable?

Surgical removal of sweat glands is used to treat the underarms while sympathectomy is mainly used to treat the hands.


What are the side effects?

All surgical procedures carry a certain risk. When the sweat glands are removed from the armpits, there is a risk of developing an infection. Patients may have pain and bruising. Permanent side effects may also occur such as loss of sensation in the armpits and scarring. Although ETS reduces or eliminates sweating in the original problem area, some patients develop compensatory sweating in other areas, usually in the abdomen, back, gluteal region, and legs. Even other serious side effects of sympathectomy may still occur. These include damage to the nerves that pass between the brain and the eyes, low blood pressure, a decrease of heart rate and inability to tolerate heat.


Many people control their hyperhidrosis by combining treatments with tips for managing. This often leads to an improvement in their quality of life. Just remember, you are not alone, and that hyperhidrosis is often entirely manageable – you just have to find the right treatment for yourself.

We hope that after reading this, that you feel a little less confused regarding your treatment options. Feel free to check out one of hyperhidrosis pages dedicated to specific body part Sweaty hands, Sweaty feet and Night sweats as well as check out our doctor Sandra Eriksson Mirkovic’s Instagram page: dr_sandra_hyperhidrosis

For more information on hyperhidrosis including its causes, symptoms and treatment, visit the International Hyperhidrosis Society website.


trustpilot trustpilot-poäng

m cdag iontophoresis machine review
5 stars: excellent
Julian has submitted a review about Hidroxa
“I can't believe it: IT WORKS! After 40 years with this annoying problem that, not always, but often plagued me, especially with heat and stress, it took less than two weeks of treatment and .. magic! The beauty is that I am not sweating in the hands anymore, but my general sweating has also been regulated, and it's fantastic. Just one word: THANK YOU“
iontophoresis machine review
5 stars: excellent
Kate has submitted a review about Hidroxa
"I bought this product because my excessive hand sweating was in certain ways limiting my social life, and disturbing me while doing sports. I did the treatments on my hands and feet every day for 12 days. I noticed small improvements already after 6 treatments, and significant results after 10 treatments. After the first 12 treatments I started to use it every other day. When writing this review I have completed 18 treatments, and I’m really happy with the result. The positive problem I have today is that my skin is very dry, and I need to moisturize frequently."
iontophoresis machine review
5 stars: excellent
Dario has submitted a review about Hidroxa
"After 8-9 treatments/days, I became completely dry on my hands. I started using Hidroxa almost a month ago. Now I do treatments every three days and am still completely sweat-free.The treatments are very easy to perform and painless. So far I have only treated hands but I have noticed that my feet also sweat much less than before. Do not really know why but it may be because my hand sweat triggered the foot sweat. It is a very desirable side effect. I would definitely recommend Hidroxa and am completely satisfied with the purchase. It's a game changer!"