Doctors call the condition " hyperhidrosis." Patients call it "embarrassing" or "humiliating" and find their fashion choices quite limited by this malady. Simply put: it's sweat, and sufferers of the condition produce a lot of it.
Genes play the biggest role, but hormones and neurological conditions such as stroke and multiple sclerosis also can cause excessive perspiring. Most common body sites affected are the underarms, palms, feet and forehead.
Over-the-counter topical treatments can be effective for some cases of hyperhidrosis. Found in drugstores nationwide, DriOff gel ($23; www.hillderm.com) can be used on the hands, feet, underarms and just about anyplace where excess sweating is problematic. The super-strength deodorant, Certain Dry ($5.29; drugstores nationwide), with aluminum chloride, also can help keep moisture under control.
When a patient seeks medical help, topical prescription medications are usually the first step in combating excess sweating. Xerac AC contains 6 percent aluminum chloride, the same medication used in antiperspirant deodorants. Drysol, used for particularly hard-to-treat cases, contains 20 percent. These medications are applied at night for three to four nights, until the problem is under control, and then used as needed. For maximum effectiveness, skin should be completely dry before applying the medication.
If topical treatments don't work, there are anticholinergic oral medications, which decrease the activity of acetylcholine, a chemical that helps regulate the nervous system. Pro-Banthine (probantheline bromide), taken daily for as long as the sweating persists, is one of these medications. Possible side effects include dry mouth and blurred vision.
For some, the potential side effects of long-term oral medications may be less attractive than the actual sweating. The alternative? An injection.
In addition to being the most popular wrinkle remedy, Botox also is approved by the U.S. Food and Drug Administration to treat hyperhidrosis and is the most recent and most effective advance for excess sweating. Treatment involves multiple injections — more than are used for wrinkles — in a pinwheel, or circular pattern. Botox works particularly well under the armpits, and it also can be done for the hands and feet. Each treatment keeps the problem under control for from three to six months.
When all else fails, a surgical procedure called retrodermal curettage is available to treat excessive underarm sweating. The procedure, similar to liposuction, requires one or two small incisions to be made in the armpit, through which the sweat glands are surgically reduced. The surgery is performed under general anesthesia or with intravenous sedation on an outpatient basis. Dressings are removed 24 to 48 hours after surgery, and exercise should be avoided for three to four weeks. The surgery has a 95 percent success rate.