No Sweat

Excessive perspiration doesn’t have to be a problem, with a range of treatment options available.



Danielle Summerfeldt

For most of us, sweating is a minor annoyance. For Stephanie Pierpont, it has been a years-long source of embarrassment and frustration. The excessive sweat and odor she experienced required her to carry deodorant everywhere she went.

Pierpont eventually learned she suffered from hyperhidrosis, a medical condition that causes sweating far beyond what’s needed to regulate body temperature. Nearly 8 million people in the United States have the condition, according to the International Hyperhidrosis Society (sweathelp.org).

Ultimately, Pierpont found success with a technique called MiraDry offered by Orlando plastic surgeon Dr. Charles Newman, who says his patients are seeing an 82 percent sweat reduction with one treatment. It’s made a big difference for Pierpont. “I can go out to lunch with customers and not feel self-conscious,” she says. “It’s a game-changer.”

Primary hyperhidrosis is confined to particular locations–palms and soles, face, underarms–and tends to run in families, says Dr. Michael Steppie, president and medical director of Associates in Dermatology in Orlando. Secondary hyperhidrosis typically affects larger areas of the body and can be caused by medication or an underlying condition, such as menopause or rheumatoid arthritis. 

Ninety percent of patients who seek help are diagnosed with primary hyperhidrosis, according to the hyperhidrosis society. As research into a cure for the condition continues, a number of treatments are available: 

Prescription antiperspirants
work by plugging the sweat ducts. Inexpensive, they are typically covered by insurance. The downside is they may irritate the skin due to high concentrations of aluminum chloride.
Cost: $10-$50/month.

Botox injections, which are effective for underarms, hands, and feet, temporarily block secretion of the chemical that activates the body’s sweat glands. Effects last 4-12 months, requiring ongoing treatment. Cost: About $1,000 for one treatment that includes both underarms. 

Iontophoresis treats hands and feet. A medical device, which the patient must buy or rent, delivers mild electrical current through water—not enough to cause a shock, but enough to block the sweat glands temporarily. Initially, it requires three weekly treatments; after satisfactory dryness is achieved, a patient can switch to once-weekly treatment. Cost: $500-$1,000 for device. 

Oral medications can be helpful for excessive facial sweating and patients who develop compensatory hyperhidrosis after surgery. The most common medications, called anticholinergics, block the action of the neurotransmitter acetylcholine in the brain and can prevent the stimulation of sweat glands. Side effects can include blurry vision, dry mouth, constipation; a 2015 study found a possible link between the long-term use of anticholinergics and dementia in people age 65 and older. Cost: $20-$80/month.

Lasers can be effective for underarm hyperhidrosis by targeting, heating, and destroying sweat glands. Cost: About $3,000 for one treatment. 

MiraDry can be a very effective treatment for underarm hyperhidrosis. A medical device delivers controlled electromagnetic energy to destroy the sweat glands. Cost: $2,000-$3,000 for two treatments

Surgery can reduce or eliminate hyperhidrosis of palms and underarms. In underarm surgery, the surgeon removes sweat glands; in palm surgery, the surgeon interrupts the transmission of nerve signals from the spinal column to the sweat glands. Palm surgery often results in compensatory hyperhidrosis on large parts of the body or all over; considered a last resort for people who have had no success with all other treatments. Cost of underarm surgery: About $5,000; palm surgery: $10,000-$20,000.

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