Expert Doctor Blog

Featuring Dr. Helen T. Shin, Board Certified Dermatologist

Dr. Helen T. ShinDr. Shin is the Chief of Pediatric Dermatology at the Joseph M. Sanzari Children’s Hospital at the Hackensack University Medical Center. She is also a Clinical Assistant Professor of Dermatology and Pediatrics at the New York University Langone Medical Center. Her medical practice includes the treatment of hyperhidrosis.

Why do certain people sweat excessively?

Answer: Sweating is a regular part of our daily lives and is necessary for regulating our body temperature by cooling the body. Certain individuals have overactive sweat glands and produce an excessive amount of sweat. In medical terms, excessive sweating is called hyperhidrosis.

Sweat glands are controlled by the hypothalamus, a part of the brain that sends signals to the sweat glands to produce sweat. Hyperhidrosis occurs when the sweat glands do not properly process these signals and end up producing excessive amounts of sweat particularly in the underarms and on the face, palms and feet.

What’s your approach for treating hyperhidrosis?

Answer: There are a variety of treatment options for hyperhidrosis of the underarms, hands and feet including clinical strength (over the counter) and prescription antiperspirants, iontophoresis, oral treatments (e.g. glycopyrrolate), botulin toxin, microwave laser treatment and surgery. All of these treatments have pros and cons that must be considered along with each patient’s individual needs.

As a general approach I typically advise my patients to first try a clinical strength antiperspirant which is often effective and consider more aggressive medical or surgical procedures only as a last resort since they can be painful, have significant side effects, need to be repeated throughout one’s lifetime and may cost thousands of dollars.

What considerations do doctors have when selecting an antiperspirant for their patients?

Answer: Clinical-strength antiperspirants are often effective at controlling the excessive sweating of hyperhidrosis patients including those who are on other forms of treatment (i.e. iontophoresis, oral medication, laser therapy) but still need additional help to control their sweating.

However, for some patients, clinical-strength or prescription antiperspirants may cause irritation and discomfort such as a tingling, burning or itching. It usually takes some trial and error to figure out the most effective regimen that will control the sweating and cause minimal irritation. One way to minimize discomfort is by applying a moisturizer to the affected area after bathing with a gentle cleanser or soap. Additionally, clinical-strength antiperspirants are not intended to be used every day so hyperhidrosis patients will also use a "regular-strength" antiperspirant and/or deodorant product for daily maintenance.

This can get complicated and confusing with patients left trying to figure out a regimen of various products that may or may not end up working for them. A clinical-strength antiperspirant "system" can help eliminate the guess work and complexity by providing a complimentary combination of products pre-formulated to work together.

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