Hyperhidrosis, the production of excessive perspiration / sweat, can be a socially crippling condition that makes life a misery for the very many men, women and children that suffer from excessive sweating. Unfortunately many family doctors are not aware of, or pay little attention to, the embarrassing and often extremely uncomfortable symptoms that excessive perspiration can produce. This has, unfortunately, led to the creation of a large group of silent sufferers. It is to these people that this site is directed. My name is Jeff Bracey, an U.K. pharmacist who has spent more than thirty years treating people with perspiration and odour problems. I decided to write these notes in order to help individuals find a treatment for excessive sweating that would truly restore their confidence. Hyperhidrosis can be treated in a number of ways. My first suggestion, however, before any "cure" is tried, would always be to surf the Net and join in one or two of the many Hyperhidrosis discussion forums out there. In this way each individual will be able to assess from others just how severe their complaint is and what treatments are most likely to work. A little "finger work" at this stage can save months of trial and error further on down the "track". You can try for example: http://forums.ctsnet.org/ctsnetpatients/index.jspa or http://communities.msn.com/ExcessiveSweatHH (also good for odour problems). There are five treatments for Hyperhydrosis, each can be effective, but it's often better to combine techniques with the more severe conditions. The restoration of normal perspiring from the "hot spots" can be achieved in almost all cases, so take heart and read on. ANTIPERSPIRANTS The treatment of first choice for Hyperhidrosis is an aluminium chloride hexahydrate antiperspirant, do stick to this aluminium salt as the other aluminium formulations are not effective enough for HH sufferers. There are, however, a number of aluminium chloride preparations to choose from and to find the most suitable product requires some care. Strengths vary between 5% and 20% of aluminium chloride in either a water or water /alcohol base. The drying effect of a product is directly proportional to the amount of aluminium chloride in the formulation, and the irritancy of the product depends both on the strength of this active ingredient and the amount of water present. The lower strength brands, such as Certain Dri, Maxim and 5-Day, whilst less effective, may offer some relief to those with the milder forms of Hyperhidrosis. The aqueous base of these products, however, is more liable to cause skin irritations, as the active ingredient, is slowly decomposed in water to form the skin irritant hydrochloric acid. Drysol, Anhydrol Forte and Driclor are well known brands of the stronger 20% aluminium chloride formulations dissolved in varying proportions of water and alcohol. The alcohol content, being water free, helps prevent the breakdown of the product, although any other water content may still cause some skin irritancy. All of these antiperspirants are packed and dispensed from roll-on or dab-on containers, the problem, however, with this form of packaging is the liability of contamination from water (perspiration or water vapour entering via the roller-ball, felt-top, etc) with the subsequent production of the irritating breakdown product hydrochloric acid. These products are generally effective antiperspirants, however, their irritancy and skin dehydrating effects are such that many individuals cannot tolerate their long-term use. Odaban antiperspirant at www.odaban.com was the first of the 20% aluminium chloride preparations to be produced in the late sixties and still remains the only product of its type to fully address the problems associated with using this effective formulation. Odaban contains a special silicone to combat the dehydrating effect of the alcohol and its' unique dispensing pump spray ensures the product remains hermetically sealed. This special container thus prevents any contamination by perspiration and other water sources that would otherwise break down the aluminium chloride; the pump spray also ensures an accurate and repeatable dose preventing over application. Odaban is manufactured to MHRA standards and is now recognised by may dermatologists, pharmacists and podiatrists around the world as the most effective and safe antiperspirant available. IONTOPHORESIS The second treatment of choice is Iontophoresis. Another topical skin treatment, which involves passing a low electric current through water or moistened-pads, which causes surface proteins in the skin to coagulate and partially block the sweat ducts. This treatment can be rather time-consuming and inconvenient but may, when used in conjunction with other treatments, prove to be effective. The Idrostar is available as a home kit at http://www.stdpharm.co.uk/iontophoresis/idrostar-hyperhidrosis.htmll and is said to be more effective and economical than earlier machines. ORAL MEDICINES Taking tablets for the more extreme cases of Hyperhidrosis does work. It is imperative, however, that if you feel the need for this extreme measure, you must do so under a doctor's supervision. You can buy prescription strength medications over the Internet, my advice is don't. Oral medicines do have side effects such as dry mouth, dry eyes, tiredness, gastro-intestinal problems, etc, and your doctor is the best person to ensure your safe use of these powerful drugs. Read up on Robinul tablets (glycopyrrolate, the official name), Ditropan (oxybutynin) and Dixarit (clonidine) by using the Internet discussion forums. Do go prepared with some background knowledge to discuss matters with your dermatologist or doctor, you need to play an active role in the treatment of your condition to achieve the best results. By using low doses of medication, it is possible to avoid heavy side effects, yet still achieve a positive control of your Hyperhidrosis, especially if the treatment is combined with the use of an effective antiperspirant. INJECTIONS Botox injections, the poisoning of nerve endings with a powerful nerve toxin does work, it is, however, extremely expensive, can be very painful, is not permanent (lasts about a year or two) and really is for the very desperate. Think twice before this one. SURGERY Surgery is a last resort for a minority of Hyperhidrosis sufferers. ETS or Endoscopic Transthoracic Surgery can dramatically reduce the incidence of excessive perspiration around the body, the problem is, and it is a big problem, the risk of setting up a high degree of Compensatory Sweating, commonly known as CS. The procedure of cutting the sympathetic nerves that trigger Hyperhidrosis has been improved over the years and the recent clamping techniques are now reversible, should the CS be found to be unacceptable. My advice, to anyone considering this operation, is to think hard about the risks, read as much as you can, and if you do decide to take the plunge, ensure you find a really good surgeon. IN CONCLUSION The Hyperhidrosis battle can be won. Most people will find that Odaban or a combination of Odaban, Iontophoresis or oral medication will solve their problems, the minority who still remain dissatisfied must tread carefully, but as surgical techniques improve the CS risk may eventually be reduced. Don't give in, keep learning about your condition and you will eventually be able to develop a technique that will control your problems. Best wishes Jeff Bracey
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