Dr. M.J. Bazos,
Hyperhidrosis or excessive sweat production is a
relatively common problem that can also be associated with abnormal sweat odor
called bromhidrosis. Hyperhidrosis frequently affects the feet but can also
involve the hands and armpits. The cause of hyperhidrosis is not known but may
be related to stress in some individuals. Other less common causes include
certain types of arthritis, nervous system diseases and trauma to the spinal
cord, disorders of the blood system, and certain medications. Diagnosis is made
based on the history and physical examination. It is usually not curable but it
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Patients with hyperhidrosis
have excess sweating of the feet, hands, or armpits, or sometimes a combination
of all three. Occasionally other areas of the body are affected. The sweating
can cause embarrassment and sometimes foul odor. Shirt, socks, and shoes can
of the feet, hands, and armpits is frequently treated with Drysol (20% aluminum
chloride hexahydrate). Before bedtime, wash and dry affected areas and apply a
small amount of Drysol. Wash off in the morning. Repeat nightly for 1–2
weeks, then once per week or as needed. For sensitive skin apply less
frequently. Once symptoms are under control, apply Drysol as infrequently as
possible, especially in the armpit area to keep symptoms under control. Other
medications to apply to the affected areas may also be prescribed if Drysol is
not effective. Occasionally oral medications called anticholinergics are
prescribed, but these may cause side effects such as dry mouth, blurred vision,
and dizziness. Iontophoresis–application of a mild electric current in tap
water–is used in some cases for about 30 minutes a
• During initial use of
Drysol for armpit sweating, do not use other commercial deodorants or
antiperspirants. Dry the armpit with a hairdryer first, apply Drysol, then dry
with hairdryer immediately after application. Once you decrease Drysol
treatments to once or twice a week, it is O.K. to use other antiperspirants and
deodorants during the day.
plenty of water to avoid dehydration. Increase fluid intake during hot summer
months to 8–10 glasses (8 ounces per glass) of water per day. Drink more
if in hot sun.
• Wear cotton clothing
that absorbs sweat, and change clothing and socks
• Take a bath or shower
every day, more often if necessary.
If stress is a major cause of sweating, consider stress reduction
• It is O.K. to shave
• Don’t wear
nylon or man-made fabrics.
applying deodorants and antiperspirants to the armpits during the initial
1–2 weeks of Drysol therapy. Baking soda can be used instead. Avoid
stressful situations that worsen the
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• If redness, swelling, or
any pus drainage occurs.
symptoms are not improved in 3–4 weeks of treatment.