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Oral Medications for Hyperhidrosis
Written by Katie Crissman
October 01 2020

Oral medications are often used for the treatment of hyperhidrosis. They are most effective when used in conjunction with other therapies, like topical treatments, to control and minimize the symptoms of hyperhidrosis. They are considered to be a second or third line therapy, and should only be used when other, more localized, treatments have failed to show significant improvement. If someone is planning to use oral medication, it is important to manage hyperhidrosis with an experienced doctor. Medications can be an important aspect of a treatment plan for individuals suffering from hyperhidrosis, and it can greatly improve their quality of life. There are several types of medications used in the treatment of hyperhidrosis which include anticholinergic agents, beta-adrenergic blockers, alpha-adrenergic agonists, benzodiazepines, and a few other less commonly used drugs. No oral drugs are currently approved by the FDA for use in patients with hyperhidrosis, but they can be used off-label for this purpose.[1]

What type of hyperhidrosis patients should consider oral medications?

Patients who tend to find oral medications the most effective are those who suffer from all-over sweating, usually caused by secondary generalized hyperhidrosis, and those with primary focal hyperhidrosis who have tried localized therapies, and found them ineffective or intolerable. It is usually recommended that patients try topical creams, botox treatment, iontophoresis, local permanent treatment options for axillary hyperhidrosis, or other localized treatments before moving on to systemic medications. Oral medications can also be especially helpful for patients in which the cause of their hyperhidrosis cannot be removed or remedied. For example, in a patient with a psychiatric illness who suffers hyperhidrosis as a result of a medication, but who can’t stop taking it. Adding another medication to reduce the sweating would be more effective than simply taking the patient off of their psychiatric medication.[1] There are several common medications that can actually cause hyperhidrosis, so situations where medications must be given as an addition to another treatment are not uncommon. Oral medication can also be useful for patients who had a surgical procedure for primary focal hyperhidrosis and need relief from compensatory sweating.[1]

Some patients, in particular, are not good candidates for oral medication. People who play sports and have hyperhidrosis and people who may become overheated easily are two groups of people that should not take oral medication for hyperhidrosis. This is especially pertinent with the use of anticholinergic agents because they cause the body produce less sweat everywhere, which makes it so the body cannot properly cool itself down during times of excessive heat or increased activity. It is also important to consider the possible dangers of oral medication use in kids who have hyperhidrosis, as they have difficulty with self-monitoring and may become dangerously overheated. There are medical treatment options for children with hyperhidrosis, but parents should be weary when considering oral medications for their children.[1]

Types of Oral Medication:

Anticholinergic Agents

An anticholinergic agentic is a type of medication that blocks the neurotransmitter acetylcholine in both the central and peripheral nervous systems. Sweat glands are innervated by the sympathetic nerves and use acetylcholine as their primary neurotransmitter, which is how they communicate. Therefore, when an anticholinergic agent blocks acetylcholine it prevents the body from sending the messages that tell it to produce sweat. This makes anticholinergic medications one of the most effective and commonly used oral medications to treat hyperhidrosis. Unfortunately, acetylcholine receptors can be found in other places throughout the central and autonomic nervous systems so anticholinergic medications can cause unwanted side effects when they block receptors that are not related to perspiration. Some of these side effects can interfere with the GI system, eye function, nervous system function and cause certain respiratory and urinary issues. There are several kinds of anticholinergic agents doctors prescribe for hyperhidrosis and each one acts slightly differently and has differing side effects. Glycopyrrolate and oxybutynin are the most commonly prescribed anticholinergics used to treat hyperhidrosis.[1]

Glycopyrrolate is the most commonly used anticholinergic agent prescribed for hyperhidrosis. This is in part because it does not cross the blood-brain barrier as easily as other anticholinergic agents, and thus causes less central nervous system side effects. This medication is taken daily and is quite effective at reducing the amount of sweat caused by hyperhidrosis. It does, however, have a host of side effects, the most common being dry mouth. In a study of children taking this medication 90% had a reduction of hyperhidrosis symptoms.[4] In another study of adults taking glycopyrrolate, it was found that up to 80% had side effects from the drug and one third had to discontinue use of the medicine because of those side effects.[1]

Oxybutynin is another anticholinergic agent prescribed for hyperhidrosis. In one study, 70% of patients taking reported improvement in their axillary and palmar hyperhidrosis symptoms, while 90% reported improvement from plantar hyperhidrosis symptoms.[1][4]

There are several other types of anticholinergic agents that may be useful in the treatment of hyperhidrosis, but studies on them are limited or they and they are less commonly used.

Beta-adrenergic Blockers

Beta blockers are a type of medication that can affect blood pressure, but are often used to treat patients who want to improve symptoms from social phobia and performance related anxiety. Many people who suffer from hyperhidrosis report a worsening of symptoms during times of performance anxiety and this is when a drug like propranolol (a type of beta blocker) can be useful. For example, a hyperhidrosis patient about to have a public speaking session may take a beta blocker beforehand.[1] These are typically taken on an as-needed basis for people who experience episodic or event related bouts of hyperhidrosis. They are not generally intended for long-term or daily use.[1]

Alpha-adrenergic Agonist

The predominant alpha-adrenergic medication used to treat hyperhidrosis is clonidine. It is generally used to treat hypertension (high blood pressure) and some anxiety and phobic disorders. It has been most effective for people who suffer from craniofacial hyperhidrosis. Some side effects include dry mouth, dizziness, constipation, and sedation.[1]

Benzodiazepines

Occasionally, benzodiazepines are listed as a treatment for hyperhidrosis but they are primarily used for the treatment of anxiety and psychiatric disorders. Hyperhidrosis is known to cause anxiety, but patients should be careful when usng benzodiazepines. Issues can easily arise due to dependence and abuse issues, so normally doctors prefer to use propranolol for performance related hyperhidrosis.[1]

Other Medications

There are other medications that may help with the treatment of hyperhidrosis but there is little to no research on these drugs, and they are only of use in limited situations. Some of these medications include the calcium channel blocker diltiazem, an arthritis medication called indomethacin and the neuropathic pain medicine gabapentin. All of these have been used in limited cases but may be worth looking into if no other treatments are effective.[1] In some situations antidepressants have been found to aid in the treatment of hyperhidrosis as well.[3]

If first-line treatments for hyperhidrosis are not working, then looking into an oral medication may greatly improve your quality of life. It is important to manage your hyperhidrosis with a doctor and talk to them about pros and cons of systemic medication.

Sources
  1. Pariser, D. M. (2014). Hyperhidrosis (4th ed., Vol. 32). Amsterdam: Elsevier Pub. Co., 2014. Retrieved
  2. Medications. (n.d.). Retrieved July 27, 2018, from https://www.sweathelp.org/hyperhidrosis-treatments/medications International Hyperhidrosis Society
  3. Walling, H. W., & Swick, B. L. (2011). Treatment Options for Hyperhidrosis. American Journal of Clinical Dermatology, 12(5), 285-295. Retrieved July 27, 2018, from https://search-proquest-com.ezproxy.wakegov.com/docview/1467836763?pq-origsite=summon.
  4. Grabell, D. A., & Herbert, A. A. (2016). Current and Emerging Medical Therapies for Primary Hyperhidrosis. doi:10.1007/s13555-016-0148-z
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Antiperspirant

What You Need to Know About Carpe Clinical Regimen

By Katie Crissman /

One of the newest clinical strength antiperspirants to hit the market is Carpe’s Clinical Grade Regimen - it combines several high performing products with a specific care routine to provide long term sweat reduction for even the heaviest sweaters. Read on to see if Carpe Clinical Regimen is right for you!

Antiperspirant is great - for most people. You apply it once a day and it stops your sweat! It’s easy. But, what if that’s not what happened? You bought it, read the label, and used it exactly as directed and, unfortunately, you’re still sweating - excessively. If this is you, then you’ve come to the right place. There are products specifically made for heavy sweaters who haven’t had luck with traditional antiperspirants. These products typically include the words “extra strength”, “clinical strength” or “prescription strength” and they are, thankfully, available over the counter without a doctor’s prescription. 


The difference between clinical strength products and their weaker counterparts are the active ingredients they use. Clinical strength lines typically use one of several newer types of metallic salt ingredients that are known to be both stronger and less irritating than aluminum chloride (which is the standard active ingredient in antiperspirants) [1]. While there are many clinical strength products on the market, we are going to focus on a new clinical strength regimen that combines a strong active ingredient with a specific care routine to get excessive sweating under control. 


Carpe Clinical Regimen -  What It Is and How It’s Different

One of the newest clinical strength antiperspirants to hit the market is Carpe’s Clinical Grade Regimen. It’s different from other prescription grade products because it combines several strong products with a specific care routine to ensure maximum product performance. It’s also different from Carpe’s other products because it uses a stronger active ingredient and delivery system. The system is geared toward people who experience intractable armpit sweating, but Carpe also makes products for people who struggle with other types of sweat. The Carpe Clinical Grade Underarm includes three specific products that, when used together, have been found to be highly effective at reducing sweat production. These products include:

  • Carpe Clinical Grade Underarm Antiperspirant 
  • Carpe Clinical Grade Exfoliating Wash
  • Carpe Clinical Grade Underarm Wipes[2]

Carpe Clinical Grade Regimen uses an active ingredient called Aluminum Zirconium Tetrachlorohydrex GLY (20%) combined with other soothing inactive ingredients to effectively stop sweat in its tracks while reducing skin irritation.[3] Aluminum Zirconium Tetrachlorohydrex is a newer generation metallic salt that stops sweat production and is known to be more effective than other types of active ingredients antiperspirants typically use. One study mentioned in the journal Dermatologic Clinics found that antiperspirants using Aluminum Zirconium Tetrachlorohydrex were, on average, 34% more effective than antiperspirants that used aluminum chloride as an active ingredient.[1] Carpe’s traditional products use an active ingredient called Aluminum Sesquichlorohydrate at 15% which is effective, but less potent than Aluminum Zirconium Tetrachlorohydrex.[4]


It’s important to note that Carpe’s Clinical Grade Regimen provides a long term impact on sweat reduction from making short term lifestyle changes. This is because the results build up over time and peak at about 4 weeks. It takes 4 weeks of using the Carpe clinical grade products once each morning and every other night to see the full effect of what they can do. This is typical of all antiperspirants as their effects tend to build up with consistent use. Consistently using antiperspirant products is especially important for those with hard to treat sweat problems because it can be the difference between treatment success or failure.[1][2] 


If you’re frustrated with the way your current antiperspirant is working or how it isn’t working, then consider giving Carpe’s Clinical Grade Regimen a try! It’s active ingredient is comparable to other prescription strength products on the market but it’s multistep system with easy to use wipes is completely unique! Remember, an easy to use, consistent antiperspirant routine is going to give you long term sweat reduction so it’s important to find a system that works for your lifestyle. 


Sources
  1. Pariser, D. M. (2014). Hyperhidrosis (4th ed., Vol. 32). Amsterdam: Elsevier Pub. Co., 2014. Retrieved from https://www.elsevier.com/books/hyperhidrosis-an-issue-of-dermatologic-clinics/pariser/978-0-323-32607-0>https://www.elsevier.com/books/hyperhidrosis-an-issue-of-dermatologic-clinics/pariser/978-0-323-32607-0
  2. How It Works (Clinical). Carpe. https://mycarpe.com/pages/how-it-works-clinical. 
  3. Clinical Underarm  PM Wipes. Carpe. https://mycarpe.com/products/clinical-grade-underarm-antiperspirant-wipes?variant=34814174724229
  4. Underarm Antiperspirant for Excessive Underarm Sweating. Carpe. https://mycarpe.com/products/underarm-antiperspirant-tube?variant=39247505358981
Body Areas Affected by Hyperhidrosis

9 Outrageous Things People Try to Avoid Excessive Armpit Sweating

By Daniel McCarthy /

9 Outrageous Things People Try to Avoid Excessive Armpit Sweating


On my first day of work a few years ago, I got dressed to impress and walked the 20 minutes to my new office to meet my new colleagues for the first time. Having just moved to the southern US, I’d been getting used to the unbearable humidity and its effects on my excessive armpit sweating. Luckily (I thought), the sun wasn’t out and the temps dropped below 80, so maybe my sweat glands wouldn’t take center stage! Well...I arrived to meet my colleagues looking like a wet bass in business clothes. Thank goodness I arrived 15 minutes early, which brings me to the first outrageous thing people try to avoid armpit sweating. 

  1. The Hand Dryer 

I anxiously scurried to the nearest bathroom, declothed, and put the hand dryer to good use on my shirt stains and sweat stains. More outrageously, I awkwardly hovered my sweaty extremities (including my sweaty underarms) over the hand dryer. Thankfully, I reapplied my antiperspirant and headed out to meet my colleagues a decently dry man. That was the day I knew I really needed clinical strength antiperspirant for my excessive armpit sweating (and a car). 


  1. Pantyliners


Many with excessive underarm sweating already know that underarm pads are one way to help with sweating armpits. But if you find yourself sans pad and worried about your excessive armpit sweating, you would not be the first person to try pantyliners. That’s right, pantyliners have been used in a pinch to help keep sweat stains at bay. 

  1. Give a shirt

In 2019, a reddit user posted that to combat his excessive armpit sweating, he skipped the typical clothing and made his own shirt. He posted asking others to try out his creation and received over 250 replies! By creating and giving others shirts, this innovative reddit user designed his way into the hearts of many with smelly armpits. 

  1. Get inked

If you’ve been debating whether to get a tasteful tattoo and you have hyperhidrosis, this finding may just help you make your decision. A 2017 study found that getting inked helped reduce sweat [1]! Now, I don’t recommend choosing a tattoo as a means of treatment for excessive armpit sweating (and maybe don’t tattoo your armpit), but the connection is a fun little fact nonetheless. 

  1. Become a naked mole rat

If you can’t pull the trigger on an armpit tattoo, another method some people have tried is hair removal. Yes, like Steve Carrell (who actually has hyperhidrosis himself) in the hit movie 40-year Old Virgin, removing hair can help reduce sweat buildup for you too. Many likely already “naturally” lose hair thanks to some sweat prevention products, but more natural hair removal may just be the trick to solving excessive sweating. 

  1. Armpit art

Even though we know most sweaty armpit causes, like too much caffeine or spicy foods, it’s no fun to cut these out completely. A more outrageous approach to excessive underarm sweating is actually turning sweating armpits into art. Multiple users of the Reddit community r/Hyperhidrosis have created shirts, sweatshirts, and other clothing that includes beautiful tie-dye in the armpits. Creative, fun, and beautiful, and even better when combined with sweat prevention like antiperspirant or carpe underarm. 

  1. Vinegar your armpit

You may already know how to get rid of pit stains with vinegar, but there are other interesting ways it can help with excessive armpit sweating. Splashing vinegar on your sweaty underarms  is one method many recommend. Those that swear by this method also recommend using deodorant or antiperspirant, too. 

While we don’t know how this was discovered, I like to think someone accidentally splashed vinegar on their pits hundreds of years ago and voila! Too bad the first person to splash his pits with vinegar didn’t also have access to the best antiperspirant for his excessive armpit sweating. 

  1. Baking soda your sweaty underarms

If you find deodorant or antiperspirant irritating, one creative way to help alleviate your excessive underarm sweating is baking soda. Many crafty people with hyperhidrosis swear that not only can baking soda help reduce sweat, but it can also help alleviate pesky underarm smell with some of the best sweat prevention. 

  1. Restart the plaid fad

Black t-shirt, black sweatshirt, black button down, black tank top. If this sounds like your closet, you’re clearly an expert on the hyperhidrosis wardrobe. But if you want some variety as you fight excessive armpit sweating, add some plaid, a trick many with hyperhidrosis use that you may not know. Hey, you just may be starting the resurgence of the plaid fad, and at worst, you’ll add some fun, lumberjack variety to your dark closet. 


Sources: 

[1] Luetkemeier, M. J., Hanisko, J. M., & Aho, K. M. (2017). Skin Tattoos Alter Sweat Rate and Na+ Concentration. Medicine and science in sports and exercise, 49(7), 1432–1436. https://doi.org/10.1249/MSS.0000000000001244
Body Areas Affected by Hyperhidrosis

How to Cure Sweaty Hands Permanently at Home

By Daniel McCarthy /

How to Cure Sweaty Hands Permanently at Home 

Scenario 1: You’re invited into the office, confident you will land the job. You’ve prepared, you’re highly qualified, you have absolutely nothing to worry about. You walk in and confidently reach out to shake the CEOs hand. But then, your confidence turns to dread as the CEO pulls her hand back, wet with your sweat. 

Scenario 2: You’re at home, playing video games with your friends and absolutely dominating. They get so upset, they tell you to take a break to let another friend play. But there’s another problem... nobody wants to use your controller after you finish. Despite your domination, your palmar hyperhidrosis (excessively sweaty hands) has taken center stage. 

Do these scenarios sound familiar? Wondering how to cure sweaty hands permanently? Although you may not have had these exact things happen to you, your sweaty hands likely have caused something similar and you’re looking for a home remedy. To stop sweating these situations, let’s talk about how to cure sweaty hands permanently at home. 

One of the best ways to cure sweaty hands at home is actually not related to the hands at all. Instead, working on reducing anxiety can have immensely positive results on how to cure sweaty hands permanently naturally. There are many root causes of anxiety, and some or many may be related to your hyperhidrosis. Likewise, it is easier said than done to reduce anxiety. But there are also many ways to work on reducing anxiety that are worth a try. One interesting way to reduce anxiety, and in turn, sweaty hands, is to be grateful. Specifically, Petrocchi and Couyoumdjian found that “grateful people experience less anxiety mostly because they are able to encourage and be compassionate and reassuring toward themselves when things go wrong in life” [1]. Other ways include stepping outside for a walk, drinking tea, or even distracting yourself. In general, starting with anxiety reduction not only can help with how to cure sweaty hands, but also your wellbeing in general. 

Another great way to cure sweaty hands at home permanently is to reduce consumption of coffee and alcohol. Now you may be reading this and thinking “Hey, those are all my favorite things! I’m done with this article!”. And while I wholeheartedly agree and enjoy coffee and alcohol myself, consumption in moderation is key, especially with hyperhidrosis. Caffeine, for example, activates part of the brain that is already a main part in causing hyperhidrosis symptoms. Instead of giving it up, try to reduce consumption to under 200 mg or add in decaf to your routine. Alcohol can affect hyperhidrosis in a similar manner, but like coffee, 1-2 glasses of alcohol may be okay. When figuring out how to cure sweaty hands permanently naturally, it is important to find a balance of coffee, alcohol, and managing your hyperhidrosis. And remember to always drink responsibly, in moderation. 

Tackling how to cure sweaty hands permanently, naturally, and at home may require more than behavioral changes we’ve talked about so far. Luckily, there are other great remedies you can try at home! First, finding the right antiperspirant is of paramount importance, especially appropriate antiperspirant for hands. Another possible over the counter option is anti-sweat wipes. If neither of these work for you, another option to cure your sweaty hands permanently is to buy your very own iontophoresis machine for at-home use. This machine delivers mild electrical currents to your hands (or other affected body part) while submerged in water. A combination of these treatments may have your hands feeling less clammy in no time! 

Ultimately, your palmar hyperhidrosis may not be treatable at home and permanently, but these recommendations may help alleviate some of your symptoms. If symptoms persist, consult a medical professional for further assistance with how to cure sweaty hands. 



Sources

Sources

1. Nicola Petrocchi & Alessandro Couyoumdjian (2016) The impact of gratitude on depression and anxiety: the mediating role of criticizing, attacking, and reassuring the self, Self and Identity, 15:2, 191-205, DOI: 10.1080/15298868.2015.1095794

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