We Sit Down With A/Prof Goodman to Talk Excessive Sweating

It is estimated that about 3% of people suffer from a condition called hyperhidrosis, where they sweat much more than they need to — having implications on their quality of life.

We sat down with our principle dermatologist Assoc. Professor Greg Goodman to discuss options and treatment for excessive sweating. 

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Q: What exactly is deemed “excessive” when talking about sweating? 

GG: People who suffer from excessive sweating are a different group to those who have normal sweating. Their levels are significantly above the population. There is a scale called the IHHS scale, which defines people into 4 groups, with 3&4 being sweating that interferes with daily activity. People take extraordinary measures for this type of sweating, including only wearing certain types of clothing, utilising air blowers in restaurants and cafés, putting paper towel under their armpits and avoiding shaking hands with people.


Q: Are there any Medical conditions that cause hyperhidrosis?

GG: Yes. Diabetes, menopause, thyroid disease and anxiety can all induce sweating. This is slightly different to focal hyperhidrosis, the more typical problematic and common sweating that we are discussing here. Sweating, if it comes on later in life can be a sign of internal malignancy or autoimmune disease and needs to be investigated. However, most hyperhidrosis common forms occur either in late childhood and early adolescence and are consistent through adult life.


 Q: What treatments are available to me?

GG: For excessive sweating, possibilities include oral anticholinergic drugs, which may in a small percentage of the population have some effect. They act like an oral form muscle relaxant injections. For axillary sweating, sweat reducing injections are used in the armpits, to decrease the flow of information from the nerves to the sweat glands and “turn off” sweating very adequately. This needs to be done every 4-8 months and is highly effective.

Topical preparations for sweating that is on the face, or on the body such as Glycoporrolate can be utilised. In a form of this a treatment called Iontophoresis that is particularly used for hands and feet may be used as an electrical device that forces tap water or anticholinergics like Glycoporrolate to go into hands and feet and stop sweating.

More recently, microwave and radiofrequency technology have been utilised for excessive sweating. Microwave technology decreases sweating on a long term basis. The most popular machine of these is called MiraDry and will bring people down from abnormal sweating towards normal sweating.


Q: What are the risks involved?

GG: This depends on the technology that is being used to manage sweating. Sometimes the oral or topical anticholinergic drugs can cause patients to report feeling “on edge” with dryness in the mouth and some degree of palpitation. With sweat reducing injections, there is not much in the way of complications from axillary use. From MiraDry or microwave technology, there is a recovery phase which may last for a 1-2 weeks until bruising and inflammation settles.


Q: How often will I have to have treatment?

GG: Oral medications usually require long term use with topical applications usually several times a week initially and then dropping to 1-2 times over a 3-month period. For sweat reducing injections every 4-8 months. For MiraDry microwave technology only 1-2 treatments are necessary.


Q: What are the success rates?

GG: The success rates are very high. Occasionally people do fail with hyperhidrosis treatments however, this is not common. Injections into the axially are very effective in most patients. 


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