Reisfeld’s belief that facial hyperhidrosis should be treated with conservative methods, rather than surgery. In cases of facial hyperhidrosis the topical application of glycopyrrolate (an anticholinergic agent) in a 0.5% solution can produce some relieving results. High concentration of this medication can cause some side effects as well. This is due to the large amount required to have a local effect on the peripheral nerves that innervate the eccrine glands (sweat glands). Unfortunately, these do not show any high rate of success. However, as of yet, there are no known clinical studies which measure toxicity after long-term use of these compounds.Īnother type of topical agent (lotion) are options that contain anticholinergic agents. Many patients have raised concerns surrounding aluminum toxicity when using these types of lotions. Lotions represent the first alternative method to surgery that many doctors will try. Long term usage can cause the skin to crack as well. Maxim is another product on the market with a somewhat higher pH level, which causes less irritation. Unfortunately, most patients do not feel any relief due to the fact that the lotion itself adds additional moisture to the skin. The goal when using this lotion, is to purposefully dry out the user’s hands and reduce excess sweating as a result. In most states, Drysol is available through prescription, and in some, can also be purchased over the counter. The most commonly used lotion is an aluminum hydrochloride known as Drysol (manufactured by Person & Covey, Inc.- Glendale, CA). As part of this surgical procedure the sympathetic chain, responsible for excessive sweating, is interrupted or excised. Most patients who undergo surgery have already tried using conservative methods and resort to ETS as a final and proven surgical solution. In fact, many insurance companies demand that alternatives be used first, before resorting to surgical methods. Patients who suffer only from axillary hyperhidrosis (armpit sweating) should try medicated antiperspirants such as Drysol, Maxim, and Odaban. That said, surgery should not be resorted to without attempting some of these alternative methods first. Patients should maintain good records of any alternative treatments they tried as this will be helpful when dealing with your insurance company. Reisfeld’s published paper in Thoracic Surgery Clinics – 2008 Volume 18. To learn more about conservative methods to treat focal hyperhidrosis please see Dr. The only highly effective and proven solution has been surgery. Conservative solutions such as Botox® Cosmetic, lotions, oral medications, electronic devices, acupuncture, anti-anxiety medications, beta blockers, biofeedback, and herbal medicines have had little or no effect on the problem. Alternative or conservative methods in the treatment of Hyperhidrosisįor decades, attempts at countering excessive sweating through alternative methods have been utilized with mixed results.Percutaneus (through the skin) or x-ray guided techniques.
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