Before you read on, don’t forget to check out Part 1 of our interview. In Part 1, we discussed Dr. Pariser’s background, what hyperhidrosis is, and its symptoms and manifestations. Today, we’ll discuss myths and misconceptions, treatment options, and the varied resources of the International Hyperhidrosis Society. 

Myths & Misconceptions

To raise awareness and spread accurate information about hyperhidrosis, it is necessary to combat some of the myths and misconceptions associated with this condition. For example, a common misconception is that people with hyperhidrosis are unclean or have poor hygiene. Dr. Pariser says:

“This simply isn’t true. When you see someone with sweaty armpits, people assume that they’re unclean or not showering. But people with hyperhidrosis are not dirty. Their bodies are just overproducing sweat.”

More so, he continues, many people believe that excessive sweating can be controlled with “natural” antiperspirants or deodorants. But, he shares:

“To reduce sweating, you should be looking for antiperspirants with active ingredients such as aluminum or zirconium salt. Patients should also check to see whether the antiperspirants are prescription-strength. These work best when applied during the least amount of sweating, such as at night and before or during sleep. We always advise patients to use an antiperspirant at bedtime. If you apply it for enough time, the benefits last for many days. Deodorant, on the other hand, has no active ingredients. It does not reduce sweating, just odors. So, to help reduce sweating, look more for prescription-strength antiperspirants.”

Finally, the last myth is that those with excessive sweating must not smell very good. However, Dr. Pariser shares, excessive sweating has nothing to do with odor:

“Sweating and body odor are too different things.”

In the underarms, we have two types of sweat glands: eccrine and apocrine. Apocrine glands secrete an oily substance; this is what body odor comes from. Eccrine sweat glands produce water sweat, which has no odor at all. It could contribute to odor, as water on the skin can create odor on a secondary basis, but those sweating due to hyperhidrosis are often wet – not odorous.

Treatment Options

Currently, there are a number of therapeutic interventions for those with hyperhidrosis. But Dr. Pariser cautions that the type of treatment depends on which area of the body is affected. Many therapeutic innovations have occurred in the area of underarm treatment. For example, clinical strength antiperspirants (which often come in a box) work way better than older antiperspirants. Dr. Pariser further explains:

“Personalized prescription treatments, such as topical anticholinergics, are also relatively new. Patients get a pad or a wipe, which can be wiped on the underarm to control sweating in milder cases. This is FDA approved. However, Botox is the preferred treatment because it always works. You can have it injected into the armpits and that will keep them almost 100% dry for a number of months, from three to ten. Some patients may even go a year without needing another treatment.”

Treating excessive sweating in the hands or feet can be slightly more difficult. Right now, there are no FDA-approved treatment options for excessive hand sweating. However, this doesn’t mean that there is nothing that can be done. Dr. Pariser explains:

“We can do iontophoresis, which is where people put their hands and feet into trays of water. A specific type of electric current is passed through the water for twenty minutes. This is done three times weekly. It is a tedious procedure and, though effective, many patients don’t necessarily have the time to do this. You can also do Botox injections in the hands, though this requires a certain amount of pain control. Since it isn’t FDA approved for this indication, many insurance companies won’t pay for that. Finally, there are a number of anticholinergic agents that you can get filled for hyperhidrosis, though none are FDA approved.”

The International Hyperhidrosis Society

So now that you’ve learned some more about hyperhidrosis and its impact, where can you go to learn more? The International Hyperhidrosis Society is a fantastic resource to continue educating yourself or – if you have hyperhidrosis – to connect with a community of understanding peers, clinicians, and more. The Society offers a wealth of information, resources, and patient stories. While there are many places online that might try to sell you a product for sweating, the International Hyperhidrosis Society has some concrete information. Says Dr. Pariser:

If you spend thirty minutes exploring the International Hyperhidrosis Society’s website, you will know more about sweating than many doctors.

Offerings on the IHS website include:

• Information on research grants
• Basic (and more extensive) hyperhidrosis information
• Treatment options
• A physician finder that helps patients find IHS-educated physicians
• Clinical trial information
• Insurance codes
• Product discounts
• Medical literature
• Content for physicians such as videos on how Botox injections are done

Recently, the IHS also ran a masterclass at the University of South Carolina – Charleston to demonstrate Botox injections in the hands for the local dermatology community. Given that many people have not been trained on this, classes like these can help inform the physician community – and create opportunities for better patient outcomes.

In the end, Dr. Pariser says:

“It’s really important for people to understand and know that this is a real condition. There should be no stigma attached to it. And no matter what age you are or area you’re in, you can get help for it. The IHS is here for you.”