Peds Derm Corner- Hyperhidrosis (Excessive Sweating)- August

Each month, Dr Swanson posts information about a common pediatric dermatology issue to educate patients and parents. This month, the topic is hyperhidrosis (excessive sweating).
What is hyperhidrosis?
Hyperhidrosis means excessive sweating. It is normal to sweat when it’s hot, when you exercise, and when you are nervous, but some people sweat all the time even when it’s cold, they aren’t active and they aren’t nervous. It typically affects one or several particular areas such as the armpits, hands, and feet, but could theoretically affect any area of the body. It can be a debilitating issue and can dramatically affect school, work and overall quality of life.
What can be done about it?
There are lots of treatment options. Certain Dri is probably the best over the counter antiperspirant and patients have often tried that already by the time they come to a doctor for help. Drysol is a prescription antiperspirant that is applied at bedtime that can be very effective and is frequently the first line prescription medicine. It can be applied to hands and feet as well if that is where the problem is. If that doesn’t work, other options include iontophoresis, robinul, and botox. Iontophoresis is a machine that delivers electric current to the skin to inhibit sweating. It is a device that can be purchased for $200-$500 and can be effective, but is frequently inconvenient. Robinul is an oral medication which is taken 1-2 times daily and is very effective at reducing sweating. Because it is a systemic medicine, it can have side effects such as dry mouth and constipation. Typically we can find a dose that controls the sweating without causing too many side effects. Lastly, there is botox (botulinum toxin). Botox is very effective at controlling sweating, but it is delivered by injection into the skin where sweating is an issue. We believe that botox works by paralyzing the little muscles that push sweat to the surface of the skin. Botox injections in the armpits are uncomfortable, but very tolerable and a topical numbing medicine can be applied first. Botox injections in the palms are much more uncomfortable and usually a relaxing oral medicine and topical numbing medicines are necessary to make it bearable. Botox lasts 6-9 months and most patients choose to repeat the treatment because of the improvement. Botox is not covered by insurance, unfortunately, and we can discuss cost based on the area that needs treatment. Other more invasive options like surgery can be attempted but is usually a last resort.
If you have any other questions regarding hyperhidrosis and how it is affecting your child, please schedule an appointment with Dr Swanson, our pediatric dermatologist.
What is a pediatric dermatologist?
A pediatric dermatologist is someone that has undergone extensive training to deal with the specific skin conditions and issues that affect children. Pediatric dermatologists have typically completed medical school, a general dermatology residency, and a pediatric dermatology fellowship. While all dermatologists receive some experience dealing with children with skin problems, a pediatric
dermatologist has chosen to subspecialize and receive more extensive education and training with the pediatric population.