Excessive Perspiration

Q:  My 23 year old son has regular problems with excessive perspiration under his arms. He has been dealing with this problem since his teen years. There is not really an objectionable odor, but he just gets very wet at times. There seems to be no nervousness or anxiety that causes this.

About 2 years ago, our family physician gave him a prescription for an anti-perspiration product which caused burning and itching. Is there something else on the market? Are there oral medications that might alleviate the symptoms? Would a specialist be able to help?

A:  Sweating is the body's way of cooling itself, but it can also be a response to emotional stress. Excessive sweating usually involves the armpits, palms of the hands and soles of the feet, and reflects increased impulses from the central nervous system (beyond our conscious control). There usually is no underlying problem with the sweat glands or brain.

The good news is that there are several options for your son to try. Brad Straka, MD, a dermatology resident at the Medical College of Wisconsin, recommends the use of aluminum chloride hexahydrate (Drysol). One to three treatments a week for a few weeks should result in improvement , and then one treatment a week should suffice to maintain dryness. This is a prescription anti-perspirant and if this is the same one that caused irritation for your son, he could try aluminum tetrachloride (Xerac), a less potent solution.

A unique treatment is the use of electrical current (iontophoresis) to block the activity of the sweat glands. The device (Drionic) is used daily for a week and may relieve sweating for up to a month! Oral medications have been used, but usually result in undesireable side effects, such as dry mouth, drowsiness, and urinary retention. If none of these options work, liposuction of the sweat glands can be performed.

A dermatologist will be able to work with your son in finding the best treatment for him.

"Dear Doctor" is a compilation of patient questions answered by doctors from the Medical College of Wisconsin.