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Sweating disorders - Treatment
Last reviewed: 06.07.2025
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Treatment of patients with sweating disorders is an extremely difficult task. Since sweating disorders are often secondary, the tactics of managing such patients should be aimed primarily at treating the primary disease.
Conservative treatment of patients with hyperhidrosis includes general and local measures. General therapy consists of tranquilizers to control emotional disorders closely associated with hyperhidrotic reactions. Biofeedback, hypnosis and psychotherapy have a beneficial effect on the condition of patients, especially with the essential form of hyperhidrosis. Traditionally, such patients are treated with anticholinergic drugs (atropine, etc.), which cause side effects such as dry mouth, blurred vision or constipation.
X-ray irradiation of the skin is an outdated method, the purpose of which is to cause atrophy of the sweat glands. In addition to the harmful effects of the irradiation itself, its use is associated with the risk of various dermatitis. A significant result can be obtained by alcoholization of the stellate ganglion.
Local treatment involves the use of astringents: 5-20% aqueous formalin solution, 10% glutaraldehyde solution, aqueous or alcoholic solution of aluminum salts (10-25%), potassium permanganate, tannic acid (2-5%), which cause a decrease in sweating due to coagulation of protein substance in sweat ducts. Long-term administration of these agents in sufficient concentration causes a significant reduction in sweating; a side effect of their use is frequent allergic dermatitis. Light water electrophoresis with long-term and frequent use causes anhidrosis of the desired area.
Patients with an- and hypohidrosis are prescribed oil compresses, greasy creams to reduce skin dryness. In case of violation of thermal adaptation, staying in comfortable conditions (temperature, humidity) is recommended.
In persistent cases of local hyperhidrosis resistant to conservative therapy, patients are shown upper thoracic postganglionic sympathectomy. Surgical treatment of palmar hyperhidrosis gives an excellent result, the technique of its implementation is simple.
As an alternative method (compared to open surgery), a new method of percutaneous radiofrequency destruction of the second thoracic ganglion is proposed.
Recently, the iontophoresis method has become widespread, which is highly effective and is the main one, especially for patients with essential hyperhidrosis. The procedures are carried out using a specially designed device "DRIONIC", which allows you to carry out procedures even at home.
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