Over the years, doctors have tried many other treatments for this frustrating condition. None of them work consistently, and some do not work at all in the cases of severe hyperhidrosis. These treatments have included powerful antiperspirants, tapwater Iontophoresis, medication and psychotherapy.
Antiperspirants (e.g., Drysol) may be applied to the hands and armpits at night and then removed in the morning. This treatment is generally tried first and may be effective in mild cases.
Tapwater iontophoresis can provide temporary relief in mild cases of primary hyperhidrosis, but it is uncomfortable, expensive and time consuming. Several times a week for several weeks, the hands are placed in an electrolyte solution with a low level electrical current. Patients may purchase the equipment to do this at home.
Anticholinergic drugs (e.g., Atropine or Robinol) are a possibility. They can reduce the perspiration but may also cause annoying side effects, such as dry mouth, urinary problems or vision difficulties.
Psychotherapy fails to treat the underlying medical problem and it may be helpful only for coping and social skills.
When researchers confirmed that the sympathetic nervous system was involved, surgery made the most sense. Sympathectomy has been performed for many years, but until recently, it required a painful, open-chest operation with the spreading of the ribs to access the nerves along the spinal column. Using an endoscope (a small fiber optic cable with a camera on it) and miniature instruments, doctors now only need to make two very small (1/2 inch) incisions between the ribs. The patient walks out the door a few hours later - with dry hands.