There are 3 levels in the management of Hyperhidrosis or excessive sweating:
1. Non-invasive treatments involve conservative and common treatments like anti-perspirants, iontophoresis, oral drug medications (anti-cholinergic, anti-hypertensives, anxiolytics)
2. Minimally-invasive treatment involves injection of Botulinum Toxins (brands – Botox, Dysport, Neurobloc) into the skin to block sweat signals sent by the brain. This can typically reduce sweating by 50-80% for a period of 4-6 months.
3. Invasive treatment involves a procedure termed Sympathectomy which is carried out to remove surgically, nerve chains located near the spines. This will cut the brain’s signal from passing to the involved areas. Being a permanent procedure, it is reserved as a last resort procedure when non- and minimally-invasive options are exhausted.