suggested management protocol for primary hyperhidrosis (sweating)
Last reviewed 09/2022
suggested stepwise management of primary hyperhidrosis
The following (based on published recommendations) have been suggested for management of primary hyperhidorsis
Type of hyperhidrosis |
Management steps |
||||
|
First |
Second |
Third |
Fourth |
Fifth |
|
|
Axillary hyperhidrosis |
topical aluminium chloride at increasing doses as tolerated |
botulin A injections |
systemic anticholinergic treatment at increasing doses as tolerated |
iontophoresis using tap water ±topical anticholinergics |
thoracoscopic sympathectomy |
| Palmar hyperhidrosis
|
topical aluminium chloride at increasing doses as tolerated |
iontophoresis using tap water ±topical anticholinergics |
systemic anticholinergic treatment at increasing doses as tolerated |
thoracoscopic sympathectomy |
|
| Plantar hyperhidrosis
|
topical aluminium chloride at increasing doses as tolerated |
iontophoresis using tap water ±topical anticholinergics |
systemic anticholinergic treatment at increasing doses as tolerated |
|
|
| Craniofacial hyperhidrosis
|
topical aluminium chloride at increasing doses as tolerated; topical glycopyrrolate |
systemic anticholinergic treatment at increasing doses as tolerated |
thoracoscopic sympathectomy |
|
|
Reference:
management of generalized hyperhidrosis (generalised sweating)
management of localized hyperhidrosis (localised sweating e.g. armpits, palms, soles)