Excessive sweating in other body regions

Excessive sweating can also occur under the breasts (sub-mammary) and inguinal (groin) regions. Shows such as "Embarrassing bodies" have made people more comfortable about talking about these areas. This is good since these can result in unsightly sweat stains and sometimes the problem can be so bad that people can be mistaken to have "wet their pants". Both sub-mammary and inguinal hyperhidrosis can also pose problems during intimate moments with partners. Excessive sweating can also occur in other areas such as the back or abdomen.

Treatments

1st line: Antiperspirant with high aluminium content

It is good to start with a clinical strength antiperspirant e.g. Driclor or Rexona Clinical Protection (contain around 20% aluminium). These can be bought from a supermarket or over the counter at a pharmacy. It is best to apply them at night prior to bed since you tend to sweat less overnight and it is more efficacious. It can result in localised irritation of the skin which might limit its use.

2nd line: PBS listed anti-hyperhidrosis treatment

If the clinical strength antiperspirants are not effective or causes localised irritation then it is good to have a clinical assessment at a clinic that specialises in hyperhidrosis. After assessment, if injections are indicated then they would be conducted on the same day as your clinical assessment. These result in good relief of symptoms for around 6 months. A consideration in terms of cost and practicality is the size of the area needed to be treated. Usually an area the size of a palm requires one vial of the treatment (the minor's starch iodine test can help delineate the area). Patients usually notice a difference 4 days post-treatment however the full effect usually takes a one to two weeks. The procedure is conducted after applying topical anaesthetic cream to minimise discomfort.

3rd line: Anticholinergic medication

If the region to be treated is extensive then another option that will be considered after a clinical assessment is anticholinergic medication. These work systemically and work by blocking transmission of the chemical messenger (acetylcholine) responsible for excessive sweating. It can cause a range of side effects e.g. dry mouth, constipation, impaired taste, blurred vision and urinary retention so the dose needs to be adjusted to minimise these while maximising the effect on sweating.

Please note: these are only guidelines and your treating doctor will discuss the hyperhidrosis treatment(s) most appropriate for you.

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