This drug is used often to relieve cramps and spasms of the digestive system or the bladder. It is especially used for people with urinary frequency (people who feel the need to urinate often). But it is also sometimes used for hyperhidrosis because antichollinergics stop the body from secreting sweat (and other secretions).

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As with all drugs of these types, if you are taking them you should be careful not to get a temperature. As the secretions are slowed down, your body’s ability to cool itself automatically is diminished.

Due to the side effects, many hyperhidrosis sufferers will take propantheline bromide as and when required e.g. when they need to do a public speaking event. Usually it is taken in 15mg doses.

This drug is also commonly known as “Pro-Banthine”. The other popular antichollinergic and most commonly taken for hyperhidrosis is glycopyrrolate, taken as a cream, solution (for iontophoresis) or a tablet.

Cranio-Facial Hyperhidrosis

Excessive scalp sweating actually has a medical name. It’s called cranio-facial hyperhidrosis.

It is also often accompanied by further sweating on the face or the back of the neck. Let’s take a closer look at how to treat it.

Clinical Antiperspirant

A medical grade roll-on is not like what you can buy in a store. First of all, it’s much stronger and secondly you can use it on any part of the body and not just the underarms.

The problem with the scalp area is that it is hard to treat with a roll-on.

One option is to shave the head although that is understandably rejected by many people. It is also possible to mix the deodorant into the hair and then work it into the scalp, much like using a shampoo and working it into the roots.

Drugs

The problem with using drugs for excessive sweating is that these drugs have a much larger effect on you, and fixing your sweating is only a small part of it.

For instance, antidepressant drugs are used to help prevent the anxiety that may trigger or worsen your sweating. However, if it wasn’t for the sweating then you wouldn’t really need them, so using such mood altering drugs may not be attractive.

Another class of drugs, anticholinergics, work by reducing all your bodily excretions including both sweat and tears. As a result there are some severe side effects as your body frequently gets too hot, such as headache and vomiting.

Surgery

If you have excessive sweating not just of the scalp but also other areas such as the hands and feet, then you may be a candidate for surgery.

Be warned however that this is a complete last resort and there are many in the medical establishment who do not approve of surgery as it involves cutting the nerves, an irreversible process.

Natural Methods

Natural methods to cure excessive scalp sweating are much more promising.

By making key changes to your diet and your lifestyle, it is possible to manage your sweating and reduce it to the levels of a normal person. Unlike the methods above, these are not a temporary fix but permanent changes to your sweating levels.

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If you’ve just started iontophoresis or you’re considering it, it’s natural to question if there are any potential side effects of the treatment. Let’s delve further into this matter.

Sensation

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There’s much argument as to whether this is really a side effect or not. The iontophoresis treatment is the application of an electric current to a liquid solution into which you place your hands, feet or some other part of the body e.g. the armpits.

A unique sensation can definitely be felt. It is not the same as a sudden high voltage electric shock and most people describe it as a tickling or “pins and needles” sensation, rarely as a “burning” sensation. If the voltage is turned too high then this could be painful. But either way, it is a matter of contention as to whether this constitutes a real side effect or not.

In particular, it is wise to conver any open wounds (simply with petroleum jelly) as these sites may be painful during the electrolysis procedure.

Other Dermal Effects

Vesiculation (like small bubbles in the skin) can occur but usually passes quickly. It affects less than 10% of all people having this procedure. Redness of the skin at the waterline is fairly common but minor and again, passes fairly quickly.

Best Practice

Anyone who undergoes regular iontophoresis sessions should keep their hands well moisturised to avoid cracking and open wounds. If they do this then they can expect minimal side effects, if any at all.

Oxybutynin itself is an anticholinergic medication most often used to relieve urinary and bladder problems but can also be used for hyperhidrosis.

Probably you’re more familiar with glycopyrrolate (Robinul) which is a more commonly prescribed anticholinergic used by hyperhidrosis sufferers in a variety of forms, sometimes as an ingredient in an iontophoresis solution, for example.

Both of these and indeed the majority of these drugs are what is known as “antimuscarinic agents”. However, oxybutyin is a tertiary amine whilst glycopyrrolate is a quarternary amine. The former therefore has a more central effect compared to the latter. However, this is not always a primary reason for choosing one over the other. The clinical effects are more likely to be the deciding factor.

Oxytrol is a brand name for a patch used to deliver the drug, also known as a “transdermal system”. Some people find that they get a better result and minimised side effects from using this patch as opposed to tablets. Others find little to no difference.

These injections are most commonly used for axillary (underarm) hyperhidrosis. Unfortunately, many people are getting these injections when all they have is a normal amount of sweating and they don’t have hyperhidrosis – I personally don’t recommend injections in these cases.

They can also be done in other areas but this can be problematic, especially when injecting the hands (palmar hyperhidrosis). Use too much and it could seriously affect your ability to use your hands for several months.

Video 1 – Axillary Hyperhidrosis

In this video, a woman receives second session of Botox injections (botulinum toxin A a.k.a. BTX-A) after having received injections 7 months prior (apparently she had exhausted other treatments although no mention is made of iontophoresis). Remember that this is a promotional video so I would ignore the claims made at the beginning of the video and I also do not endorse this particular doctor or clinic.

He makes a claim that the botulinum toxin they are using is “the safest type of Botox available”. This is quite a sensational claim because there are others available (Dysport, Neuronox) and there is no evidence to suggest they are any less safe – in fact all three are likely to be very similar indeed!

The doctor makes around 20 injections under each arm. He mentions that after about 5 – 7 days there should be a decrease in sweating of over 90%.

Video 2 – Plantar Hyperhidrosis

In this video the sole of the foot is prepared with what may be anesthetic I am guessing. The doctor then proceeds to inject just below the surface of the skin. You can see that the injection sites are carefully spaced out.

Botulinum Toxin Type A (BTX-A)

Also known by the brand name “Botox”, this drug has FDA approval for treatment of axillary hyperhidrosis and several studies have shown a dose of between 50 and 100 U per axilla to be effective[1][2]. It has also been successfully used for palmar hyperhidrosis with a recommended dose of between 50 and 100 U per hand[3]. However it can rarely cause the side effect of temporary weakness in the thumb if used for this purpose[4].

Other Botulinum Toxin Types

There are a number of other types of this toxin ranging from B through to G. Very rarely, a person may have an immune resistance to type A and another type could be beneficial in such cases. Although only type A has FDA approval for treatment of hyperhidrosis, clinical trials have been carried out to comparing the efficacy of all types.

Type B, also known as Neurobloc, is known to be effective in humans only at high doses and type F has a much shorter action compared to the baseline type A and is therefore not suitable for treatment of hyperhidrosis. One study showed that types B (in an increased dose) and type C have a similar profile to type A and could be used as alternatives[5]. However, type B has been shown to have greater autonomic side effects than type A such as dryness of the mouth and eye irritation[6].

Animal studies indicate that type A has the longest action of all the types and given the low number of side effects or complications it is preferable. The next longest acting types are B, F and E[7].

Conclusion

Unless there is the presence of immune resistance, botulinum toxin type A should be used for treatment of axillary and palmar hyperhidrosis. It is highly tolerated and if used in the recommended doses causes few side effects.

In the case of such immune resistance, type B can be used instead.

1. http://www.bmj.com/cgi/content/abstract/323/7313/596
2. http://derm.jwatch.org/cgi/content/full/2002/529/2
3. http://www.neurology.org/cgi/content/abstract/57/11/2095
4. http://www.ncbi.nlm.nih.gov/pubmed/10827408
5. http://www3.interscience.wiley.com/journal/107633255/abstract?CRETRY=1&SRETRY=0
6. http://content.karger.com/produktedb/produkte.asp?typ=fulltext&file=ene49034
7. http://tinyurl.com/95k9ar

I get the same thing myself. When I worry about “butt sweat” when I sit down, it is more likely to happen. So how can we break this “forward feedback loop” where worrying about sweating can actually help it to happen.

One way is to use EFT (Wikipedia link) or emotional freedom techniques. You may think that anything new age is simply silly and not worth learning about but, if it could offer you a way to cure your problem then why not listen and open your mind?

EFT was created by Gary Craig in the 1990s and is a method of tapping acupuncture points on the body to remove negative emotions.

You might not believe in acupuncture theory of “energy” and meridians but please take note of this: the inventor of this technique is a man of science, a Stanford qualified engineer!

It does not matter “how” it works, what really matter is “does it work”? The answer is “yes” for many, many people.

If you’re interested in learning more about EFT then the best way is to check out the freebies at Gary’s site here: EFT Freebies.

EFT has many applications and I reckon it could work great for hyperhidrosis. You’d be able to banish those worrying thoughts about being in an embarrassing sweaty situation. You’d get back the confidence you used to have or that other people have and, as a result, your nervous system would not make you sweat buckets.

Remember, keep an open mind because it could really help you.

Whites

This is easiest with whites. Once a month you should bleach them with a dilute solution.

Otherwise, white vinegar can work very well to get stains out. Treat the clothes like this and rinse before throwing into the main wash.

Antiperspirant and deodorant residue can also interact with the detergent in your washing machine. For this reason, dry off your deodorant/antiperspirant before putting on your shirt.

Also, dry your clothes by hanging them out in the sun. As you notice with your colors, the sun will naturally bleach your clothes and remove the stains.

Colours

Unfortunately your options are more limited for colored clothes. You cannot wash at too high a temperature or risk the colors running. Same goes for drying in the heat of the midday sun.

The best thing is to use a biological washing detergent i.e. one that contains enzymes.

Additionally, try soaking your clothes in warm water as soon as you take them off. This is not the best practical solution but by not letting the stain to establish itself for days in your clothes then you stand a much better chance of getting it out.

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This study sampled 150,000 households in the US and projected that 2.8% of the population are affected by this condition. Of these, 50.8% have axillary hyperhidrosis.

In terms of genetics, this study undertook genetic analysis of palmar hyperhidrosis and conclude that there is stong evidence for vertical transmission of this condition and that the allele for hyperhidrosis is present in 5% of the population. Agreeing with a similar study below, the authors conclude that there is “variable penetrance” of this condition.

This study confirms the findings of the earlier study. The investigation of family history of this condition indicates that hyperhidrosis is an inheritable condition and transmission is autosomal dominant – this means that only one parent need have the allele to pass this condition to you.

This study conducted in China also looked into the epidemiological characteristics of palmar hyperhidrosis with a sample size of 13,000. It was determined that this type of hyperhidrosis alone was found in 4.59% of the sample.

This study looked into patients already referred for treatment. As expected, the majority (73%) referred had symptoms of axillary hyperhidrosis. Interestingly, trends of cranio-facial hyperhidrosis were found to be more common in men than women.

As you can see, results of epidemiologic studies for hyperhidrosis vary widely. It is very difficult to isolate the exact number of people who suffer from the many forms of this condition. However, we can conclude that the number is significant and worthy of attention by national health services, the world over.

The Procedure

This operation is always done under general anesthesia. 3 small cuts are made and the nerve is clamped or, more usually, severed.

It takes about an hour to perform and usually the patient can be released in a day. In this sense, it is less invasive than ETS.

Who Is A Candidate?

This type of surgery is only useful for those with sweating from the feet and lower regions of the body.

What Are The Risks?

There are always risks with any operation using general anesthesia.

In addition, many people will experience compensatory sweating. This is when the body feels it needs to release sweat elsewhere to replace that which would otherwise have been lost through the feet. Normally it emerges through the chest or the back.

In this sense, you can see that a lumbar sympathectomy does not actually cure excessive sweating or reduce it, it merely diverts it.

Alternatives

Surgery should always be the last resort. If you’re considering it, have you really given yourself a chance and tried absolutely EVERYTHING else out there?

I would personally advise a natural and holistic approach. I strongly suggest you at least take a look before going for risky surgery. You can read my critical review of the top 3 natural excessive sweating by clicking here: Top 3 Natural Sweat Cures.