Hyperhidrosis is increased sweating of the palms, soles or underarms. Treatment is discussed below.

Initial Therapy
Aluminum chloride 20% in anhydrous ethanol (Drysol) is the preferred first treatment. It must be used carefully and exactly. Written patient instructions are suggested as follows:

1. The skin must be totally dry before application. Use a blow dryer in the axillae if necessary. Do not apply for 24-48 hours after shaving. In the axillae, apply only to the hairy area.
2. Apply at night to take advantage of reduced nocturnal sweating. It must remain on for 6-8 hours.
3. Wash off aluminum chloride in the morning.
4. If axillary irritation results, apply hydrocortisone 1% cream two times a day.
5. If irritation persists despite use of hydrocortisone cream, reduce the concentration to 6.25% (Xerac AC).
6. If nightly treatment for 1-2 weeks has not reduced sweating, cover the aluminum chloride with gloves (palms) or plasticwrap (axillae, soles). For the axillae, put a rolled-up soak on top of the plastic wrap in the axillary vault, and wear a slightly small T-shirt. This may increase efficacy and decrease irritation.

For hyperhidrosis of the feet, we recommend you wear breathable footwear (leather shoes, cotton socks) and absorbent foot powder. Alternating pairs of shoes to allow previously worn shoes to thoroughly dry is also useful.