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January 22, 2014

'Hyperdidrosis' literally means 'too much sweat'

DEAR DR. ROACH: I hope you will be able to help me with my problem. I am 67 years old and have been sweating profusely from my head for about six years. I believe it is secondary hyperhidrosis. No one in my family has this problem. The sweating seems to happen at all different times, but not at night. The moisture runs in rivulets from my scalp anytime from morning to evening, but mostly in the morning. I tried stopping my water pill, but it still happened. It happened when I stopped vitamins and took only my medications for physical problems. My doctor tested my thyroid, and it was fine.

Please help me, as it is an embarrassing ailment, and it happens no matter the season or what I have eaten. I do drink tea and coffee, but not soda. There are people who have said I should take Botox, but I have little faith in the product, as it can cause serious health problems and death. — M.E.

ANSWER: “Hyperhidrosis” simply means “too much sweat.” I think you probably have primary hyperhidrosis, meaning that the sweating is the only problem, as opposed to secondary, which means it’s due to something else. Other conditions that can lead to secondary hyperhidrosis include the thyroid disease your doctor looked for, and medications (which it also doesn’t seem to be). Other rare causes, such as tuberculosis and lymphoma, surely would have produced other symptoms by now.

The most common sites for hyperhidrosis are the palms, armpits and soles of the feet. Nearly everybody sweats in those places, but with hyperhidrosis, the amount of sweat is much greater than normal and can have serious emotional, professional and social effects.

The first treatment I would recommend would be a prescription antiperspirant, either aluminum chloride (Xerac) or topical glycopyrrolate (available by compounding pharmacies in the U.S. and Canada). The scalp is a harder place than most to apply it, but after applying, you can dry with a hair dryer, and use a plastic shower cap to keep the medicine on at nighttime. Occasionally, oral medications such as clonidine are used.

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