Hyperhidrosis medications: effective, but with a price

From sage to acetylcholine: a magic pill against excessive sweating?

The auto­nom­ic ner­vous sys­tem con­trols sweat­ing in the human body. The neu­ro­trans­mit­ter acetyl­choline is respon­si­ble for trans­mit­ting ner­vous impuls­es to the sweat glands. This is where the ther­a­peu­tic approach in drug ther­a­py for hyper­hidro­sis begins. Anti­cholin­er­gics are agents that sup­press the action of acetyl­choline in the ner­vous sys­tem. By tak­ing anti­cholin­er­gics, the activ­i­ty of the sweat glands is thus blocked. The two anti­cholin­er­gics approved in Ger­many for use in treat­ing hyper­hidro­sis are bor­naprine hydrochlo­ride and methanthe­lin­i­um bro­mide. Anti­cholin­er­gics usu­al­ly take 2 to 3 weeks to show results, since the dose must be slow­ly increased at the start of treat­ment.

Effective, but with side effects

The prob­lem is that tak­ing anti­cholin­er­gics also sup­press­es oth­er impuls­es in the body that are trans­mit­ted by acetyl­choline, so not only is sweat secre­tion sup­pressed, but also the secre­tion of sali­va, gas­tric juices, and bronchial flu­ids. There is also a decrease in the tone of the smooth mus­cles in the gas­troin­testi­nal tract, the uri­nary tract, and the bronchial mus­cles, an increase in heart rate, an increase in periph­er­al vas­cu­lar resis­tance, enlarge­ment of the pupils, and blur­ry vision pos­si­bly requir­ing pre­ma­ture use of read­ing glass­es. Visu­al dis­tur­bances, stom­ach upset, severe dry­ness of the mouth, eye, and skin, con­sti­pa­tion, uri­nary reten­tion, and heart pal­pi­ta­tions may occur as side effects.

Some ill­ness­es, the use of cer­tain med­i­cines, as well as preg­nan­cy and lac­ta­tion are con­traindi­ca­tions for treat­ment with anti­cholin­er­gics. Since anti­cholin­er­gic drugs require a pre­scrip­tion, an indi­vid­ual check-up with your doc­tor is always nec­es­sary before tak­ing them.

Sage as cure for heavy sweating?

As an alter­na­tive to pre­scrip­tion anti­cholin­er­gics, some peo­ple rec­om­mend using sage to pre­vent heavy sweat­ing. It is believed that the essen­tial oils of sage have a calm­ing effect on the cen­tral ner­vous sys­tem that con­trols the sweat glands, there­by inhibit­ing sweat pro­duc­tion. Sage sup­ple­ments are wide­ly avail­able as tablets, drops, teas, or baths (which are rec­om­mend­ed espe­cial­ly for the treat­ment of sweaty feet).

Other medications for sweating:

In rare cas­es, oth­er med­ica­tions can also help reduce exces­sive sweat­ing. These include, for exam­ple, beta block­ers. If stress and emo­tions are the cause of heavy sweat­ing, psy­chotrop­ic drugs can be used to calm the auto­nom­ic ner­vous sys­tem.

Will insurance cover drugs prescribed for sweating?

Once evi­dence of its med­ical neces­si­ty has been sub­mit­ted, the statu­to­ry health insur­ance car­ri­ers in Ger­many will cov­er such med­i­cines if pre­scribed, less the co-pay.

Benefits and risks of drugs compared to HIDREX iontophoresis treatment

Com­pared to tak­ing med­ica­tion, ion­tophore­sis treat­ment is free from long-term neg­a­tive side effects and deliv­ers results direct­ly to the area of skin being treat­ed. Unfor­tu­nate­ly, tak­ing anti­cholin­er­gics also affects oth­er desir­able process­es in the body. The suc­cess of HIDREX ther­a­py has been proven in many stud­ies, where­as the effec­tive­ness of alter­na­tive treat­ments such as sage have not been sci­en­tif­i­cal­ly proven and results vary wide­ly from indi­vid­ual to indi­vid­ual.


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Additional hyperhidrosis treatment options shown: