Hyperhidrosis

Hyperhidrosis, characterized by excessive sweating beyond what is necessary for normal thermoregulation, typically begins in adolescence. Any site on the body can be affected, but the sites most commonly affected are the palms, soles, and axillae. Usually, this condition is idiopathic (not attributable to any specific cause) or secondary to other diseases, metabolic disorders, febrile illnesses, or medication use. Hyperhidrosis exists in 3 forms: emotionally induced, localized, or generalized. The condition often causes great emotional distress and occupational disability for the patient.

Treatments Include:

  • Drysol (20% aluminum chloride hexahydrate in absolute anhydrous ethyl alcohol) is usually the most effective topical agent. Drysol should be applied nightly on dry skin with or without occlusion until a positive result is obtained, after which the intervals between applications may be lengthened. Drysol may be irritating to the skin.
  • Pills used to treat hyperhidrosis include anticholinergic medications. Anticholinergics are effective because the neurotransmitter for sweat secretion is acetylcholine, which stimulates the onset of sweating. Use of anticholinergics may be unappealing because their adverse effect profile includes blurry vision, dry mouth and eyes, and constipation. In addition, other systemic medications, such as sedatives and tranquilizers, venlafaxine, beta blockers, and calcium channel blockers, may be beneficial.
  • Iontophoresis consists of passing a direct current across the skin. There are several models available under the brand name Drionic, which can be viewed on their website; these models are specifically designed for the area being treated.
  • Botulinum toxin injections are effective because of their anticholinergic effects at the neuromuscular junction and in the postganglionic sympathetic cholinergic nerves in the sweat glands. They are FDA-approved and sometimes covered by insurance for the treatment of the axillae. The Botox efficacy lasts from 4-8 months and requires retreatment regularly. Palmar and plantar treatments are not FDA-approved and unlikely to be covered by insurance.

In addition to pharmacologic therapy, other treatments include surgical sympathectomy, surgical excision of the affected areas, and subcutaneous liposuction. Each modality has been used effectively but both carry significant risks compared to the above treatments.

Before Your Visit

Please be sure to bring a list of all medications and allergies. If you are covered by an insurance plan that requires prior authorization, the authorization or referral form must be presented to our office before or at the time of your appointment. It is your responsibility to obtain necessary referrals. If you don’t have one, we will ask you to sign a waiver stating you are responsible for the bill. Payment will then be expected at the time of service. Please bring your insurance cards to each visit so the information can be checked and a copy placed in your chart.

Financial Information

Your insurance coverage is an agreement between you and your insurance company. Financial responsibility rests with the patient for deductibles, co-insurances, and non-covered services. Insurance coverage is a variable, and we cannot guarantee what services will be covered by your particular plan. We request that you sign an authorization form, which will enable us to receive insurance payments directly when applicable. Co-payments are due at the time of service. For your convenience, we accept personal checks, Visa, MasterCard, Discover, American Express, and cash.

A no-show fee of $50.00 will be charged to patients who fail to appear for their appointment and provide less than 24 hours' notice of cancellation.

Pathology, Labs, and X-rays

Surgical specimens are sent to a laboratory for analysis. The fee for this is a separate charge from the office visit and may be billed directly by the processing lab. Results are usually available 7-10 days after the test has been performed. Questions regarding payments for laboratory services should be directed to the laboratory.

Prescription Refills

Prescription refill requests will be taken only during regular office hours.