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Topical options for axillary hyperhidrosis
Drysol® is an inexpensive prescription treatment that works well for some patients. Given its low cost, it should be tried by everyone. I typically recommend patients begin by applying it every other night but once it is working well, most patients for whom it works cut back to 2 x weekly or so. Since drysol will mark up the sheets, be sure to wear a Tshirt over it. For many patients, burning of the skin keeps one from using it.
Qbrexza® (glycopyrronium) is an FDA approved towelette that is applied nightly to each underarm. Some patients are very happy with this treatment as well. Depending on your insurance, it may be cheaper or more expensive than botulinum toxin treatments.
Oral agents are sometimes used for underarm sweating but are generally not useful. This is because these causing drying everywhere and in general the side effects are too extreme for the benefit. Sometimes, patients will use a low dose of these medications to extend the benefit of botulinum toxin when it starts to wear off. The most common medications are glycopyrrolate and oxybutynin. Generally, Dr. Loftus will only give patients a trial of these medications when required for insurance coverage of better agents.
Botulinum Toxin treatment
Botulinum toxin treatment of hyperhidrosis is truly life changing for many hyperhidrosis patients. Dr. Loftus has been using this treatment for over 20 years. Starting therapy is typically at 50 units per axilla. The medication is applied evenly over the under arm surface. Higher doses clearly work better and longer but it is not clear they are more cost effective than lower doses. Therefore, higher doses are generally only used when the 100 unit total dose is too low to last at least 3 months.
Many insurances will cover the treatment of axillary hyperhidrosis. There are 2 parts to the cost of the treatment. The majority of the cost is the Botulinum Toxin itself. If covered by insurance, typically Botox® brand is the only one covered. While the treatment fee itself is out of network, Dr. Loftus will use the patient’s specialty pharmacy to get the Botox® itself in network if this affects the cost of the treatment to the patient. Dr. Loftus may be the only doctor in the Houston area willing to use insurance for hyperhidrosis patients.
Botulinum toxin requires binding to Zinc in order to function. Dr. Soparker and associates demonstrated that the use of Zytaze (a combination of Zinc and phytase) resulted in extending the benefit of botulinum toxin (at least Botox brand for blepharospasm and forehead wrinkles). Given the low cost, Dr. Loftus recommends all of his patients use Zytaze when using botox for hyperhidrosis. Patients can expect the underarm treatment for axillary sweating for underarms to last 6-9 months. Unfortunately, some get only 3 months.
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Kathleen G.(Patient Since 2016)
Dr Loftus and his staff are amazing and super friendly. They make you feel comfortable and quickly respond to your needs.
Rhonda G.(Patient Since 2019)
Dr. Loftus was very professional and attentive.
Providing headache and hyperhidrosis care & wellness for over 25 years.
Dr. Brian Loftus, M.D.
Dr. Loftus is Board Certified in Headache Medicine as well as Neurology. In private practice since 1994, Dr. Loftus’ practice has gotten busier and he has decided to concentrate his practice in areas that he can make a particular difference compared to other neurologist. Therefore, Dr. Loftus has chosen to focus his neurology practice on headaches & head pain, headaches during pregnancy, and hyperhidrosis. In the spring of 2006, Dr. Loftus relocated his practice from the Texas Medical Center to Bellaire, just 5 miles west. He has been named a Texas Monthly “Super Doctor” and an H Texas magazine “Top Doctor” multiple times.