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Treatment overview

03Treatments

From first-line topicals to last-resort surgery.

Ten evidence-backed options, organized from common first steps to treatments used only in severe cases. Stronger antiperspirants often come first. Prescription skin treatments and iontophoresis may come next. Pills affect the whole body, while Botox, miraDry, Brella, and surgery require a clinician or specialist.

30-second sweating check

How much does sweating affect you? Four quick choices.

Answer where you sweat and how much it gets in the way. You will get a simple summary and useful information to read next.

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04All options

Treatment options, from first steps to specialist care.

Step 01

Antiperspirants applied to the skin

Step 02a

Prescription skin treatments that reduce sweating

Step 02b· alternative

Iontophoresis

Step 03

Pills that reduce sweating

pill that reduces sweating

Ditropan · oxybutynin

Regions
underarm, hand, foot, face and scalp, in several separate areas, generalized
Severity fit
HDSS 3, HDSS 4
Type
oral drug
FDA
off label for excessive sweating
Read Ditropan →
Step 04

Injectable and in-office procedures

Step 05

Surgery (ETS) — last-resort context

05All treatment pages

Read each option in detail.

  • 01

    Aluminum chloride antiperspirant for excessive sweating

    Aluminum chloride hexahydrate is the first-line topical for underarm, hand, and excessive foot sweating. It is available over the counter at lower concentrations and as a prescription at higher strengths. Decades of clinical use establish it as the foundational rung of the usual order of treatment options.

    Regions: axillary, palmar, plantar · Severity fit: HDSS 1, HDSS 2, HDSS 3

    Read →
  • 02

    Qbrexza (glycopyrronium tosylate) for excessive underarm sweating

    Qbrexza is a once-daily prescription skin treatment that reduces sweating cloth FDA-approved for primary excessive underarm sweating in patients 9 years and older. It is one of two FDA-approved prescription skin treatments that reduce sweating for excessive sweating (the other is Sofdra). Qbrexza is underarm-only by label; hand, foot, and face and scalp use is off-label and not supported by the trial evidence base.

    Regions: axillary · Severity fit: HDSS 2, HDSS 3, HDSS 4

    Read →
  • 03

    Iontophoresis for excessive sweating

    Iontophoresis is a device-based treatment that uses a small electrical current passed through tap water to reduce sweating, primarily in the hands and feet. It is one of the oldest documented excessive sweating treatments and is available as both clinic-based and home-use devices.

    Regions: palmar, plantar, axillary · Severity fit: HDSS 2, HDSS 3, HDSS 4

    Read →
  • 04

    Sofdra (sofpironium topical gel) for excessive underarm sweating

    Sofdra is a once-daily prescription skin treatment that reduces sweating gel FDA-approved for primary excessive underarm sweating in patients 9 years and older. Its molecule (sofpironium) is structurally a soft sweat-reducing medicine designed to limit whole-body exposure. Sofdra is underarm-only by label.

    Regions: axillary · Severity fit: HDSS 2, HDSS 3, HDSS 4

    Read →
  • 05

    Oral glycopyrrolate for excessive sweating

    Oral glycopyrrolate is a whole-body sweat-reducing medicine used off-label for excessive sweating when topical and in-office procedures are insufficient. Because it acts systemically, it can address sweating across multiple body regions in one medication. The tradeoff is the sweat-reducing medicine side-effect burden.

    Regions: axillary, palmar, plantar, craniofacial, multifocal, generalized · Severity fit: HDSS 3, HDSS 4

    Read →
  • 06

    Oxybutynin for excessive sweating

    Oxybutynin is a whole-body sweat-reducing medicine FDA-approved for overactive bladder and used off-label for excessive sweating. It is one of two pill that reduces sweating options commonly considered for severe or in several separate areas disease, alongside glycopyrrolate. Effect is broad (covers all sweat regions) but so is the sweat-reducing medicine side-effect profile.

    Regions: axillary, palmar, plantar, craniofacial, multifocal, generalized · Severity fit: HDSS 3, HDSS 4

    Read →
  • 07

    Botox (onabotulinumtoxinA) injections for excessive sweating

    OnabotulinumtoxinA (Botox) is FDA-approved for severe primary excessive underarm sweating that is inadequately managed by topical agents. Injection produces months of sweat reduction at the treated site. Off-label use for hand, foot, and face and scalp disease is well-established in specialist practice.

    Regions: axillary, palmar, plantar, craniofacial, groin-inguinal · Severity fit: HDSS 3, HDSS 4

    Read →
  • 08

    Brella SweatControl Patch for excessive underarm sweating

    The Brella SweatControl Patch is an FDA-cleared in-office procedure that uses targeted alkali thermolysis to reduce underarm sweat. It is applied as a 4-minute patch session repeated as needed. Brella is one of the newer additions to the underarm procedural order of options, alongside miraDry.

    Regions: axillary · Severity fit: HDSS 3, HDSS 4

    Read →
  • 09

    miraDry (microwave thermolysis) for excessive underarm sweating

    miraDry is an FDA-cleared in-office procedure that uses focused microwave energy to destroy underarm sweat glands. One or two sessions typically produce durable reduction. It is underarm-only and not applicable to hand, foot, or face and scalp disease.

    Regions: axillary · Severity fit: HDSS 3, HDSS 4

    Read →
  • 10

    Endoscopic thoracic sympathectomy (ETS): last-resort surgical context

    Endoscopic thoracic sympathectomy (ETS) is a surgical procedure that cuts or clamps the sympathetic nerve chain in the upper thorax to reduce sweating, primarily in the palms and face. It is highly effective for severe excessive hand sweating but carries the risk of compensatory sweating — increased sweating elsewhere on the body that can be permanent. Modern practice reserves ETS for severe disease that has failed all less-invasive options.

    Regions: palmar, craniofacial, axillary · Severity fit: HDSS 4

    Read →