[Therapy of hyperhidrosis].

In the treatment of hyperhidrosis stabilization of psychovegetative functions is certainly desirable. However, autogenic exercise, hypnosis, psychotherapy as well as the administration of sedatives and tranquilizers serve only as adjuvant therapeutic measures. Systemic antihidrotics, like sage or camphor, proved ineffective; anticholinergics pose the risk of side effects. For topical therapy aldehydes, organic acids, and especially metallic salts are favorable. Tanning agents are of limited effect. Topical anticholinergics suppress sweating but provoke systemic side effects, if resorbed in larger quantities. Surgical treatment includes sympathetic blockade, sympathectomy, excision or curettage of eccrine glands, and cryotherapy or application of sclerosing agents. Concerning efficacy and risks of therapy only excision of axillary skin fields can be advocated. Among physical measures X-ray therapy is rendered obsolete. However, tap water iontophoresis is gaining increasing significance as an effective and safe treatment in palmar and plantar hyperhidrosis. In hyperhidrosis axillaris, palmaris, or plantaris topical application of aluminum chloride solution is emphasized as an efficacious treatment modality. If it fails, axillary skin fields can be excised and hyperhidrosis of palms or soles can be treated with tap water iontophoresis.