Evidence-Based Review of the Nonsurgical Management of Hyperhidrosis

The most common nonsurgical modern treatments for hyperhidrosis include topical treatments such as aluminum chloride, iontophoresis (usually with tap water), oral medications such as anticholinergics, and botulinum toxin type A. Topical treatments should always be first-line therapy. For those for whom such treatment fails, iontophoresis is typically recommended for those who have palmar or plantar hyperhidrosis, whereas botulinum toxin is often considered as first- or second-line therapy for severe axillary hyperhidrosis. Oral anticholinergics are considered after failure of all other nonsurgical treatments.