Start Low Go Slow - A Logical Approach

Treating hyperhidrosis should follow a methodical approach similar to other medical conditions, emphasizing the "Start Low Go Slow" principle. This means initiating therapy with the lowest effective dose, then incrementally increasing it until achieving the desired therapeutic outcome. This approach not only helps optimize treatment effectiveness but also reduces the likelihood of skin irritation or other adverse effects.

Helping Create Dryer Lifestyles

Therapeutic Determinants

Essentially, there are two aspects to consider when determining the choice of therapy.

1) The severity of your condition

While it ultimately involves some judgment, a severity scale has been developed to aid in assessing the seriousness of an individual's condition. This scale is known as the Hyperhidrosis Disease Severity Scale (HDSS):

• My sweating is never noticeable and never interferes with my daily activities (Score 1)

• My sweating is tolerable but sometimes interferes with my daily activities (Score 2)

• My sweating is barely tolerable and frequently interferes with my daily activities (Score 3)

• My sweating is intolerable and always interferes with my daily activities (Score 4)

A score of 1 or 2 indicates a mild to moderate condition, while 3 or 4 is considered severe. The HDSS can be used for each affected region to determine the individual severities (e.g., underarms vs. palms).

2) Skin sensitivity

The primary areas affected by excessive sweating include the underarms, palms, soles, face, scalp, and groin—often referred to as the extremities and "folds." While sensitivity levels can vary among individuals, as a general rule, the "folds" (such as the underarms) and the face/scalp tend to be more sensitive. In contrast, the palms and soles are less sensitive.

Due to these variations in sensitivity, treatment strategies often involve a more aggressive approach for the palms and soles, typically starting with higher strength treatments to effectively manage excessive sweating in these areas.

Treating the "Folds" and Face/Scalp

For the underarms/groin and face/scalp; start with DryDerm 10, 15, or 20 and increase to a maximum of 35%.

Treating the Palms and Soles

For the palms and soles; start with DryDerm 20 and increase to 35%. If the desired outcome is not satisfactory try DryDerm PP (extra-strength formulation at 45%).

CHAC Hyperhidrosis Treatment Guidelines

The Canadian Hyperhidrosis Advisory Committee provides a comprehensive, easy-to-follow review of primary hyperhidrosis treatment algorithms on a "per region" basis.