Managing Excessive Sweating (Hyperhidrosis) of the Hands, Feet, and Armpits — Village Dermatology Katy & Houston, Texas
By: Dr. Caroline Vaughn
Excessive sweating can significantly impact daily activities, confidence, and quality of life. At Village Dermatology, serving patients throughout Katy, Texas and Houston, Texas, we provide comprehensive evaluation and personalized treatment options for hyperhidrosis, a common but often underdiagnosed condition.
This case highlights the evaluation and management of a 42-year-old female presenting with long-standing excessive sweating affecting multiple areas.
Chief Complaint
The patient presented as a new patient with excessive sweating involving the:
Palms
Soles of the feet
Armpits (axillae)
She described the sweating as dripping, moderate in severity, and present for many years, noting that it negatively affected her quality of life.
Clinical Examination
A focused examination was performed of the:
Right and left axillae
Hands
Feet
The patient appeared well-developed, well-nourished, alert, and in no acute distress.
A dermatoscope was used during the exam.
Key Findings
Clinical findings were consistent with hyperhidrosis, with excessive sweating noted on:
Left thenar eminence
Right radial palm
Right and left dorsal feet
Right and left axillary vaults
Diagnosis
Hyperhidrosis
(ICD-10: L74.512 – Palmar, L74.513 – Plantar, L74.510 – Axillary)
Hyperhidrosis is a condition characterized by excessive sweating beyond what is necessary for temperature regulation. It most commonly affects the hands, feet, and armpits and can significantly interfere with social and professional activities.
Treatment Discussion
A detailed discussion was held regarding available treatment options, including:
Topical & Medical Options
20% aluminum chloride antiperspirants (applied at bedtime)
Qbrexza® (glycopyrronium) wipes
Oral glycopyrrolate (Robinul) for severe cases
Procedural & Device-Based Treatments
Iontophoresis (Dermadry device)
Botulinum toxin (Botox®) injections for axillary or palmar hyperhidrosis
After reviewing risks, benefits, and lifestyle considerations, the patient elected to try iontophoresis first using the Dermadry device. A prior authorization for the device was initiated during the visit.
Plan
Dermadry iontophoresis device: PA started
Qbrexza wipes: Sample provided (box of 5 single-use cloths)
Continue monitoring symptoms and response to treatment
Patient Counseling
The patient was counseled on:
Skin Care & Expectations
Hyperhidrosis is a chronic condition
Multiple treatment options exist, and therapy can be adjusted over time
Consistency is key for optimal symptom control
When to Contact the Office
If sweating persists despite treatment
If side effects develop from topical or systemic therapies
The patient expressed understanding and agreement with the treatment plan.
Follow-Up
Follow-up as needed (PRN)
Reassess symptom control and consider additional therapies if needed
At Village Dermatology in Katy and Houston, we focus on improving quality of life through customized hyperhidrosis treatment plans tailored to each patient’s needs.
