Hyperhidrosis describes the excessive production of sweat.

Management options include

• topical aluminium chloride preparations are first-line. Main side effect is skin irritation
• iontophoresis: particularly useful for patients with palmar, plantar and axillary hyperhidrosis
• botulinum toxin: currently licensed for axillary symptoms
• surgery: e.g. Endoscopic transthoracic sympathectomy. Patients should be made aware of the risk of compensatory sweating