Bruce P.Robinson, MD


An estimated 2-3% of Americans suffer from excessive sweating of the underarms, or of the palms and soles of the feet. Sweating is embarrassing, it stains clothes, ruins romance and complicates business and social interactions. Severe cases can have serious practical consequences as well, making it hard for people who suffer from it to hold a pen, grip a car steering wheel or shake hands. 

If left untreated these problems may continue throughout life. We can help!

Once other medical conditions have been ruled out, we offer a range of exciting treatment options – from prescription products to in-office treatments – to manage this condition. Dr. Robinson has many happy patients who were treated for Hyperhidrosis. 

What Causes Hyperhidrosis?

Although neurologic, endocrine, infectious, and other systemic diseases can sometimes cause hyperhidrosis, most cases occur in people who are otherwise healthy. Heat and emotions may trigger hyperhidrosis in some, but many who suffer from hyperhidrosis sweat nearly all their waking hours, regardless of their mood or the weather.

What is the Treatment for Hyperhidrosis?

Through a systematic evaluation of causes and triggers of hyperhidrosis, followed by a judicious, stepwise approach to treatment, many people with this annoying disorder can sometimes achieve good results and improved quality of life.

The approach to treating excessive sweating generally proceeds as follows:

  • Over-the-counter antiperspirants containing a low dose of metal salt (usually aluminum) are usually tried first because they are readily available. Antiperspirants containing aluminum chloride (for example Certain Dri) may be more effective when other antiperspirants have failed.
  • Prescription strength antiperspirants, when regular antiperspirants fail to treat excessive sweating, we recommend aluminum chloride hexahydrate (Drysol), a prescription strength version of aluminum chloride.
  • Iontophoresis: Its exact mechanism of action is still unclear, although it probably works by temporarily blocking the sweat duct. The procedure uses water to conduct an electric current to the skin a few times each week, for about 10-20 minutes per session, followed by a maintenance program of treatments at 1- to 3-week intervals, depending on the patient's response.
  • Oral medications: Anticholinergics can reduce sweating, but are not commonly used because in order to work they often produce side effects like dry mouth.
  • BOTOX (botulinum toxin)-A, has been approved in the U.S. by the FDA for treating excessive axillary (underarm) sweating. Currently, the FDA has not approved Botox for sweating of the palms and soles of the feet, though some dermatoologists are administering it as an off-label use, reportedly with success. Palm injections cause more pain, requiring nerve blocks to numb the hands in order to make the injections more comfortable. Skilled practitioners have used Botox for the head and face, as well.
  • miraDry: Approved in 2011 by the FDA for excessive underarm sweating. It is a non-invasive treatment that uses electromagnetic energy targeting heat on sweat lands, destroying them. Local anesthesia is used and the skin is cooled during this hour-long procedure. It can be repeated 2-3 times for optimal effect.
  • Lasers: Lasers can target and focus a narrow beam of heat and kill the underarm sweat glands.
  • Surgery: A procedure called thoracic sympathectomy may be considered as a last resort.

Cosmetic Consultation Reimbursement Policy

Schedule an office visit to discuss your concerns and skincare goals with Dr. Robinson and the office visit cost will be applied to the future cost for the "consulted procedure". The "consulted procedure" must be completed within 30 days of your consult visit.

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