Yes, in some cases facial wipes that contain 1% glycopyrrolate can be effective. DryDerm is an overseas brand. There are many online pharmacies in Canada that can supply off label compounded solutions. Just Google.

Excessive sweating of the scalp or head can be particularly difficult to treat,  simply because the scalp can be more difficult to reach. For most of us, the scalp is a hairy region, making application of a high-strength anti-perspirant more challenging – not to mention sometimes messy. DryDerm solution is specially formulated to help those with craniofacial HH. The solution can be applied directly to the scalp.

The solution comes in a convenient dropper bottle that can also be applied to specific areas such as the hairline. For more information on the product goto drypharmacist online.

Anti-sweat creams such as glycopyrrolate can be used up to twice a day, but we advise all patients to start once at night. It is best applied to dry, clean skin, avoiding the eyes and mouth areas. Remember to wash your hands after application of any anti-sweat creams!

• Leave the cream on for 3-4 hours before washing off. If you do not experience any side effects, patients can leave overnight, before washing off in the morning.
• Twice a day application is the maximal application recommended for Glycopyrrolate.
• If side effects occur, decrease the contact time with the skin. Titrate according to side effects & efficacy.

Anti-sweating creams, such as compounded glycopyrrolate and propantheline are usually well tolerated, however side effects can occur. They include-

• Skin irritation: especially if used in skin folds of excess sweat areas such as the groin and armpit. (Armpit areas respond best to Driclor or sweat stopping treatments injections).
• Systemic absorption: This means the drug gets sufficiently absorbed through the skin, leading to drugs in the bloodstream. This may cause side effects such as dry mouth, sedation (feeling tired), blurred vision and constipation.
• Side effects are usually dose related. The trick is to find a concentration that will deliver the necessary results, at a certain concentration, whilst minimizing side effects. Your dermatologist will come up with a solution for you.

Botox. Why? Because-

1. It is effective in over 96% of cases.
2. It takes 2 minutes to perform.
3. It last up to 6-8 months
4. It is subsidised under Medicare (under arms only)

If creams are of limited value, or if side effects occur there are other treatment options available.

Iontophoresis involves blocking the sweat gland with ions and minerals. Additionally this method can be used to deliver drugs such as glycopyrrolate directly into the sweat gland areas. It is best used for sweating of the hands and feet, and less useful for excessively sweaty armpits.

Anti-sweat injections can block sweating for up to 7 months. This procedure involves multiple small injections into the area of maximal sweating. Over a period of 7-14 days, sweat stopping treatments block the function of sweat glands. This treatment can be used to treat excessive sweating of the underarms, face, feet, hands, and focal areas of compensatory hyperhidrosis. It is subsidised by Medicare for the treatment of severe underarm sweating not responding to over the counter antiperspirants.

ETS or Endoscopic Thoracic Sympathectomy is a surgical procedure that transects or destroys the nerves in the chest wall. This procedure has a very high success rate, and can be considered for treatment of excessive sweating of the hands and cases of facial sweating associated with blushing. It can not treat sweaty feet. ETS for underarm sweating has largely been replaced with sweat stopping treatments injections.

Systemic agents are tablets used to decrease sweating. They can be useful for generalised sweating, but may help localised areas such as sweaty hands and feet, as well as facial sweating. Most commonly used tablet is propantheline bromide. The limiting side effect is sedation, dry mouth, blurred vision and constipation.