Treatment choices that are offered to people suffering from primary hyperhidrosis can be classified into two treatments: Non-surgical (topical antiperspirants, iontophoresis, systemic medication) treatment and surgical (endoscopic thoracic sympathectomy, excision of axillary tissue) treatment.

Botulinum toxin injection is supposed to be minimally invasive and has become an accepted therapy for patients who do not react favorably to more conventional forms of treatment.  This treatment therapy is normally done prior to resorting to surgery. Different therapeutic alternatives also vary in their length of efficacy. Side effects and response speed differ depending on the anatomic area treated. Topical therapy for focal hyperhidrosis or generally called antiperspirant treatment can be carried out with chemicals of several different classes. These classes comprise of astringent agents, topical anticholinergics, local anesthetics, and aluminum and other metallic salt solutions.

Most of the population in developed countries uses easily available over the counter antiperspirants for cosmetic and hygienic control of underarm sweating and odor. Individuals suffering from moderate to severe hyperhidrosis on the other hand require stronger remedies. Prescription medication and specially compounded solutions are commonly required for hyperhidrosis sufferers. Unfortunately these cures do not always give the desired effect.

Various topical agents analyzed are not easily obtainable commercially or do not have United States Food and Drug Administration endorsement and approval for the cure of hyperhidrosis. Only aluminum chloride has the approval of the USFDA for hyperhidrosis treatment. The preliminary treatment usually made for hyperhidrosis is normally non-invasive and does not necessitate any surgical procedure. There are commercially available ointments and salves (i.e., Drysol) that work as astringents and they have a tendency to dry up the sweat glands.

On the other hand, a different and acceptable cure for hyperhidrosis is iontopheresis. This is a hyperhidrosis treatment wherein electrical stimulation is used to lessen sweating. This procedure is normally done on the hands. Patients put their hands in a bath or basin of water wherein an electrical current is passed. This procedure stuns the sweat glands and tends to decrease the secretion of sweat for periods ranging from six hours to about 7 days.

One of the latest cures offered for hyperhidrosis is the injection of botulinum toxin or more commonly known as Botox. It is injected into the area where excessive sweating is experienced. This is a toxin that affects and sort of paralyzes the nerve endings. This toxin eventually reduces the transmission of the nerve impulses to the sweat glands which in turn results to reduce perspiration. It would normally require quite a few injections in the palms of the hands or armpits to complete the procedure.  The effect of the procedure is observed to range from 1 month to 6 months. Continual injections are practically needed to sustain an acceptable level of dryness.

Besides the above-mentioned treatments, many drugs and remedies have been used with varying degrees of success. These include sedatives (for patients with stress induced hyperhidrosis) and medications that have an effect on our central nervous system. A family practitioner or internist is usually the one who makes the diagnosis and initial treatment for hyperhidrosis. Hyperhidrosiscases that do not respond accordingly to simple treatment regimens are often referred to a specialist such as a dermatologist or neurologist. As a rule of thumb, surgery is only considered when the less invasive medical treatments have been exhausted.