Treatment Axillary hyperhidrosis can sometimes be helped by 20%aluminium chloride in alcohol applied at bedtime. Palmarand plantar hyperhidrosis are usually better treated withiontophoresis, either using water alone or with the anticholinergicdrug glycopyrronium bromide in solution. Thistreatment utilizes DC electricity to drive ions into the skin.Psychological methods and even psychotropic drugs areuseful in some patients in whom anxiety is a prominenttrigger. Transthoracic endoscopic sympathectomy can bevery effective in selected patients with palmar hyperhidrosis.Recently, success has been claimed for localizedinjections of botulinum toxin.