David Pariser, MD starts the update on hyperhidrosis with a case that helps illustrate the treatment options available for the condition. He then discusses the safety and efficacy of topical antiperspirants, including aluminum and zirconium salts, aluminum chloride, glycopyrronium cloth, and targeted alkali thermolysis patch. Next, he talks about microwave thermolysis and botulinum toxin for hyperhidrosis. He then discusses the use of iontophoresis devices which are especially helpful for hyperhidrosis of the hands and feet. After that, he goes further in detail about glycopyrronium cloth and the caution needed to not use them on the face. Dr. Pariser also discusses the possible use of propranolol, anticholinergic medications, and endoscopic thoracic sympathectomy as treatment options. He ends with a discussion of how to treat hyperhidrosis in different difficult to treat areas.