Mizzou Student No Longer Has to Sweat the Small Stuff

HM Alaska

In elementary school, Heather Maltbie learned to hide a medical condition that made her the target of teasing. Instead of playing games like kick the can with her classmates during recess, she kept to herself. She wore gloves year-round, telling friends her hands were always cold. And she routinely carried handkerchiefs in her pocket to wipe her hands.

“I always told everyone I just washed my hands,” said Maltbie, who is now 21. 

Hyperhidrosis affects more than 6 million people in the United States. It is characterized by excessive sweating, even when the body isn’t lowering its temperature. Doctors aren’t sure what causes hyperhidrosis, so the only option is treating the symptom.

Maltbie, who was diagnosed at age 9, started using topical creams and wipes to keep her sweating under control, but they never completely dried her palms. After she went through puberty, she tried oral hormone medication as a second-phase treatment. That worked slightly better but didn’t totally solve the problem.

After high school, Maltbie moved from the state of Washington to Columbia to live with her father and to attend the University of Missouri. In the middle of her sophomore year, Maltbie had an adverse reaction to the oral medication and was hospitalized. 

“When I wasn’t able to take the oral medication, my hands were constantly dripping with sweat,” Maltbie remembered. “When I’d be taking notes in class, they would smudge. I always wore dark colors and breathable fabrics like cotton to wipe my hands off on and help disguise all my sweat. It was embarrassing.”

She began to see dermatologists Jonathan Dyer, MD, and Kari Martin, MD. Dyer and Martin worked together to offer Maltbie personalized options.

Kari Martin, MD
Kari Martin, MD

“When medications fail, we move to the next tier of treatments for hyperhidrosis patients,” Martin said. “Patients at MU Health Care, like Heather, now have both medical and surgical options available to them.”

Dyer and Martin suggested two options — medical Botox injections or iontophoresis. Botox would mean a shot every centimeter in each of her hands. She would have to come back in four to six months for another round before her body would adapt and go longer between injections. Iontophoresis treatment would require submerging her hands and feet into a shallow bed of water for 30 minutes three times per week and allowing a mild electrical current to pass through them. 

Maltbie decided to try Botox. Two physicians and two nurses administered the injections simultaneously while numbing her hands with ice. The treatments stung and left her hands black and blue for a few days, but the payoff was worth it. 

“Even though the Botox injections make her feel kind of feel crummy and are uncomfortable, Heather gets so much benefit out of it and wants to keep going that she pushes through each treatment,” Martin said. 

Maltbie will return in late summer for her next round of injections. For now, she is enjoying life without hiding her hands.

“It’s been a miracle,” Maltbie said. “It’s been really cool getting to enjoy my hobbies without sweating. I can finally knit without soaking the fabric or shake hands with someone without apologizing for mine being wet.” 

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