Prescription treatment, written for the UK
If a pharmacy antiperspirant has not been enough, the next step in the UK is a GP. It is not a US telehealth brand, and it is not an insurance form.
This page follows the NHS page on excessive sweating, the NICE clinical knowledge summary, NICE evidence summary ES10 on oxybutynin, and NICE TA1175 on Axhidrox. It is not a prescribing guide. A prescriber decides the dose and whether a medicine is suitable. The practical route is set out in our NHS treatment guide.
The order used in the UK
- Lifestyle measures and a 20% aluminium chloride antiperspirant. Driclor, Anhydrol Forte and Odaban are pharmacy medicines. You do not need a prescription to buy them. Perspirex is the gentler roll-on many people try if a 20% product irritates the skin. Use the product as the leaflet describes before deciding it has failed.
- An oral antimuscarinic, if the GP agrees. Propantheline is the oral medicine licensed for hyperhidrosis in the UK. Oxybutynin is often used off-label; NICE ES10 is the public summary of that evidence. Dry mouth and other anticholinergic effects are common. Which drug, and what dose, is a prescriber's decision. Our prescription medicines guide explains the differences without telling you what to take.
- A dermatology referral when first-line treatment is not enough. Clinics may offer iontophoresis, especially for hands and feet, or botulinum toxin for severe underarms. Whether the NHS funds either one is decided locally by your Integrated Care Board.
- Axhidrox (glycopyrronium bromide cream) for a narrow group. NICE TA1175 (9 July 2026) says the cream can be an option for severe primary underarm sweating in adults after lifestyle measures, aluminium antiperspirants and oral antimuscarinics have not worked or cannot be used. It is not a pharmacy product. It is not for hands, feet or the face.
Not licensed in the UK
American sites lead with three products you cannot be prescribed here. US approval is not a UK licence, and US insurance is not an NHS pathway.
Qbrexza is a glycopyrronium cloth sold on prescription in the United States. It is not licensed in the UK. A GP cannot write it, and a UK pharmacy will not dispense it. Do not treat an American list price or an insurance prior authorisation as something the NHS does. Background on the US product is in our Qbrexza note; that page is not a UK buying guide.
Sofdra (sofpironium gel) is also a US approval. We have found no UK marketing authorisation. The detail, and what to use instead, is in Can you get Sofdra in the UK?.
Twofold is a US telehealth subscription for a compounded cream posted to a US address. It is not an NHS service, and a UK pharmacy does not dispense it as a licensed medicine. The Twofold review describes that American service for people who have seen the ads. It is not the first prescription step in the UK.
Botulinum toxin
Hospital dermatology uses botulinum toxin for severe underarm sweating when simpler treatment has not worked. A randomised trial measured a large fall in underarm sweat; the figure, the link, and the limits of that study are on the NHS treatment guide. It is not a guarantee. The effect wears off, repeat funding is a local decision, and treatment for hands, feet or face is rarely available on the NHS. Private UK prices are compared on that same guide.
What to ask a GP
A useful appointment covers four things:
- Where you sweat, and how it affects work or daily life.
- What you have already used, for how many weeks, and whether the skin tolerated it.
- Whether an oral antimuscarinic is appropriate.
- What your local area funds if you need a dermatology referral, including botulinum toxin for underarms and, for severe underarm sweating in adults, Axhidrox under TA1175.
Bring a short note. Our severity check uses the same four statements clinicians use to describe impact. It is not a diagnosis.
There is no single best prescription
For most people in the UK the sequence is a pharmacy antiperspirant, then a GP, then whatever that GP and the local NHS can actually provide. Axhidrox is a later option for severe underarm sweating in adults, on the terms in TA1175. Qbrexza, Sofdra and Twofold are US products. Reading that they are "FDA approved" does not make them available here.
