A study* published a few days ago indicates that several treatment options are quite effective when treating scalp and/or facial hyperhidrosis. The authors of the study looked at data published over the last five decades (48 years to be precise). They reviewed over 800 references and selected close to 30 studies that met their strict inclusion criteria.
Most effective treatments include topical glycopyrrolate, botulinum toxin A injections, oral oxybutynin and surgery. Both glycopyrrolate and botulinum were highly effective (over 96 to 100%) but the latter is often (50 to 100%) associated with forehead muscle side effects. On the other hand, glycopyrrolate side efects are rare. Oxybutynin seems a little less effective (80 to 100%) and has side effects in 76 to 83% of the cases. Sympathectomy (surgery) is quite effective in some cases (70 to 100%) but is often associated with troublesome compensatory sweating in 8 to 95% of cases according to the studies that were reviewed. For this reason, the authors recommend that surgery should be left as an alternative to other treatments if these fail.