Frequently Asked Questions

Getting personalized sweat care with SweatRx is simple and convenient:

1. Complete a quick online consultation to share your symptoms and health history.
2. A licensed healthcare provider will review your information and create a customized treatment plan tailored to your needs.
3. Receive your prescription treatments delivered right to your door, with ongoing support to ensure your plan is working. We'll check in regularly to answer questions and adjust your treatment as needed.

With your personalized treatment plan in place, you're well on your way to effectively managing your sweating and gaining more control over your daily life.

We bring expert sweat care straight to you:

• Skip the Doctor's Office: No appointments, no wait times—everything is done online.
• Specialist Expertise: We work exclusively with providers who understand hyperhidrosis and how to treat it effectively.
• Convenient and Private: Receive your treatments at home with discreet delivery.
• Unlimited Ongoing Support: Access your provider anytime for follow-up questions or adjustments to your plan.

Our products are prepared by trusted 503A compounding pharmacies that meet stringent quality and safety standards. These pharmacies follow FDA guidelines, state and federal regulations, and undergo rigorous testing to ensure the highest quality and efficacy. Each medication is compounded by licensed pharmacists with specialized training in compounding to meet your unique needs.

Hyperhidrosis requires ongoing care, and our subscription model ensures you consistently have access to the treatments and support you need.

By subscribing, you'll receive:

• Regular Care: Regular shipments of your prescribed treatments, so you never run out.
• Flexibility: Adjust, pause, or cancel your plan as your needs change.
• Ongoing Support: Unlimited access to your care team for follow-ups and adjustments.

Our subscription is designed to fit seamlessly into your life, making managing your sweat stress-free and convenient.

Our care team is composed of highly trained, licensed medical professionals with expertise in treating hyperhidrosis.

Twofold is designed for people experiencing excessive sweating, whether it's systemic or localized.

You may be eligible if you:

• Are 18 years or older.
• Struggle with excessive sweating that impacts your daily life.
• Have no medical conditions or medications that might conflict with treatment

Our licensed providers will assess your symptoms and medical history during the consultation to determine if Twofold is right for you.

Compounding is the process of creating a customized medication by a licensed pharmacist to meet the specific needs of an individual patient. This is done when commercially available drugs aren't suitable, such as:

• The patient cannot tolerate the available medication.
• The required formulation or dose isn't commercially available.
• The medication is in shortage or discontinued.

The U.S. Pharmacopeia (USP) defines compounding as preparing, mixing, altering, or packaging medications based on a licensed practitioner's prescription to tailor the treatment to the patient. Compounded medications are not FDA-approved.

Twofold is a virtual sweat clinic dedicated to helping people manage their hyperhidrosis, or excessive sweating. We provide treatment plans designed by licensed providers to address excessive sweating.

Twofold is all about making expert sweat care simple, effective, and accessible—delivered straight to your door without the need for in-person visits.

Twofold simplifies the process of managing hyperhidrosis with personalized care:

1. Start with an Online Consultation
   Complete a quick, secure questionnaire about your symptoms, medical history, and treatment goals.
2. Receive Your Treatment at Home
   If approved by your Twofold provider, your treatments will be compounded and shipped directly to your door in discreet packaging—no need for in-person visits.
3. Ongoing Support
   You'll have unlimited access to your care team for follow-up questions or adjustments to your treatment plan, all through the Twofold portal.

Excessive sweating is primarily caused by an overactive nervous system. In people with hyperhidrosis, the sweat glands receive more signals than necessary from the nerves that control sweating, leading to excessive production.

This can happen due to:

1. Primary Hyperhidrosis: Often linked to genetics, this type is caused by an overactive sympathetic nervous system and typically affects specific areas like the hands, feet, underarms, or face. It usually starts in adolescence or early adulthood and is unrelated to external factors like heat or exercise.
2. Secondary Hyperhidrosis: In this type, the excessive sweating is a result of another condition, such as thyroid disorders, diabetes, infections, or hormonal changes, or as a side effect of certain medications.

Triggers like stress, anxiety, spicy foods, or heat can make sweating worse in both types. Understanding the underlying cause is key to effective treatment.

 Oxybutynin is FDA-approved for treating conditions like overactive bladder. This is its official, or "on-label," use.

However, like many medications, oxybutynin can also be prescribed off-label for other conditions—in this case, hyperhidrosis (excessive sweating). Once a medication is FDA-approved, healthcare providers can legally prescribe it off-label if they believe it will benefit their patient. Oxybutynin has been used for years in dermatology and hyperhidrosis care to help reduce excessive sweating.

Hyperhidrosis is a medical condition that leads to excessive sweating—up to 4–5 times more than what the body needs to regulate temperature. It can affect specific areas, like the underarms, hands, feet, or face (localized hyperhidrosis), or occur all over the body (systemic hyperhidrosis). For many, it’s more than just a physical issue—it can impact confidence, comfort, and daily life.

Glycopyrrolate, the primary ingredient in our treatment, is FDA-approved for several medical uses, but its use for treating hyperhidrosis is considered "off-label" in the U.S. Off-label prescriptions are a common and legal practice used when providers determine that a treatment is medically appropriate based on a patient's needs.

While glycopyrrolate's use in hyperhidrosis is off-label, it's widely prescribed by dermatologists due to its proven efficacy in reducing excessive sweating. Many studies have demonstrated the safety and efficacy of glycopyrrolate, and it has become a well-established treatment among specialists in the field. Our treatment plans are informed by existing research and customized by board-certified dermatologists to ensure you receive the best possible care.

Yes, Twofold offers targeted treatments for localized sweating. Our topical oxybutynin gel is specifically designed to address excessive sweating in areas like your hands, underarms, and feet. These treatments focus directly on the affected areas, reducing sweat while minimizing systemic absorption and potential side effects.

No in-person visits are required. All consultations and follow-ups are conducted securely online through your patient portal.

If you stop applying your hyperhidrosis treatment, your excessive sweating is likely to return. These treatments manage symptoms but don't cure the condition, so consistent use is necessary to maintain results.

If you're considering discontinuing your treatment or have concerns, contact your Twofold provider for guidance and potential alternative options.

Topical treatments are a great option for managing localized sweating — like under the arms, on the hands, feet, or other specific areas. They work directly where they're applied without affecting the whole body, which can lower the risk of side effects compared to oral medications. If your sweating is limited to certain areas, a topical treatment can offer targeted relief without the need for a systemic medication.

Yes, like all medications, hyperhidrosis treatments may cause side effects. Based on clinical studies, topical oxybutynin is generally well-tolerated for treating focal hyperhidrosis. However, some users may experience side effects including but not limited to:

• Mild skin irritation
• Dry mouth
• Headache
• Dizziness or blurred vision
• Constipation

Most side effects are mild and tend to diminish as your body adjusts to the treatment. If you experience persistent or bothersome symptoms, it's important to consult your healthcare provider for guidance.

For a comprehensive list of potential side effects and safety information, please refer to the medication's official documentation or consult your healthcare professional.

Oxybutynin belongs to a class of medications called anticholinergics. It works by blocking the action of acetylcholine, a neurotransmitter that signals sweat glands to produce sweat. By reducing these signals, this medication decreases sweat production in treatment areas.

It usually takes about 4 weeks of daily use to see full, consistent results — so don’t worry if it feels slow a first. Many people will notice changes within their first 1–2 weeks, and it should keep improving from there. Consistent use of your prescribed medication is key to achieving and maintaining the best results. Individual response times can vary based on the severity of your hyperhidrosis and the area being treated.

No, there are no extra fees for messaging your Twofold medical team. Unlimited support is included with your quarterly plan, so you can communicate with your provider through the Twofold portal at no additional cost.

Currently, Twofold does not accept insurance. This approach allows us to offer transparent pricing with no surprise costs, copays, or hidden fees.

Twofold offers quarterly subscription-based treatment plans, at $165 for 3 months of treatment.

Shipping is always free, and there are no hidden fees.

If your order is missing or damaged, we're here to help!

Steps to resolve the issue:

1. Check Tracking Information: Review the tracking details in your shipping confirmation email. Carriers sometimes mark packages as delivered a few days early.
2. Contact Support: If your package is missing or damaged, reach out to us within 10 days of the original ship date.

Our Replacement Policy:

• Missing Orders: If it has been 10 or more business days since your order shipped and it hasn't arrived, let us know, and we'll arrange a replacement.
• Marked as Delivered but Not Received: If 3 business days have passed since your package was marked as delivered but you still haven't received it, contact us to resolve the issue.
• Damaged or Defective Items: If your order arrives damaged or defective, we'll replace it at no additional cost. Please report any issues within 10 days of the original ship date.

Unfortunately, we can't update the address for an order that has already been processed and shipped. However, you can update your address for future shipments in your Twofold portal.

If you have any questions or need assistance, please reach out to our support team:

• Email: hello@itstwofold.com
• Call: (628) 201-6812

Your first shipment will arrive within 2–5 business days after your order is approved. Refills are processed a few weeks before your medication runs out, ensuring you always have what you need.

If you need to adjust your shipment schedule, contact our support team:

• Email: hello@itstwofold.com
• Call: (628) 201-6812

You'll receive an email confirmation with tracking information as soon as your treatment ships. If you can't find the email, try searching for \hello@itstwofold.com\" in your inbox. Your first order typically ships within 2–5 business days from when you place your order.

If you have any questions or concerns please contact our support team:

• Email: hello@itstwofold.com
• Call: (628) 201-6812

If your tracking information shows that your package has been returned to sender, it's likely due to an outdated or incorrect address on file. Please check and update your address in your Twofold portal. If your order has been returned, contact us for assistance:

• Email: hello@itstwofold.com
• Call: (628) 201-6812

Absolutely. All orders are shipped in discreet packaging and delivered right to your door to protect your privacy.

We currently ship to all states except West Virginia, Virginia, Kansas, New Mexico, Alabama, and Arkansas. We're looking at expanding into these states soon, so if you're located there, let us know!

Yes, shipping is always included in the cost of your treatment—no additional fees.

Once your treatment plan is approved, your medication is compounded fresh and shipped within 2–5 business days. Delivery times may vary depending on your location, but tracking information will be provided to keep you updated.

Yes, you can cancel your Twofold subscription at any time.

To do so, log into your account dashboard and navigate to the billing settings. From there, you can deactivate your subscription.

Please note that if a prescription medication order has already been approved by our clinical team, it may not be eligible for cancellation or refund. For assistance, contact our support team at hello@itstwofold.com.

You can email us at hello@itstwofold.com or call us at (628) 201-6812 with any questions.

Our customer support hours are:

• Monday–Friday, 9 AM–6 PM EST

If you need help outside of these hours, feel free to email us, and we'll respond as soon as we can.

At Twofold, we strive to make managing your hyperhidrosis as simple and convenient as possible. You are free to cancel, pause, or adjust your subscription at any time prior to your next shipment. To help us process changes smoothly, we kindly ask for a minimum of 48 hours' notice before your next order is set to process.

Due to the personalized nature of prescription medications, Twofold cannot guarantee refunds for cancellation requests received after your order has been processed by the pharmacy. Additionally, for safety and regulatory reasons, we are unable to accept returns or issue refunds for any products once they have left the pharmacy.

If you experience any issues with your shipment or are dissatisfied with your treatment, please reach out to us within 10 days of your order fulfillment. We'll work with you to address your concerns and do our best to make things right.

• Contact us: hello@itstwofold.com
• Call us: (628) 201-6812

We require your ID and selfie to verify your age and identity, ensuring compliance with certain regulations. Any personal information you provide us is stored on a HIPAA-compliant server to protect your privacy.

If this is not an emergency and you have questions or concerns about side effects, you can message your provider directly through the Messages tab in your Twofold portal. Your provider will respond as soon as possible to address your concerns.

For emergencies, call 911 or visit your nearest emergency room.

If you're experiencing a physical or mental health crisis, call 911 or go to your nearest emergency department immediately. If you are contemplating suicide, call 911 or reach out to the National Suicide and Crisis Lifeline by calling or texting 988. These services are available 24/7 to provide support.

Please do not message your Twofold provider if this is an emergency, as response times can take up to 12 hours.