Stop Underarm Sweating

Hyperhidrosis

Hyperhidrosis can either be generalized or localized to specific parts of the body. Hands, feet, axillae, and the groin area are among the most active regions of perspiration due to the relatively high concentration of sweat glands; however, any part of the body may be affected. Primary hyperhidrosis is found to start during adolescence or even before, and interestingly, seems to be inherited as an autosomal dominant genetic trait.

Primary hyperhidrosis must be distinguished from secondary hyperhidrosis, which can start at any point in life. For some, it can seem to come on unexpectedly. The latter form may be due to a disorder of the thyroid or pituitary gland, diabetes mellitus, tumors, gout, menopause, certain drugs, or mercury poisoning.

Treatment

There are surgical and non-surgical treatments for excessive sweating, a condition also known as hyperhidrosis. If you suffer from hyperhidrosis, you should consult your doctor before starting any treatment plan. It is important to speak with your doctor because excessive sweating may be caused by some other disease process, known as "secondary" hyperhidrosis.

Excessive sweating that is not due to an underlying medical condition is known as "primary" hyperhidrosis. (Please see Primary versus Secondary Hyperhidrosis). This section is focused on the treatment for primary hyperhidrosis. In general, patients with hyperhidrosis should try to treat symptoms with non-surgical treatments before considering surgery for excessive sweating.

There are many non-surgical approaches to controlling excessive sweating. Many of these treatments may be effective for people with mild to moderate cases of hyperhidrosis. All treatment plans should be based on individual needs and under the direct care of a physician. The first step is to determine if excessive sweating is due to an underlying illness, known as secondary hyperhidrosis. The treatment for secondary hyperhidrosis is to treat the underlying cause of excessive sweating. If there is no known source for hyperhidrosis after medical workup by a physician, primary hyperhidrosis is present. The following treatments are used in treating primary hyperhidrosis.

Medications for Excessive Sweating
There are three general groups of medications used to treat the symptoms of excessive sweating. They include sedatives, beta-blockers, and anticholinergics (medications that block the substances that are responsible for nervous system activity.)

Anticholinergic medications were not developed to specifically treat hyperhidrosis and carry many side effects. The side effects of anticholinergic medications include dry mouth, blurred vision, and urinary retention. These side effects often significant, and anticholinergic medications are often not well tolerated by patients.

Sedative medications like benzodiazepines (Valium) are useful in treating excessive sweating that is caused by stress.

Antiperspirant Treatment for Excessive Sweating
Antiperspirants and deodorants are used on a daily basis by most people to reduce underarm wetness and fight odor. In people with excessive sweating, special antiperspirants containing aluminum chloride hexahydrate (Drysol ®) are often the first therapeutic measure recommended. They work by blocking the opening of sweat glands. These topical medications are simple treatments that are easy to apply, and usually given at night. Side effects include skin irritation, and the results are often not sufficient to stop excessive sweating. Topical agents are most effective in individuals with light to moderate hyperhidrosis.

Iontophoresis Treatment for Excessive Sweating
Iontophoresis is primarily used to stop sweaty hands, stop sweaty feet, and stop sweaty palms. A special setup is also used to stop underarm sweat. This treatment uses low-intensity electrical current to disrupt the function of the sweat glands. Each hand or foot is rested on a wet pad in a tray. The pads are connected to an electrical current that passes through the pads. The currents are sent through the skin to sweat glands, which results in blocked sweat glands.

Iontophoresis is a safe, non-invasive treatment and causes only minor discomfort. The biggest drawback is that the iontophoresis process is time consuming, and must be repeated at regular intervals. Each iontophoresis treatment may take 15 to 30 minutes to complete. Often the intervals between treatments can be lengthened once control is achieved. Iontophoresis has been shown to stop excessive sweating in around 85% of patients with sweaty palms, sweaty hands, or sweaty feet. (Citation 1)(Citation 2)

Botox® treatment for Excessive Sweating
Botox ® (botulinum toxin type A) is a medication that is used in the treatment of excessive sweating. Botox is a toxin that blocks the function of nerves. When the toxin is spread througout the body, paralysis will occur. When the toxin is injected into a specific site, only the nerves in that area will be paralyzed. Botox injection leads to decreased sweating in the area where it is injected. Please see our section on botox treatment to stop palm sweating for more information.

Endoscopic Sympathectomy Surgery for Excessive Sweating
The creation of endoscopic thoracic sympathectomy to stop palm sweating has lowered the complication rate of surgery for excessive sweating. Surgical treatment is now a good option for patients who cannot control symptoms on medication alone. The most common side effect of endoscopic thoracic sympathectomy is compensatory sweating, where the patient may experience increased sweating in other areas that previously were not a problem. Please visit our section on surgical treatment for excessive sweating.

The surgery has been shown to be effective to stop sweaty palms, stop sweaty hands, stop sweaty underarms, and stop excessive facial sweating. Overall, the surgery is safe and effective for the treatment of hyperhidrosis.

Studies on endoscopic thoracic sympathectomy have shown the procedure to reduce increased sweating in the majority of patients. In one study of 850 patients, 98% of the patients said that the results of the surgery were satisfactory, (1) while another study of 233 patients showed satisfactory results in 95% of patients (2).

The main side effects include hemothorax (blood in the thoracic cavity, behind the lungs) in 1% to 2%, recurrence of symptoms in 2%, and compensatory sweating (increased sweating in other areas of the body) in 55% to 67% of patients.