Sweaty Armpits

Underarm excessive sweating, also called axillary hyperhidrosis is an annoying, embarrassing, and isolating problem (to say the least). From the discomfort of sweat running down your sides, to the embarrassment of obvious sweat stains, to the fear of being "discovered," excessive underarm sweating can feel like it's ruining your life.

But there is good news: Safe treatments for excessive sweating are available, the treatments work, and you have a number of options to choose from--or combine.

The first line-of-defense against excessive underarm sweating are antiperspirants. Antiperspirants are non-invasive, topical (applied on top of your skin), and available in a number of different strengths including "regular" over-the-counter products, "clinical strength" over-the-counter products, and perhaps even prescription antiperspirants. Most physicians recommend that you start with the mildest formulations ("regular" over-the-counter products) and if they don't give enough symptom relief, work your way up to the stronger clinical strength formulations and then, perhaps prescription antiperspirants. The recent advent of clinical strength antiperspirants such as Secret Clinical Strength and Gillette Clinical Strength have been shown to provide the same level of sweat management as prescription products, but with much less irritation. We are glad to see these new, and greatly improved, formulations on the drugstore shelves and easily available to everyone.

How you use antiperspirants is also incredibly important. Check out our information available about this, but the most important take-aways are: 1. apply antiperspirants at night before bed and 2. apply to totally dry skin to avoid irritation.

If antiperspirants don't give you the relief you need, your next option may be Botox (also known as onabotulinumtoxinA). An experienced dermatologist can inject Botox into your underarms to dramatically reduce sweating. In one clinical study involving 322 patients with severe underarm sweating, 81% of the patients receiving injections achieved more than 50% reduction in sweating. And, 50% of the patients had their excessive sweating relieved for at least 201 days (nearly 7 months). Some, for over a year!

Another treatment, miraDry, is a completely new type of treatment for axillary hyperhidrosis (underarm excessive sweating) and was cleared by the US FDA in January 2011.  This the first novel treatment option approved by the US governing body in nearly 7 years! As of April 2012, clinical data from two study sites affiliated with the University of British Columbia showed miraDry successful in reducing underarm sweat in over 90% of patients through the final study visit that was 12 months after treatment. The average sweat reduction was 82%. And, patients rated their satisfaction with the treatment at 90%. miraDry has been developed by Miramar Labs of Sunnyvale, California. While miraDry is promising news for those who suffer with underarm sweating, it cannot be used to treat excessive sweating in any other area. Read the research findings, and understand the procedure for miraDry here.

The use of miraDry and Botox for the treatment of hyperhidrosis is most effective when performed by a physician who has received special training and who has experience with the procedure. To find a physician in your area who is familiar with hyperhidrosis treatments, use our Physician Finder.

While most people find that antiperspirants, Botox injections, miraDry or a combination of these hyperhidrosis treatments are enough to manage even the most severe case of excessive sweating in the underarms, there are those who seek a surgical approach to treat their axillary hyperhidrosis. Underarm surgery techniques include: excision, curettage, liposuction, and laser. During excision, sweat glands may be cut out. Similarly, during curettage they may be scraped out. During liposuction they may be removed by suction. Using lasers, tissue containing sweat glands is liquefied. Combinations of curettage and central excision, or of curettage and liposuction may be used, as well as combinations of liposuction and laser treatments. Dermatologists often have good results with these techniques. Each of these procedures can be done under local anesthesia (meaning that the patient is not completely "out") and in an office setting (as opposed to in a hospital setting). To learn more about these local surgical options for axillary (underarm) hyperhidrosis, click here.

Please note that in most cases we don't recommend endoscopic thoracic sympathectomy (ETS) for excessive underarm sweating. While ETS is perhaps the most commonly discussed, (as well as criticized) surgery for hyperhidrosis, there are other, far less risky, and far more predictable, options for people who suffer from excessive sweating of the underarms.

We hope that you'll find the information on the site helpful as you search for the best way to manage your underarm sweating problem. For updates about new research, the latest treatments, and daily management tips, be sure to subscribe to our free e-mail newsletter, SweatSolutions. We also have an extensive library of hyperhidrosis articles from peer-reviewed medical journals, so you can see where we get our facts and can share reliable medical data with your physician.