Excessive Underarm Sweating

Axillary hyperhidirosis [ax-il-ar-ee  hiper-high-dro-sis], also called excessive underarm perspiration, seems to be a more common problem I (and other dermatologists) am seeing every day. Axillary hyperhidrosis usually starts in young adults and occurs during the day, but not really during the night when someone is sleeping. Shirts and blouses routinely get ruined with underarm stains. Some people even drip wetness through their clothes onto the floor.

If axillary hyperhidrosis isn't too advanced, over the counter antiperspirants should be used first to try and improve it. Semi-solid antiperspirants seem to be the most effective way to get underarm protection accurately into the sweat glands. Less effective but still OK are gels and solid antiperspirants. Sprays are the least effective way to obtain antiperspirant protection. Antiperspirants work best when they are applied twice a day, morning and evening. Also, a simple "wipe, wipe" on your armpits to quickly apply the material will diminish its effectiveness.

You should wipe many times for at least 20 or so seconds back and forth under each armpit for these products to work. Doing this ensures the sweat glands become clogged most efficiently with the antiperspirant material. Obtaining clogged sweat glands usually takes at least a week or more of twice daily (appropriate) use of antiperspirants. So, someone shouldn't expect an antiperspirant to work any quicker than that. Secret Clinical is a brand name antiperspirant that is new and has clinical data that shows with proper use it is very effective at clogging the sweat pores and hence preventing sweating. It is most effective, of course, with proper use twice daily.

Aluminum chloride solution is a prescription antiperspirant that is effective when regular antiperspirants don't cut it. It is so strong, it often works when used only every other night. You don't need to use regular antiperspirants anymore when using aluminum chloride. Unfortunately, it is very irritating, and even with detailed instructions on how to use it, many people still get an irritating red rash when using aluminum chloride.

Botox is an extremely effective way to help treat excessive underarm sweating in people where nothing else works. A series of injections of Botox under each arm can almost completely stop any sweating for anywhere from 4-8 months. It is very expensive though, and although medical insurance may pay for Botox, it takes a lot of paper work and persistence to get it covered. For extreme cases when nothing else works, a surgical procedure with general anesthesia can be performed to remove sweat glands.