Excessive underarm sweating may be seen with hyperhidrosis. There are surgical and non-surgical treatments that may be used stop underarm sweating. You should consult your doctor before starting any treatment plan because excessive sweating may be caused by some other disease process, known as "secondary" hyperhidrosis.
In general, patients with primary hyperhidrosis should try to treat symptoms with non-surgical treatments before considering surgery. There are many non-surgical medications and procedures used to stop underarm sweating.
Medications for Underarm Sweating
There are three general groups of medications used to stop excessive underarm sweating. They include sedatives, beta-blockers, and anticholinergics (medications that block the substances that are responsible for nervous system activity.)
Anticholinergics carry significant side effects, including dry mouth and blurred vision. These side effects often significant and not well tolerated by patients. Benzodiazepines (like Valium) are useful in treating excessive underarm sweating that is caused by stress, but carry the risk of dependence.
Antiperspirants for Underarm Sweating
Antiperspirants and may be used to stop underarm sweating, including special antiperspirants containing aluminum chloride hexahydrate (Drysol ®). These are usually the first therapeutic measure recommended, and are most effective in individuals with light to moderate hyperhidrosis. They work by blocking the opening of sweat glands, and side effects include skin irritation. Unfortunately, the results are often not sufficient to stop excessive underarm sweating.
Botox® treatment for Excessive Underarm Sweating
Botox ® (botulinum toxin type A) is a medication that is used to stop underarm sweating. Botox is a toxin that blocks the function of nerves. Botox injection leads to decreased sweating in the area where it is injected. One of the primary side effects of Botox is pain at the site of injection. Injections to stop underarm sweating tend to be less painful than when used to stop hand sweating or to stop palm sweating. Please see our section on botox treatment for more information.
Iontophoresis Treatment for Underarm Sweating
Iontophoresis uses low-intensity electrical current to disrupt the function of the sweat glands. During inotophoresis, each hand or foot is rested on a wet pad in a tray that is connected to an electrical current that passes through the pads, and currents are sent through the skin to sweat glands. This current results in blocked sweat glands and reduced underarm sweating. Iontophoresis is a safe, non-invasive treatment and causes only minor discomfort. The biggest drawback is that the iontophoresis process is time consuming, and 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 underarm sweating in around 85% of patients with sweaty underarms. (1) (2)
Endoscopic Sympathectomy Surgery for Excessive Underarm Sweating
Surgical treatment is 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 for more information.
Overall, the surgery has been shown to be effective to stop sweaty underarms, and is safe and effective for the treatment of hyperhidrosis.
Studies on endoscopic thoracic sympathectomy to stop underarm sweating have shown the surgery to be effective in reducing underarm 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, (3) while another study of 233 patients showed satisfactory results in 95% of patients. (4) The main side effects of sympathectomy for underarm sweating include hemothorax (blood in the thoracic cavity, behind the lungs) in 1% to 2%, recurrence of symptoms in around 2% of patients, and compensatory sweating (increased sweating in other areas of the body) in 55% to 67% of patients.
References
Useful Links on Underarm Sweating
