Treatment Options for Excessive Underarm Sweating

Dr Sanjay Gheyi
By Dr Sanjay Gheyi

Dr Gheyi has triple board certifications in General Surgery, Family Medicine and Anti-ageing Medicine. He devotes full time to his Aesthetic and Anti-ageing practice.

Excessive underarm sweating is common but often not recognized or treated. Medical definitions have looked at quantifying the amount of sweat produced but for all practical purposes, any sweating that interferes with normal living is considered hyperhidrosis.

Sweat is your body's temperature regulator. Severe underarm sweating is usually due to overactive sweat glands.

In severe primary axillary hyperhidrosis, sweating significantly exceeds the body's normal requirements for cooling. Sometimes excessive sweating is due to other medical causes.

As with any medical condition, a diagnosis must first be made to exclude and treat any underlying cause. Diagnosis is usually made on the clinical picture but sometimes further testing is necessary.


Treatment options are:

General measures such as daily showering, wearing loose clothes made of natural fibre, frequent change of clothing, etc., and antiperspirants you can buy over the counter. Some more robust aluminium chloride-based antiperspirants help but can sometimes cause irritation. Iontophoresis [electrical stimulation] can be cumbersome.

One very straightforward and effective option is botulinum toxin injections which is a prescription-only medication. A starch iodine test is carried out to accurately map the overactive sweat glands and then injections are made into layers of the skin to block the nerve signals from reaching the sweat glands. Duration of response can be variable but I find most of our patients to be dry for up to one year.

There are other more invasive options such as curettage or removal of sweat glands. Rarely, keyhole surgery removes nerve ganglions from inside the thorax [sympathectomy]. This is a major undertaking and side effects can be more unpleasant than the original condition so I do not recommend this for most people. Recently liposuction laser and vaser devices have been used to destroy the sweat glands under local anaesthesia. This would be a desirable option if long-term results are favourable.

If you want to read more, the experts at Consulting Room really know what they're talking about and have put together hyperhidrosis, botox liposuction and vaser lipo FAQs just for you. 

If you have more questions, you can use the hyperhidrosis, liposuction and vaser lipo questions feature to talk to our panel of trained medical experts. 

If you're keen to get started with any of these treatments right away then you're in luck - those clever folks also have a list of trusted, accredited hyperhidrosis, liposuction and vaser lipo clinics in your area.

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