Excessive Underarm Sweating


It has been a very hot summer in St. Louis which has made me realize just how severe and embarrassing my armpit sweating has been. I had to change blouses several times a day as my sweating stained the armpits of the blouses and in some cases ruined blouses creating a huge expense just buying new clothes. I tried every deodorant and antiperspirant on the market including those for men without any benefit. I see ads on TV that claim there is a treatment for excessive sweating. Is that true?


There are people who have abnormal excessive armpit sweating. The medical diagnosis for this condition is called “axillary hyperhidrosis.” Most patients suffer with this condition for years before seeking medical evaluation. The embarrassment and feeling that nothing can be done to treat the condition causes patients to delay evaluation and treatment options for the excessive sweating. Severe axillary hyperhidrosis is a debilitating disease characterized by markedly excessive sweating which severely limits patients’ abilities to carry on daily activities. There are tests to measure the severity of axillary sweating, however, this is usually confirmed by history and physical examination of clothing.

The psychological impairment includes unwillingness to participate in physical activities and social events. Economic loss includes the destruction of blouses, shirts, sweaters, and other clothing and excessive cleaning bills. I think the TV advertisements have created an awareness that there are a number of treatment options for excessive armpit sweating if over-the-counter preparations are not effective. This requires evaluation by a physician trained in the treatment of this condition.

Dermatologists are the most qualified in this area, however, some other physicians may have expertise treating excessive armpit sweating. There are topical prescription medications, such as drysol solution and other topical preparations. There are also oral medications used to treat excessive armpit sweating, however, they may have unwanted side effects.

With a diagnosis of severe axillary hyperhidrosis and failure to respond to oral and topical treatment, Botox injections are an effective alternative. Botox, botulinium type A, was approved by the US Food and Drug Administration in 2004 for the treatment of severe primary axillary hyperhidrosis that is inadequately managed with topical and oral medication. This treatment is very effective, but needs to be repeated at about six-month intervals. The treatment is not always covered by medical insurance, but can be submitted to the insurance company to determine cost coverage by one’s insurance plan. Obviously, the treatments with Botox are expensive.

Although there are surgical treatments available for excessive armpit sweating, they should be a last resort and clearly have significant expense and possible side effects or complications, along with the fact that the surgery is not always effective. The first step is to seek evaluation and treatment from a dermatologist.

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