What Is Severe Underarm Sweating?

Severe underarm sweating is a medical condition known as severe primary axillary hyperhidrosis, which involves overactive sweat glands. Sweat is your body's temperature regulator. In severe primary axillary hyperhidrosis, sweating significantly exceeds the body's normal requirements for cooling.

How Is the Condition Diagnosed?

Only a medical professional can diagnose severe underarm sweating (severe primary axillary hyperhidrosis) that is not being effectively managed with topical agents. Be prepared to tell your dermatologist about your medical history, family history, and when you first noticed your severe underarm sweating. You may be asked to answer a self-assessment question regarding the extent to which severe underarm sweating affects your daily activities. This is known as the Hyperhidrosis Disease Severity Scale (HDSS). (See Self-Assessment to try this on your own.) Once a diagnosis has been made, your doctor will discuss the appropriate treatment options with you.

Self-Assessment

To help you understand the impact underarm sweating is having on your daily activities, answer the following question. You may find it helpful to print out this self-assessment and bring it with you to your dermatologist for discussion.

My underarm sweating is:

1. Never noticeable and never interferes with my daily activities
2. Tolerable but sometimes interferes with my daily activities
3. Barely tolerable and frequently interferes with my daily activities
4. Intolerable and always interferes with my daily activities

Treatment Options

A number of different treatments and products are available to help people with severe underarm sweating. Here's an overview of some you may have heard about or considered trying. If you have any questions about which treatment option may be right for you, speak with your physician.

Antiperspirants/Deodorants

Often considered the "first line" of treatment for severe underarm sweating, over-the-counter and prescription antiperspirants work by blocking sweat ducts, thereby reducing the amount of perspiration that reaches the skin. The most widely used ingredients in antiperspirants are metallic salts, including aluminum chloride hexahydrate. Antiperspirants can cause skin irritation, and higher concentrations of aluminum chloride can be destructive to fabrics.

Deodorants help control body odor, which is caused by a reaction between bacteria and sweat. The deodorants work by making the skin more acidic, and hence less attractive to bacteria. They are often used in combination with antiperspirants to help control sweating in addition to odor.

BOTOX Treatment

BOTOX is FDA-approved for severe underarm sweating that is inadequately managed with topical agents. BOTOX helps control this condition by temporarily blocking the chemical signals from the nerves that stimulate the sweat glands. When the sweat glands don't receive chemical signals, the severe sweating stops.

Iontophoresis

This procedure involves sending a small electrical current to the surface of the affected area while it is submerged in water. In general, treatments must be repeated 3-4 times per week. The procedure can be done at home using a home device. Although this procedure can be used for treating severe underarm sweating, it is usually more useful for controlling sweating in other areas of the body, such as the hands and feet.

Surgery

A variety of surgical approaches have been used to treat severe sweating, but they are usually reserved for the most severe cases that do not respond to other treatments. One of the most common types of surgery used today for this condition is called endoscopic thoracic sympathectomy (ETS). With ETS, the patient is put to sleep with general anesthesia and then the surgeon attempts to interrupt the transmission of nerve signals between the spinal column and sweat glands in the affected area. This procedure requires special training, and may result in unwanted increased sweating from other areas of the body—called "compensatory sweating." Other types of surgery sometimes used for severe underarm sweating include liposuction and removal of the sweat glands under the armpits.

Alternative therapy

Herbal remedies such as sage tea or sage tablets, chamomile, valerian root, and St. John's wort, as well as biofeedback, acupuncture, hypnosis, and relaxation techniques, are sometimes suggested as treatments for excessive sweating. However, there is little research at this time to indicate the effectiveness of such treatments.