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What Treatments Are Available for Excessive Sweating?

I am a heavy sweater and it is very embarrassing to me, mainly during exercise. It is to the point of where it gains negative attention. I like the fact that I do sweat and some wish they could but it is too much and I also have a stronger underarm odor so I'm very particular about bathing. It was not unnormal for me to take 3-4 showers a day. What procedure can be taken for excessive sweating?

Doctor Answers (17)

Underarm Sweating (Hyperhidrosis)

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It is normal to sweat when we exercise. It is not normal to sweat when we are sitting in an air conditioned office and we experience excessive sweating from the underarms, palms, feet or any combination of the above.

The question you asked about sweating is very generic - but I will address primary hyperhidrosis alone as it is the type of hyperhidrosis that is treatable. Secondary hyperhidrosis is due to an underlying medical problem and when that medical problem is treated, it is possible that the hyperhidrosis may be lessened. What differentiates secondary hyperhidrosis from primary hyperhidrosis is that secondary hyperhidrosis is sweating which occurs throughout the body whereas primary hyperhidrosis is located in distinct parts of the body - head, underarms, palms, groin, feet, or any combination of these areas.

For your problem with excessive sweating you should first try topical agents containing aluminum chloride, such as Drysol or Clinical Secret. If these don't work, or if they cause skin irritation, then you should try Botox injections which can ameliorate sweating in the underarms for about 4 months.

Finally, you can have suction curettage by an experienced hyperhidrosis specialist or endoscopic thoracic sympathectomy (ETS). The latter is more than 97% successful in eliminating sweating from the underarms in carefully selected patients. However, ETS is no longer the preferred treatment for underarm sweating. miraDry is the preferred treatment for underarm hyperhidrosis. The second preferred technique for underarm hyperhidrosis is Botox injections.

ETS should only be performed by board certified thoracic surgeons (American Board of Thoracic Surgery) as it is a procedure requring experience in minimally invasive chest surgery.

There are many treatments for excessive sweating

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including topical solutions such as drysol, pills such as Robinul, and treatments such as Botox/Dysport which are temporary.  THere is now a new long lasting treatment for underarm sweating, the MiraDry procedure.  It uses microwave technology to eliminate sweat glands in the underams.  Typically two treatments are done 3 months apart.  Dermatologists are the experts in excessive sweating and can let you know what choices may be available for you.

Carolyn Jacob, MD
Chicago Dermatologic Surgeon
5.0 out of 5 stars 5 reviews

Neurotoxin, miradry, axillary shaving for underarm sweating

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Underarm sweating and odor are common problems.  Neurotoxins, such as botox or dysport are very effective at dramatically reducing sweating for ~ 6-9 months.  Miradry is a relatively newer non-invasive procedure that uses microwave technology to destroy the sweat glands.  The first treatment typically results in an immediate reduction in sweating and the second treatment builds upon the first treatment.  On average, patients note a > 80% reduction in sweating.  A small percentage of patients don't respond to miradry - these people may do better with a procedure called axillary shaving, which surgically disrupts sweat glands.  We offer all of these procedures in our office.

Are you after a permanent or temporary solution? Botox vs miraDry

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OK- lots of treatments available, Im sure you have tried aluminium hexahydrate or Driclor - this is the cheapest, most convenient method to treat mild to moderate sweating. 

Seems like you fall into the 'tried everything'/severe sweating patient. 

You now have 3 options, and I will rank them in order of merit based upon YOUR question. 

1. miraDry- 2 treatments, 3 months apart. 95% success rate including decreasing odour- permanent solution

2. BOTOX injections- 95% success, repeated every 4-6 months. May or may not help odour. 

3. ETS - surgery (not localised excision but ablation of part of you spinal nerve plexus)- Last resort. Permanent, but high chance of rebound sweating. 

I hope this answers your question. 


Dr Davin Lim 
Laser and aesthetic Dermatologist
Brisbane and Gold Coast

Davin Lim, MBBS, FACD
Brisbane Dermatologist
5.0 out of 5 stars 2 reviews

Options for Excess Underarm Sweating

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miraDry is a clinically proven and safe FDA-approved solution for significantly reducing underarm sweat. It’s an outpatient procedure performed in your physician’s office. It is not surgery so doesn’t involve surgical incisions. miraDry delivers controlled electromagnetic energy to the arm pit, eliminating the underarm sweat (eccrine) glands. It does not penetrate enough to cause significant fat reduction and if anything might tighten, not loosen skin.Two procedures are typically recommended. Each occurs approximately three months apart for best results.

Other options include: antiperspirants, Botox or Dysport with off label usage toxins temporarily prevents the sweat glands from working for varying lengths of time. This requires repeat treatments to maintain results. Other options involve superficial liposuction or excision of sweat gland skin poses additional risks and leave scars.

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 59 reviews

Miradry and Botox for Underarm Sweating and Odor

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There are two main treatments I recommend, Botox for a temporary relief and MiraDry for a long term permanent solution.

Dr. Grant Stevens Marina Plastic Surgery Associates Marina del Rey, CA The Institute

Grant Stevens, MD
Los Angeles Plastic Surgeon
4.5 out of 5 stars 76 reviews

Don't Sweat The Petty Things, And Don't Pet The Sweaty Things....

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There are multiple treatments for axillary hyperhydrosis. Nonsurgical treatments include  prescription antiperspirants that patients apply to the skin of the axilla on a daily basis. Patients can also be prescribed robinul (glycopyrrolate), which is an oral medication, originally developed to treat the symptoms of peptic ulcers by reducing the secretions of the stomach.  It was discovered that it had an ancillary benefit of decreasing the secretions of perspiration. Unfortunately, it also has a number of side effects, including headache, blurred vision, nervousness, nausea, bloating, heartburn and constipation. Botox can have efficacy in treating axillary hyperhydrosis, however it often does not completely control the problem, and it's effects are limited to between 3 to 6 months at a time.  

Surgical treatments  of axillary hyperhydrosis include liposuction with sharp cannulae that can cause damage to some of the axillary sweat glands through mechanical trauma and subsequent scarring. SmartLipo of the axilla can cause damage to the sweat glands by heating them with the laser.  Endoscopic thoracic sympathectomy can disrupt the sympathetic nerve chain that controls the activity of the axillary sweat glands. 

However, only the miraDry system offers a noninvasive treatment of axillary hyperhidrosis that has greater than 90% clinical efficacy (82% average sweat reduction in patients) and stability (i.e., lasts for a minimum of 2 years) with minimal pain and discomfort, and virtually no downtime after the procedure. 

Peter Lee, MD, FACS
Los Angeles Plastic Surgeon
4.5 out of 5 stars 19 reviews

Treatment options for bromhidrosis (excessive sweating)

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Besides Botox, other treatment options available for excessive armpit sweating include topical solutions, oral medications, laser, iontophoresis, curettage and surgery.  Botox injections for excessive underarm sweating have to be repeated after 4-6 months as the results are not permanent.  MiraDry is the only device on the market that is able to eliminate both eccrine (normal sweat) apocrine ("smelly" swat) glands.  MiraDry is also the only FDA-approved procedure that offers long lasting results.  Studies demonstrate that miraDry results last up to 2 years and are likely permanent as sweat glands do not regenerate.

Joshua L. Fox, MD
Long Island Dermatologic Surgeon
5.0 out of 5 stars 12 reviews

Treatment Options for Sweating

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There are many treatment options for sweaty armpits.

Topical treatments such as deodorants, Drysol, etc.

Botox & Dysport:  highly effective but requires repeat treatments 4-6 months apart

MiraDry:  uses microwaves to destroy the sweat glands - a more permanent approact

Axillary shaving:  A small incision is made in the armpit and the sweat glands are physically removed from the undersurface of the skin.  Highly effective.

Prescription strength antiperspirants, botox injections, miradry, I dont recommend surgery

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Thanks to the many advances in the field of dermatology, the options have really grown in the past few years.  Aluminum based antiperspirants are at the first option.  These have to be applied at least three times a week at a minimum.  Botulinum toxin injections (botox, dysport, xeomin) are another FDA approved option.  In the armpits the results last 6-9 months.  This procedure has a high patient satisfaction rate.  Miradry is the latest FDA approved procedure that treats excessive sweating on a long term basis.  This procedure is highly effective, with extremely high patient satisfaction rates with potentially permanent results.  Two sessions are done three months apart and the results can be as impressive as 90% reduction in sweating with two treatment sessions.

Cameron Rokhsar, MD
New York Dermatologic Surgeon
4.5 out of 5 stars 32 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.