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 24

Underarm Sweating (Hyperhidrosis)

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.

Buffalo Phlebologist
4.8 out of 5 stars 41 reviews

There are many treatments for excessive sweating

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

Underarm sweating and odor are common problems.  

Miradry is a non-invasive procedure that uses microwave technology to destroy the sweat glands.  The treatment typically results in an average of 80-90% immediate reduction in sweating and odor.  

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.

Neurotoxins, such as botox or dysport are also very effective, dramatically reducing sweating for ~ 6-9 months.  However, because of the cost and temporary nature of their effect, I consider MiraDry a better procedure for this indication.

Melissa Chiang, MD, FAAD
Houston Dermatologic Surgeon
5.0 out of 5 stars 12 reviews

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

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
4.7 out of 5 stars 75 reviews

Treatment options for excessive sweating

The first step in managing primary hyperhidrosis is to make sure it is indeed primary. Going by your symptoms, you seem to be having generalised hyperhidrosis, so it is important to rule out a secondary cause like thyroid dysfunction,  which responds very well to treatment.  Again, for generalised sweating, oral medications which suppress sweating may be better options than localised treatments. Some of these meds worth great, but need monitoring to look for/manage side effects, dose adjustments.  For sweating localised to specific areas like the underarms, face, scalp, palms, soles,  botulinum toxin, iontophoresis and microneedling radio frequency treatments are definitely useful.It is best to go with a step ladder plan, and step up /down treatments as per your response to the therapy. At our Hidrosis Clinic, we use the HDSS (Hyperhidrosis Disease Severity Scale) to do this. Good luck!

Renita (Lourdhurajan) Rajan, MD, DNB
India Dermatologist
4.9 out of 5 stars 16 reviews

What Treatment is Right For Your for Excessive Sweating

Some treatments other than miraDry would be prescription medications & antiperspirants, hypnosis, laser therapy, radiotherapy, and surgery. Do your research before paying high dollars for a treatment.

David L. Robbins, MD, FACS
West Des Moines Plastic Surgeon
4.6 out of 5 stars 35 reviews

Treatments for excessive sweating

miraDry is the only non-invasive, FDA cleared treatment to permanently eliminate sweat and odor glands in the underarm area. In as little as one easy treatment, miraDry can leave you feeling clean, confident and carefree forever!
Botox or surgery are other options

#MiradryforSweat #GoodbyeOdor #SweatandOdor

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 109 reviews

Treatments for Excessive Sweating

Topical treatments include over the counter antiperspirant and prescription strength antiperspirant like Drysol.  Drysol can cause chaffing of the skin and sensitivities such as tingling sensations.  

Botox can also be performed for excessive underarm sweating and lasts about 6-8 months.

A permanent solution for underarm sweating is MiraDry, which uses energy to kill the underarm sweat and odor glands.  This is a short minimally invasive procedure performed in our office with local anesthesia.  There is minimal downtime and potential bruising and swelling.  It results in an 80% reduction in underarm sweating with as little as one treatment - very few patients need 2 treatments.  

Shareef Jandali, MD
Fairfield Plastic Surgeon
5.0 out of 5 stars 18 reviews

Excessive sweating treatments

There are several options for treating hyperhidrosis. As mentioned by other physicians, there are topical agents (like Drysol) that can be effective temporarily. I have had a number of patient's with skin reactions to these agents, but they can be very useful.  A more long lasting effect can be created with Botox injections in the underarm. This typically lasts around 6 months and then the area needs to be retreated. A more permanent solution to excessive sweating is the miraDry procedure which uses non-invasive microwave technology to permanently eliminate the sweat glands in the armpit. One miraDry treatment can be very effective, but some patients need a second treatment for optimal result.  

Cynthia Diehl, MD
Durham Plastic Surgeon
5.0 out of 5 stars 9 reviews

Miradry best for armpits, Botox for other areas.

Although miraDry is getting a lot of attention recently, it has actually been around for a while. It has been extensively studied and there is no cancer association. The FDA has cleared it for safe use as well. The microwave energy only penetrates 4-5mm in depth and heats up and destroys the sweat and odor glands. The energy does not reach lymph nodes or deeper structures and it in non-ionizing radiation (the safe kind, like radiowaves). I have had the procedure done myself and it has truly been a gift. One and done for 80% of people! In the long term, much more cost-effective than Botox which has to be repeated every 3-6 months. Let us know if we can help in any way.
Botox can be a good alternative while miradry is being approved for use in those areas. Botox prevents the nerves from telling the sweat glands to produce sweat and odor. Hope that helps!
And we are the busiest miraDry practice in California with great results. Let us know if you can help in any way.

Sheila S. Nazarian, MD
Beverly Hills Plastic Surgeon
4.8 out of 5 stars 56 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.