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 27

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

Neurotoxin, miradry, axillary shaving for underarm sweating

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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.

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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. 

Cheers

Dr Davin Lim 
Laser and aesthetic Dermatologist
Brisbane and Gold Coast

Excessive Sweating calls for miraDry

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You sound like the perfect miraDry candidate.  Sweating is normal, and though there are only 2% of your sweat glands under your arms, this region is often a problem spot because the fold of the underarm means that sweat is coming from more than one direction, with nowhere to go but to drip down your body.  Additionally the smelly glands of the underarm are not as present elsewhere on the body.  MiraDry is the perfect treatment for the underarm, as it eliminates both of these problems while allowing you to sweat normally throughout the rest of your body.   It's safe, and in fact prevents you from needing chemical treatments (antiperspirants and deodorants) to control sweat and smell here!

Best wishes, 

Dr. L

Miradry

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miradry will eliminate all sweat from your underarms from the first day your treated. I would recommend it

Excessive underarm sweating

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Controlling underarm hyperhydrosis has a variety of approaches especially for the underarm area.  Typically these approaches are used when conservative measures are utilized first:

  • Botox- The standard for hyperhidrosis with local side effects only.  May require a larger dose for the scalp.
  • Oral medications- Typically involve anticholinergic medications such as glycopyrrolate and are not well tolerated due to systemic side effects.
  • Topical medications- Drysol is often a first line treatment but may not be effective for all patients.
  • Surgery- May be last resort for some patients but hyperhidrosis treatments tend to be moving away from this
  • LASERS/Miradry/ Radiofrequency- Very effective and for some patients can approach a permanent solution.  In my office, we combine radio frequency needling (fractora) with laser hair removal as a semi-permanent to permanent solution.  

Anil R. Shah, MD
Chicago Facial Plastic Surgeon
4.8 out of 5 stars 181 reviews

Treatment options for excessive sweating

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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!

What Treatment is Right For Your for Excessive Sweating

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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

Treatments for excessive sweating

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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
4.9 out of 5 stars 116 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.