Sweating is a natural and necessary physiological response, which controls body temperature, regulates fluid and salt levels in the body and unclogs pores. However heavy sweating over the under arm region is a common and embarrassing concern in men and women in all age groups.
Excessive sweating over the under arm region is medically known as ‘Axillary Hyperhidrosis’. A small fraction of patients suffering from hyperhidrosis may have an underlying medical cause (such as Hyperthyroidism, menopause, heart disease or anxiety disorders) (Secondary Hyperhidrosis) which requires evaluation and treatment. However, most patients who sweat heavily are healthy individuals with no underlying medical cause (Primary Hyperhidrosis). Such sweating is excessive and occurs unpredictably and even in the absence of any triggers.
The fear of unsightly sweat stains on one’s clothes and commonly associated body odor, can lower an individual’s confidence in social situations, whether in a corporate boardroom or at a party. This fear is further aggravated by increased sweating in hot, humid weather and in stressful situations, such as a job interview, examination or a date. However, patients of hyperhidrosis may see such excessive sweating when relaxed or at rest, even in cold weather.
Celebrities are not exempt from the fear of sweat stains. Excessive sweating often happens in active and otherwise healthy persons. However this can be a significant cause of embarrassment and loss of confidence in social situations. Treatment of hyperhidrosis is now possible with several options, including antiperspirants and injection of Botox into the armpits.
Treatment Options for Axillary Hyperhidrosis
Antiperspirants:
Products containing salts such as Aluminium Chloride Hexahydrate may be prescribed for application over the underarms at bedtime. These antiperspirants work by blocking the sweat glands and shrinking their pores, thereby reducing sweat production. The aluminium salts react with the salts in sweat to form a plug, which blocks the sweat glands. In some patients, antiperspirants may cause skin irritation and discoloration of clothes. Traditionally alum crystals (such as shaving alum) have been safely used for this purpose. These products can be used in conjunction with deodorants, which have an impact on the odour, but not production of sweat.
Botox for Hyperhidrosis:
Botox is a purified bacterial protein (Botulinum toxin type A) which is used in extremely small doses to cause blockage of the nerve pathway that leads to sweating in the skin. Botox injections are also commonly used for the treatment of medical concerns such migraine and cervical dystonia and for the reduction of dynamic lines and wrinkles over the face and neck.
The doctor may paint the armpits with iodine solution. When starch powder is sprinkled on this, the areas producing excessive sweat are highlighted blue. This procedure, called the Starch-Iodine Test, helps to demarcate the treatment areas prior to injection of Botulinum toxin.
The procedure takes no more than 15-30 minutes and feels like an ant bite in the under arms. Rarely patients may feel some heaviness in the arms for a few days after treatment, which is temporary and reversible. Botox injections are US FDA approved, safe, comfortable and effective, with results lasting up to 6 months.
Other treatment options:
Some patients with primary hyperhidrosis may be prescribed oral anti-cholinergic drugs to reduce sweat production. However, these may cause some dizziness and dryness of the mouth. In rare and severe cases not responding to the above treatments, doctors may recommend the surgical removal of the nerves supplying local sweat glands through a minimally invasive technique. This procedure is known as Endoscopic Thoracic Sympathectomy or ETS.
Excessive sweating is a common and embarrassing concern. Safe and effective treatment options are now available to address this concern. Please contact your doctor for details.
