Excessive sweating is a common experience when the weather is hot and humid or when we’re nervous before a big presentation or performance. But for some, excessive underarm sweat is a constant problem that affects all aspects of daily life. Hyperhidrosis, or excessive sweating, is a benign disorder in that it poses no danger to a person’s health. However, it can have huge implications on a person’s quality of life and social well-being. According to some experts, 3% of the population deal with sweating that bothers them on a daily basis, with women affected more often than men. This is probably an underestimate since those affected may not seek medical advice for their condition.
The majority of hyperhidrosis patients report that the condition has a direct effect on their emotional state. In one survey, up to 50% of people with excessive sweating reported feeling less confident as a result of their excessive sweat. Frustration during daily activities, depression and embarrassment are commonly reported by individuals with hyperhidrosis.
There are a variety of treatment options for relief. The most basic form of treatment is an antiperspirant, which comes in both over the counter and prescription strengths. Antiperspirants block the ducts that lead from the sweat glands to the skin to prevent sweat from reaching the surface. Their active ingredients are metallic salts, most commonly aluminum compounds such as aluminum chloride hexahydrate found in many prescription antiperspirants. If antiperspirants don’t control sweat levels, a treatment called iontophoresis may be the next step. Although more popular for hand or foot sweating than underarm sweating, iontophoresis is a simple procedure that can be performed in a doctor’s office or at home with varying degrees of success. Although the exact way iontophoresis helps to reduce excessive sweating is unclear, it can help temporarily reduce sweating with little risk of side effects. It should be performed frequently for the best results.
An alternative, noninvasive treatment for axillary hyperhidrosis that requires fewer treatments than iontophoresis are botulinum toxin (Botox) injections. It is FDA-approved for the treatment of hyperhidrosis and works by blocking the nerve endings that signal the sweat glands to produce sweat. It effectively reduces sweat for anywhere from three to 16 months. Follow-up injections are needed as the effect wears off and sweat production returns to levels seen before treatment.
In 2012, an FDA-cleared, non-surgical treatment called MiraDry was introduced to deliver long-term relief of excessive underarm sweat. The procedure uses electromagnetic energy to heat and destroy many of the 22,000 to 30,000 sweat glands in the underarm area. Research shows the MiraDry procedure can reduce sweat up to 80% and has immediate, long-lasting results in the majority of treated patients after a series of treatments. Most people can return to normal activities quickly after the procedure, although redness, swelling and soreness several days after the treatment are expected. Although more uncomfortable than any of the other treatments for excessive sweating, the results from the MiraDry can be life-changing. It gives a whole new twist on the phrase “Never let ‘em see you sweat.”