Don’t Let ‘Em See You Sweat: Noninvasive Treatments for Excessive Sweating

Desert woman thirsty dehydrated in Death Valley

As the hazy, hot, and humid summer months are right around the corner, we can all expect to sweat a bit more. But for some people, excessive underarm sweat is not a seasonal nuisance, but a constant problem that affects all aspects of daily living. Hyperhidrosis, or excessive sweating, is a benign disorder in that it poses no danger to a person’s health; however it can have major implications on quality of life and social well-being. According to some experts, it affects up to 3% of the population, with women being more affected than men. It is likely under-reported as most people affected by excessive sweating do not seek medical advice for their condition.

People with excessive underarm sweating often try a variety of treatment methods for relief. The most basic form of treatment is antiperspirants which come in both over-the-counter and prescription strength. They work by blocking the openings that lead to the sweat glands, preventing sweat from reaching the surface. Their active ingredients are metallic salts, most commonly aluminum compounds such as aluminum chloride hexahydrate, which is popular in prescription antiperspirants. If antiperspirants are unable to control sweat levels, a treatment called iontophoresis may be the next step. Although more popular for hand and/or foot sweating than underarm sweating, iotophoresis is a simple procedure that can be performed either 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 is best performed frequently for the most reliable results.

An alternative, non-invasive treatment for axillary hyperhidrosis that requires fewer treatments than iontophoresis is a session of botulinum toxin injections, or Botox. It is FDA-approved for the treatment of excessive underarm sweating. Botox works by blocking the nerve endings that signal the sweat glands to produce sweat. It effectively reduces sweat ranging 3 to 16 months. Follow-up injections are needed as the effect wears off and sweat production returns to previous levels.

In 2012, an FDA-cleared treatment called miraDry was introduced to deliver long-term relief of excessive underarm sweat without surgery. The procedure (recently seen on the Dr. Oz show) uses electromagnetic energy to destroy many of the 22,000 to 30,000 sweat glands in the underarm area. Research shows the miraDry procedure can reduce sweat by over 80% and has immediate, long-lasting results in the majority of treated patients. Most people can return to normal activities quickly after the procedure, although redness, swelling and soreness after the procedure are expected. Other (potential) benefits may include long-term hair reduction in the underarm area and odor reduction, however the results of that exciting research is ongoing.