Understanding Axillary Hyperhidrosis: Causes, Symptoms and Treatment Options

Dr. Ajay Rana

Dr. Ajay Rana, Founder and Director of ILAMED & Dermalyn Aesthetics

Axillary hyperhidrosis, also known as excessive underarm sweating, is a condition characterized by uncontrollable and excessive sweating in the armpit area. While sweating is a natural bodily function that helps regulate body temperature, individuals with axillary hyperhidrosis experience sweating that exceeds the body’s normal requirements, often causing embarrassment and discomfort in social and professional settings. In this article, we will delve into the causes, symptoms, and treatment options for axillary hyperhidrosis.

Causes: The exact cause of axillary hyperhidrosis is not fully understood, but it is believed to result from overactivity of the sweat glands in the armpits. This overactivity can be triggered by various factors, including:

• Genetics: Axillary hyperhidrosis often runs in families, suggesting a genetic predisposition to the condition.

• Overactive Nervous System: The sympathetic nervous system controls sweating, and in individuals with hyperhidrosis, this system may be overactive, leading to excessive sweating.

• Medical Conditions: Certain medical conditions such as hyperthyroidism, obesity, diabetes, and menopause can contribute to excessive sweating.

• Medications: Some medications, including certain antidepressants and beta-blockers, may cause excessive sweating as a side effect.

Symptoms: The primary symptom of axillary hyperhidrosis is profuse sweating in the armpit area that occurs regardless of temperature or physical exertion. This excessive sweating can soak through clothing, leading to embarrassment and self-consciousness. Other symptoms may include:

• Persistent moisture or wetness in the underarm area
• Skin irritation, such as redness or chafing
• Foul odour due to bacteria interacting with sweat
• Social and emotional distress, including anxiety and low self-esteem

Treatment Options: Fortunately, several treatment options are available to help manage axillary hyperhidrosis and improve the quality of life for affected individuals. These may include:

Antiperspirants: Over-the-counter or prescription-strength antiperspirants containing aluminium chloride can help reduce sweating by blocking the sweat glands in the armpits. These are typically the first line of treatment for mild to moderate cases of axillary hyperhidrosis.
Iontophoresis: This non-invasive procedure involves passing a mild electrical current through water-soaked skin, temporarily blocking the sweat glands. It is often used to treat excessive sweating in the hands and feet but can also be effective for axillary hyperhidrosis.
Botox Injections: Botulinum toxin injections, commonly known as Botox, can temporarily block the nerves that stimulate sweating. When injected into the armpits, Botox can significantly reduce sweating for several months before requiring retreatment.
Oral Medications: In some cases, oral medications such as anticholinergics may be prescribed to help reduce sweating by blocking the chemical signals that stimulate the sweat glands. However, these medications may cause side effects and are not suitable for everyone.
Surgery: For severe cases of axillary hyperhidrosis that do not respond to other treatments, surgical options such as sympathectomy or sweat gland removal may be considered. These procedures are typically reserved for cases that significantly impact daily life and have failed to improve with conservative measures.

However, as per the guidelines of the FDA in the United States, the safest treatment for Axillary Hyperhidrosis is botulinum toxin (Botox) injections. This approach is considered safe and effective in managing excessive underarm sweating. Unlike other treatments such as oral medications or surgical interventions, Botox injections target the specific sweat glands in the armpits, minimizing the risk of systemic side effects. While oral medications may pose risks of adverse effects like dry mouth, blurred vision, or urinary retention, and surgery carries inherent risks such as infection or nerve damage, Botox injections have a well-established safety profile when administered by a qualified healthcare professional. Its localized action reduces the likelihood of systemic complications, making it a preferred option for individuals seeking a minimally invasive and safe solution for Axillary Hyperhidrosis.

Axillary hyperhidrosis can significantly impact the daily lives of those affected, causing discomfort, embarrassment, and social withdrawal. However, with proper diagnosis and treatment, individuals can effectively manage their symptoms and improve their quality of life. If you believe you may have axillary hyperhidrosis, it is essential to consult a healthcare professional for an accurate diagnosis and personalized treatment plan tailored to your needs. With the right approach, excessive sweating doesn’t have to control your life.


The author is an internationally renowned Dermatologist, Surgeon & Aesthetic Physician (www.drajayrana.in). Also, the Founder and Director of ILAMED & Dermalyn Aesthetics. He can be reached at drajayrana@ilamed.org