Treatment Options for Excessive Underarm Sweating

Treatment options are:

General measures such as daily showering, wearing loose clothes made of natural fibre, frequent change of clothing, etc., and antiperspirants you can buy over the counter. Some more robust aluminium chloride-based antiperspirants help but can sometimes cause irritation. Iontophoresis [electrical stimulation] can be cumbersome.

One very straightforward and effective option is botulinum toxin injections which is a prescription-only medication. A starch iodine test is carried out to accurately map the overactive sweat glands and then injections are made into layers of the skin to block the nerve signals from reaching the sweat glands. Duration of response can be variable but I find most of our patients to be dry for up to one year.

There are other more invasive options such as curettage or removal of sweat glands. Rarely, keyhole surgery removes nerve ganglions from inside the thorax [sympathectomy]. This is a major undertaking and side effects can be more unpleasant than the original condition so I do not recommend this for most people. Recently liposuction laser and vaser devices have been used to destroy the sweat glands under local anaesthesia. This would be a desirable option if long-term results are favourable.