Excessive or Abnormal Sweating

Excessive or heavy sweating, called hyperhidrosis, is a medical condition that can be devastating. Excessive sweating effects every moment of every day. And all too often, suffering from hyperhidrosis is a silent struggle –  avoiding social situations and trying to disguise the excessive sweating with clothing, powders, and pads.

Do you think you may have hyperhidrosis?

Sweat glands in patients with hyperhidrosis are no different from those in normal patients, nor is there an increase in the number or size of glands. The condition is caused by hyper-function of the sweat glands. Everyone sweats, but not everyone sweats to excess. To see if you fit the profile for hyperhidrosis Use the Self Assessment Tool

Why we sweat:

  • Messages from the brain indicating that the body is too hot
  • Hormones
  • Emotions
  • Physical activity or exercise

In the hyperhidrosis sufferer, sweat glands appear to overreact to stimuli and may also be generally overactive, producing more sweat than is necessary.

Areas of the body typically affected by hyperhidrosis

Hyperhidrosis appears to run in families, but little else is known about its exact causes.

Treatment Options

BOTOX® Treatment

BOTOX® is FDA-approved for severe underarm sweating that is inadequately managed with topical agents. BOTOX® helps control this condition by temporarily blocking the chemical signals from the nerves that stimulate the sweat glands. When the sweat glands don’t receive chemical signals, the severe sweating stops.

BOTOX® treatment is very effective. One clinical study involved 322 patients with severe underarm sweating.

  • 57 out of 104 BOTOX® treated patients (55%) achieved an effective response—compared to only 6 out of 108 treated without BOTOX® (6%).
  • 84 out of 104 BOTOX® treated patients (81%) achieved a greater than 50% reduction in sweating—compared to only 44 out of 108 treated without BOTOX® (41%).

What Is Treatment With BOTOX® Like?
The procedure is relatively straightforward. A small volume of BOTOX® solution is injected into the affected underarm area through a very fine needle. The needle is placed just under the skin, so you may experience some injection-related discomfort. Underarm injections are typically near pain-free.

How long does the BOTOX® last?
With a 201 day duration response,
1 to 2 BOTOX® injections were sufficient for most patients who responded to BOTOX® treatment in the 52-week pivotal clinical study*

“I’d just moved to Miami and was looking for a job as an accountant. I knew I’d have to go on interviews and was terrified of shaking hands with potential employers—hyperhidrosis makes my palms so cold and clammy. After treatment with botulinum toxin, my palms were drier than I’d even hoped for…. Things are looking up. I even landed a job at a large accounting firm.”
—Dan, 27 (Excerpt from Sweathelp.org)

Is Botox covered under insurance?
The BOTOX ADVANTAGE® Program works with a growing number of insurance carriers and healthcare providers to facilitate the reimbursement process. To find out how BOTOX® is covered under your insurance plan, call the BOTOX ADVANTAGE® Reimbursement Hotline, toll-free, at 1-800-530-6680, Monday through Friday, from 8 AM to 8 PM Eastern Time.

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Antiperspirant and Deodorant

Often considered the “first line” of treatment for severe underarm sweating, over-the-counter and prescription antiperspirants work by blocking sweat ducts, thereby reducing the amount of perspiration that reaches the skin. The most widely used ingredients in antiperspirants are metallic salts, including aluminum chloride hexahydrate. Antiperspirants can cause skin irritation, and higher concentrations of aluminum chloride can be destructive to fabrics.

Deodorants help control body odor, which is caused by a reaction between bacteria and sweat. The deodorants work by making the skin more acidic, and hence less attractive to bacteria. They are often used in combination with antiperspirants to help control sweating in addition to odor.


This procedure involves sending a small electrical current to the surface of the affected area while it is submerged in water. In general, treatments must be repeated 3-4 times per week. The procedure can be done at home using a home device. Although this procedure can be used for treating severe underarm sweating, it is usually more useful for controlling sweating in other areas of the body, such as the hands and feet.


A variety of surgical approaches have been used to treat severe sweating, but they are usually reserved for the most severe cases that do not respond to other treatments. One of the most common types of surgery used today for this condition is called endoscopic thoracic sympathectomy (ETS).
With ETS, the patient is put to sleep with general anesthesia and then the surgeon attempts to interrupt the transmission of nerve signals between the spinal column and sweat glands in the affected area. This procedure requires special training, and may result in unwanted increased sweating from other areas of the body—called “compensatory sweating.” Other types of surgery sometimes used for severe underarm sweating include liposuction and removal of the sweat glands under the armpits.

Alternative Therapy

Herbal remedies such as sage tea or sage tablets, chamomile, valerian root, and St. John’s wort, as well as biofeedback, acupuncture, hypnosis, and relaxation techniques, are sometimes suggested as treatments for excessive sweating. However, there is little research at this time to indicate the effectiveness of such treatments.

Every Day Tips

While only a doctor can prescribe or perform certain hyperhidrosis treatments, there are things you can do to help make excessive sweating less of a burden on your everyday life:

  • Bathe daily to keep the amount of bacteria on your skin in check.
  • Dry yourself thoroughly after you bathe. Bacteria and fungi (which can cause body odor and infections on irritated skin) thrive in damp spaces, like between your toes. If you have sweaty feet, use foot powders to help absorb sweat.
  • Apply antiperspirant products in the evening. Antiperspirants may be used on hands and feet as well as on underarms. Gently massaging them into the skin may be useful. If you’re using a prescription or high-potency antiperspirant, follow your doctor’s instructions carefully and remember that these products may damage clothing and linens. To limit this damage, wear old pajamas if the antiperspirant is applied at night, before bedtime.
  • Choose air-permeable clothing. Wear natural fabrics, such as cotton, wool, and silk, which allow your skin to breathe. When you exercise, you might prefer high-tech fabrics that wick moisture away from your skin.
  • “Dress shields,” small pads that go in your armpits to absorb sweat, may be an option for you. You may also want to keep an extra shirt with you for emergencies.
  • Launder your clothes and/or change your shoes and clothing often.
  • If you have trouble with sweaty feet, rotate your shoes. Your shoes may not dry out overnight, so try not to wear the same pair two days in a row.
  • Wear the right socks. Moisture-wicking athletic socks are a good choice. These may be made of merino wool (which doesn’t itch) or a synthetic blend sometimes called “polypro.”
  • Change your socks often. Change socks or pantyhose once or twice a
    day, drying your feet thoroughly each time. Women should try pantyhose with cotton soles.
  • Air your feet. Go barefoot when you can, or at least slip out of your shoes now and then.
  • Avoid hot beverages (such as coffee), alcohol, and spices, which can make you sweat.
  • Try relaxation techniques such as yoga, meditation, or biofeedback. These can help you learn to control the stress that can trigger perspiration.
  • Change your diet. Make note of any foods or beverages that cause you to sweat more than usual. Consider eliminating caffeinated drinks (like coffee and cola) from your diet as well as alcohol, certain “hot” spices, and foods with strong odors, such as garlic and onions.
  • Join a support group or online discussion board for moral support and to learn more about new treatments.


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