Sweat is a natural body function. It is only ever a problem once it starts to have a negative impact on your daily activities. If this is the case for you, you may want to look into a medical condition called hyperhidrosis.
Sweat is a solution of water and salts produced by glands immediately under the skin and cools the body by evaporation during exercise and in warm surroundings. The activity of these glands is normally controlled by the nervous system. In a small number of people (less than 1.0% of the population), this control mechanism fails to function normally causing excessive sweating, even when body temperature is normal. This condition is known as hyperhidrosis.
Occasionally, hyperhidrosis occurs as a result of abnormal hormone levels and these will be measured as part of the assessment of people with this condition. In most cases, no reason for the excessive sweating treatment will be identified by these tests.
Excess sweating may occur anywhere but usually affects the hands, armpits, scalp, face, and/or feet. Although some people may find this excess sweating embarrassing, it is not a dangerous or life-threatening condition.
It is diagnosed when you have a common occurrence of excessive sweat in specific areas of your body. This usually happens in the hands, feet, face, and armpits. When it happens on your underarms, it is specifically referred to as axillary hyperhidrosis.
What is axillary hyperhidrosis?
Axillary hyperhidrosis is characterized by an increased amount of sweat production, localized to the armpits, to compensate for environmental conditions, and to control thermoregulation. It affects about 3.12% of the US population.
Needless to say, it has a significant effect on one’s psychological and physical health, as well as one’s occupational life.
Axillary hyperhidrosis in particular can be personally distressing and interfere socially and professionally.
Many treatments have been offered, including topical, medical, and surgical, but they have had limited success and none has been without potential complications.
Recently, botulinum toxin A (Anti Wrinkle Injection) has been proven to provide treatment for axillary and palmar hyperhidrosis.
What causes axillary hyperhidrosis?
People with hyperhidrosis have overactive nerves that trigger the major sweat glands, producing excessive and unnecessary armpit sweat. While sweating can be a side effect of medications or medical conditions, primary axillary hyperhidrosis is a medical condition itself.
Research shows that the condition can be genetic, so if a family member has hyperhidrosis, you’re more likely to inherit it.
This type of excessive underarm sweating tends to begin during puberty (around age 13 or 14), but symptoms can appear up to age 25. Strangely, those with primary axillary hyperhidrosis don’t experience the symptoms while sleeping.
Treatment for axillary hyperhidrosis
When left untreated, excessive armpit sweating will only continue throughout life. There are many conservative treatments that can and should be attempted, including prescription antiperspirants, medications, Anti Wrinkle Injection injections, and psychotherapy.
- ETS Surgery. For those who find the botulinum toxin treatment ineffective, surgery may sometimes be of benefit. While this procedure is very effective in treating hand (or palmer) hyperhidrosis, it is not as successful for axillary sweating because more nerves must be divided to make the axillary skin dry which increases the risk of compensatory hyperhidrosis. ETS is an abbreviation for endoscopic thoracic sympathectomy, which utilizes state-of-the-art surgical equipment to effectively reduce the amount of sweat a person produces from the targeted area. During the procedure, the nerves that supply the sweat glands in the hands and axilla (armpit) are permanently divided within the chest cavity. This procedure is performed as a Day case.
The nerves are divided using a keyhole surgery technique under general anaesthesia. Two or three small incisions (5-10mm) are made in the skin under each arm. In order to see the nerves, the lung is collapsed. The nerves are divided and then sealed using cautery to prevent them regrowing.
- Axillary Suction Curettage. The sweat glands are removed with a curette through this surgery, through very small incisions. Then, the glands are removed through liposuction. This is especially effective to reduce underarm sweat.
- Antiperspirants. The most effective antiperspirant is Aluminum Chloride – typically Anhydrol Forte(TM) – which may be prescribed for you. This is applied in the evening 2-3 times per week and washed off the following morning. In some cases, it causes skin irritation. The treatment must be repeated regularly for life. This agent cannot be used on the face or scalp.
- Botulinum toxin (Anti Wrinkle Injection) injection. This treatment is suitable for people who find the topical antiperspirants ineffective or develop skin problems. This procedure is performed using local anaesthesia in the day ward or outpatient department. The evening before your procedure you should carefully shave your underarm area. Do not apply antiperspirants or deodorants.
Is Anti Wrinkle Injection effective for axillary hyperhidrosis?
These injections may cause minimal discomfort. The botulinum toxin binds to the nerve endings and prevents their effects on the sweat glands.
The injections may take several days to work. During this time you should not shave but may use antiperspirants or deodorants. The nerve endings begin to regrow six to nine months after the injections and you may notice recurrence of the sweating.
While downright embarrassing and bothersome, the good thing about having axillary hyperhidrosis is that there are now a lot of available treatment options you can choose from. The efficacy of each treatment will still depend on your unique case.
This is why at Skin Club, we highly recommend having an initial consultation with our clients. This allows us to know more about your condition and what may have caused it. This way, we can align our treatments to your individual needs and goals.