What Is Axillary Hyperhidrosis?

Excessive underarm sweating is a condition known as axillary hyperhidrosis. In general, hyperhidrosis affects around 3% of Americans.

The excessive sweat occurs when the body doesn't need to be cooled down. The causes for excessive armpit sweating remain unknown. However, the condition is possibly due to a problem with the body's regulation system for sweating.

This type of hyperhidrosis has primary and secondary types, though most cases are of the primary type. Hyperhidrosis is also not preventable, but there are ways to help treat and manage the condition and the bodily areas it affects.

Symptoms

A person with profuse underarm sweating might see or feel a lot of sweat when they're not actively moving around. Their clothes may be soaked under their arms, and their skin may feel wet for long periods of time. A person with axillary hyperhidrosis could also experience frequent skin infections.

Causes

Excessive underarm sweating not caused by another medical condition is referred to as primary axillary hyperhidrosis. It's also possible for people to develop sweaty armpits due to generalized, or secondary, hyperhidrosis. Of note, secondary hyperhidrosis can be focal—meaning that it happens in a specific area—but this type of the condition occurs less commonly.

Though not completely understood, there seems to be a genetic component to primary hyperhidrosis. Still, the exact causes of the condition are unknown.

There is a reason for how hyperhidrosis can happen. Eccrine sweat glands are found in the axillae, palms, soles, or face. These glands respond to sympathetic nerve signals during physical and psychological stress. However, hyperhidrosis causes the sympathetic nervous system to overreact, leading to increased sweat.

Risk Factors for Axillary Hyperhidrosis

Some factors increase the likelihood that someone will have hyperhidrosis, including:

• Family history of excessive sweating
• Medical conditions that result in sweating
• Medicines or foods that lead to hyperhidrosis

Also, primary hyperhidrosis tends to start during childhood.

Diagnosis

A dermatologist will ask questions about a person's symptoms and medical history when diagnosing the condition. In some cases, testing may not be required. In other cases, a dermatologist may give a sweat test using a powder that changes color when the skin becomes wet.

Healthcare providers may suspect hyperhidrosis if a person has excessive sweating without cause for at least six months. They may also consider the condition when two or more of the following criteria are met:

• Bilateral, symmetrical sweating at least once per week
• Excessive sweating onset before 25 years old
• Family history of hyperhidrosis
• Lack of sweating during sleep
  

Treatments

There are a variety of treatments for axillary hyperhidrosis, which are designed to control how much a person sweats and improve their quality of life. A dermatologist can work with you to find the best treatment option.

Antiperspirants

Because antiperspirants are the least invasive and are inexpensive, they are often the first type of treatment healthcare providers will use for treatment.

When antiperspirant is applied, the sweat in that area grabs onto it, pulling antiperspirant particles into the pores under the skin. This causes the sweat ducts to "plug," which tells your brain to stop sending messages to sweat in that area.

Botox

Botox (onabotulinumtoxinA) is approved by the US Food and Drug Administration (FDA) to treat primary axillary hyperhidrosis. These injections can temporarily block the nerves responsible for sweat.

miraDry

MiraDry is an FDA-approved device to treat this kind of hyperhidrosis. It uses microwave technology to destroy sweat glands in the underarm without damaging the skin. While two treatments are sometimes enough, some people may benefit after more sessions.

Oral Medications

Prescription medications taken by mouth can help stop the sweat glands from producing sweat temporarily. Anticholinergics, such as oxybutynin, are oral medications that can be used for hyperhidrosis.

Just be aware that these medications can cause side effects such as dry mouth, muscle cramps, and urinary retention.

Topical Wipes

Qbrexza is FDA approved to treat axillary hyperhidrosis. These cloths are used once per day on the underarm. The active ingredient is an anticholinergic called glycopyrronium tosylate.

Underarm Surgeries

Underarm surgery can also be an option for treating excessive underarm sweating. Common techniques include:

• Excision, which involves cutting out sweat glands
• Curettage, in which sweat glands are scraped out
• Liposuction, involves suctioning out sweat glands
• Laser, in which sweat glands are vaporized

Dermatologists may use different combinations of each surgery. Because these surgeries permanently remove or damage sweat glands, they can have long-lasting effects.

How Preventable Is Axillary Hyperhidrosis?

Because excessive armpit sweating typically falls under primary hyperhidrosis, the condition is not preventable. There is no way to avoid primary hyperhidrosis in general.

Also, secondary hyperhidrosis is often unpreventable. Still, if a person has secondary axillary hyperhidrosis, there may be ways to eliminate symptoms. That may involve actions like switching medications or not consuming food or drinks that lead to excessive sweating.

Complications

When individuals have hyperhidrosis in general, it can lead to the following:

• Disability in school or work situations
• Embarrassment in social situations
• Emotional and psychological distress

Living With Axillary Hyperhidrosis

The prognosis for hyperhidrosis is relatively poor, particularly in more severe cases. This is because it can come with societal, emotional, and psychological complications above.

Although treatment is not always effective, it can still help you manage your symptoms. Antiperspirants can be beneficial when applied before going to bed and when following a dermatologist's guidance on how to use them.

Also, keeping a sweat journal to learn what your sweat triggers can be useful for having a little control over sweating.

A Quick Review

When your underarms sweat excessively, it's a condition known as axillary hyperhidrosis. The exact cause is unknown, and some factors—like family history of the condition—increase how likely it is for a person to have it.

Having the condition can also be embarrassing and distressing, and because it is often the result of primary hyperhidrosis, there's no way to prevent it. Fortunately, there are various treatments you can try, such as antiperspirants and underarm surgery, that can reduce how much you sweat if you have the condition.