A large amount of the population uses over-the-counter antiperspirants for cosmetic control of underarm sweating and odor. For patients with moderate-to-severe hyperhidrosis, a stronger therapy may be more appropriate. In these cases, there are a few types of hyperhidrosis treatments – topicals, minimally invasive aesthetic treatments and surgery. Each therapeutic route differs by duration of efficacy, side effects, and response rate. The best hyperhidrosis treatment for each patient varies based on individual goals and anatomy.
Topicals For Sweating
According to the International Hyperhidrosis Society, topical treatments for focal hyperhidrosis (excessive sweating) can be done by using astringent agents, topical anticholinergics, local anesthetics (including the topical anticholinergic wipes approved by the FDA in 2018), aluminum and other metallic salt solutions. Unfortunately, prescription products and specially compounded solutions are not always effective. With the exception of aluminum chloride, many of the topical agents reviewed are not available commercially or do not have U.S. FDA approval as a hyperhidrosis treatment option.
Topical treatments are often what patients try first because of the low up-front cost. Topicals subdue the sweat glands, but cannot remove them. This option can get tiresome, as it requires daily upkeep.
Injections For Sweating
Botox injections are an FDA-approved treatment option for excessive underarm sweating. “Off-label” Botox can reduce sweating in other areas, such as the hands, feet, and face. How does it work? When your body temperature rises, your nervous system activates to cool the body down. This causes your sweat glands to produce moisture. Botox injections temporarily paralyze the nerves that are responsible for activating sweat glands.
There is no downtime with Botox injections. Many insurance companies will cover some of the cost. At Aesthetic Solutions, we do not accept insurance but are happy to refer you to an office that does. You will notice improvement starting 48 hours post-treatment, while full results can take up to 2 weeks. This hyperhidrosis treatment lasts anywhere from 3 to 6 months, giving it a high long-term cost.
miraDry For Sweating And Odor
Another minimally invasive option, miraDry uses energy to create heat where underarm sweat and odor glands reside. miraDry targets and safely destroys sweat and odor glands without harming any nearby tissue. The treatment takes about one hour and uses a local numbing agent to relieve any discomfort. Most patients are happy with results from one treatment, but in more severe cases will opt for a second.
miraDry is an attractive hyperhidrosis treatment option to many patients because it permanently eliminates sweat glands under the arms, rather than just subduing their activity. MiraDry is the only treatment option also working to reduce odor! Over time, miraDry is often the most cost-effective option and requires no upkeep like other non-invasive alternatives.
The most common question we get is “how can the body still cool itself?”. Each person has an estimated 2-4 million sweat glands in their body. If eliminated, those glands do not regenerate. About 2% of the body’s sweat glands are found under the arms, which does not hinder the body’s ability to cool itself. There is no compensatory sweating with miraDry, meaning you will not sweat more in other areas post-treatment.
Surgery For Sweating
The excision of axillary tissue and endoscopic thoracic sympathectomy are two invasive, surgical options for hyperhidrosis. The goal of surgery is to interrupt the transmission of nerve signals from sympathetic ganglia that send fibers to the area involved in excessive sweating. This often requires overnight stay at a medical facility. Depending on your insurance plan, there may be some coverage.