Hyperhidrosis: Excessive Sweating

Severe excessive underarm sweating is estimated to affect approximately 8 million in the world and around 4 million in the United States. The condition can be disabling and inhibiting within everyday situations affecting lifestyle and emotional well-being.

How is severe underarm sweating diagnosed?

Severe underarm sweating, or severe primary axillary hyperhidrosis, is a medical condition that involves overactive sweat glands.
Qualitative Test: You may be asked to answer a self-assessment question regarding the extent to which severe underarm sweating affects your daily activities.
Quantitative Test: Starch- iodine test- done in the office.

Treatment Options:

  1. Botox
  2. ThermiDry


BOTOX® is approved by the FDA to treat the symptoms of severe underarm sweating when medicines used on the skin (topical) do not work well enough. BOTOX® neurotoxin is injected into the affected areas to help 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.

How long does a BOTOX® treatment last?

In a clinical study, the median duration of response in BOTOX ® patients was 201 days or 6.7 months. (This means that half the patients had treatment duration of at least 201 days or 6.7 months.) BOTOX ® injections are not a cure—your symptoms will gradually return and you will know when the time is right for another treatment. We will recommend a treatment strategy to ensure that you receive the best possible results with BOTOX ® treatment.

How many units are required?

Depending upon the severity of condition each axilla requires from 50 to 200 units.

Can Botox help?

BOTOX® neurotoxin treatment helps control the symptoms of severe underarm sweating when topical medicines do not work well enough 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® injections are expected to temporarily stop the production of excessive sweat in the treated areas only. Sweat continues to be produced elsewhere.

Where does the sweat go?

Your sweat doesn’t go anywhere or get backed up because the sweat simply is not produced in the areas treated with BOTOX®. Remember, the rest of your body is free to produce moisture normally.

What is treatment with BOTOX® like?

The actual treatment takes about 10 to 15 minutes. A small amount 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. The most common side effects following injection include injection-site pain and bleeding, non-underarm sweating, infection, sore throat, flu, headache, fever, neck or back pain, itching and anxiety. You’ll receive about 15 injections during the session. Bear in mind that BOTOX® treatment is not appropriate for all sufferers.

What happens after treatment?

You should notice a significant reduction in underarm sweating within 4 weeks of your first treatment. Once the treatment becomes effective, you may be able to stop using dress shields and carrying extra changes of clothing and you can probably use a regular deodorant instead of a prescription antiperspirant. There is a possibility that some sweat glands may be missed, and you may continue to experience some sweating from the untreated areas.


Thermidry is an option to treat severe hyperhidrosis which minimally-invasive, only requires one treatment and offers lasting results.


ThermiDry is a procedure, which delivers controlled thermal energy under the skin.

How does THERMIDRY work?

ThermiDry is a micro-invasive procedure. A tiny probe is inserted under the skin; then, radio frequency energy is applied directly to the target tissues. The probe has a radio frequency fiber inside of it, the radio frequency energy to be applied directly at the sweat glands and hair follicles. The heat then destroys the sweat glands in the underarm area.

What are the advantages of THERMIDRY for hyperhidrosis over conventional solutions for excessive underarm sweating?

Other treatment options include topicals, injections of Botox, and traditional surgical options. Many of these options result in recurrence and compensatory sweating. As opposed to traditional surgical methods, ThermiDry is a minimally-invasive, in-office procedure for which only a local anesthetic is required. Only one treatment is needed. Since the sweat glands are destroyed, it is a long-lasting solution.

Approximately how long does the procedure take?

The entire procedure is typically done in an hour.

How does a THERMIDRY treatment for hyperhidrosis feel?

There is little discomfort associated with the ThermiDry treatment for excessive sweating as patients are treated with a local anesthetic to numb the areas that will be treated.

How long before a patient sees results?

Results are noticeable after 2 weeks or so and last for years.

How long do the results of a treatment last?

Since the sweat glands are destroyed, the results are long-lasting. There can be some regrowth or hyperactivity of sweat glands but it usually does not go back to baseline.


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