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Botox for Axillary Hyperhidrosis
Written by Katie Crissman
October 01 2020

Axillary hyperhidrosis is characterized by excessive sweating in the armpit region and is often associated with primary focal hyperhidrosis which can also affect the hands, feet and face. Sweating in the axillary region is often also associated with a pervasive bad odor, which comes about because of a separate condition called bromhidrosis that causes sweat to stink.[1] Axillary hyperhidrosis can cause anxiety and can be particularly detrimental socially and psychologically. This is because of the potential smell associated, and because of the propensity of sufferers to sweat through multiple layers of clothing.[2] There are certain types of clothing that work best for people with excessive sweating, so wearing specific types of clothing, like light weight cotton, can help some people stay more comfortable. For most people, the onset of the disease begins during their teenage years and both men and women are affected equally. A difference between axillary sweat and sweat produced by other areas of the body impacted by hyperhidrosis are the type of sweat cells present. Eccrine cells (sweat cells) are present all over the body, but the axillary region also contains apocrine cells. Aprocrine cells produce a secretion that is thicker and more prone to smell due to bacteria breakdown that is present. Both types of sweat glands are overactive in people with primary focal hyperhidrosis.[1]

One of the most effective current treatments for axillary hyperhidrosis is the use of botox injections to reduce sweating. This type of therapy requires hyperhidrosis to be managed by a doctor. Botox injections have been approved by the FDA for the treatment of axillary hyperhidrosis since 2004.[1] Botox is also used for treatment of palmar and plantar hyperhidrosis, but is most effectatious in cases of axillary hyperhidrosis.

What is Botox and How it Works

Botulinum toxin is a type of neurotoxin made by the bacteria Clostridium botulinum and can cause paralysis in humans. Doctors use this toxin to treat a wide range of medical conditions from wrinkles to headaches, and in recent years it has been found to be especially effective in the treatment of axillary hyperhidrosis. When injected, the botulinum toxin binds to a specific site within a sweat cell and blocks the release of acetylcholine, which is what tells eccrine cells to produce sweat, and therefore prevents the secretion of sweat.[1]

There are multiple types of botulinum used to treat hyperhidrosis. Most commonly, botulinum toxin type A and botulinum toxin type B are utilized. The FDA specifically approved the use of type A for the treatment of axillary hyperhidrosis and there are a plethora of brands and formulations available. The type of botox that is used depends on the doctor performing the procedure.[1]

How It Works

Prior to administering botox injections doctors will usually test the area to see where the injections should be placed. This is done by performing a Minor iodine-starch test in which they apply an iodine solution to the armpit. When sweat accumulates it causes the skin to stain a dark color which contrasts with the color of the iodine solution. This allows the doctor to visualize where the injections should be placed. Photographs are often taken for future reference. After the test is done a doctor will then mark the area where the injections will go with a marker pen. A topical anesthetic, to prevent pain, is usually applied at this point. It usually takes between 10 and 20 intradermal injections in each armpit to achieve proper results. The effects usually occur between 2 and 4 days after the injections take place. There are a few other techniques used to inject Botox although the method described above is the most common. One such technique involves a round plate that allows multiple injections to be given at once, it has been found to be effective but is less practical as it requires a more specialized tool.[1]

Adverse Effects

There are typically few side effects from this type of procedure, and those experienced are mild. The most common side effect is pain at the injection site. Patients can also experience bruising, flu-like symptoms, dry eyes, indigestion and local bleeding.[3]

Efficacy of Treating Axillary Hyperhidrosis with Botox Injections

Several studies have found that Botox is a very effective treatment option for axillary hyperhidrosis. The results of each treatment typically last between six and nine months so the procedure needs to be repeated every so often. It has been documented that patients receiving Botox injections usually experience a 75% to 100% reduction in sweat.[3] One study using botulinum toxin type A on 300 patients found immediate and significant improvements in most patients and concluded that Botox injections are a safe and effective treatment for axillary hyperhidrosis. There have also been other double-blind studies corroborating these results.[4] Botox injections offer a method of treatment that is safer and less invasive than other surgical treatments available for primary focal hyperhidrosis at this time. The biggest downsides involve the need to repeat treatments fairly frequently and the discomfort of the procedure itself. There are other permanent local treatment options that can be used for axillary hyperhidrosis, like MiraDry, but they are significantly more expensive. The cost of hyperhidrosis treatments is often a factor when patients are choosing the treatment that is right for them.

Future Applications

Although there has been great success with the use of Botox injections to treat axillary sweating, there is ongoing research to find future treatment options for hyperhidrosis that are less invasive but that still involve the use of botulinum toxin. Specifically, researchers are trying to develop a cream that would deliver Botox to the appropriate site without the use of needles to make treatment more comfortable and convenient for patients.[1]

While there are several treatment options available to those suffering with axillary hyperhidrosis, Botox has been found to be one of the most effective options with the least side effects. It can be an exceptional option for those with severe sweating who wish to avoid more extensive surgical procedures.

Sources
  1. Pariser, D. M. (2014). Hyperhidrosis (4th ed., Vol. 32). Amsterdam: Elsevier Pub. Co., 2014. Retrieved
  2. Doft, M. A., Kaston, J. L., & Ascherman, J. A. (2011). Treatment of Axillary Hyperhidrosis With Botulinum Toxin: A Single Surgeon’s Experience With 53 Consecutive Patients. Aesthetic Plastic Surgery, 35, 1079-1086. doi:10.1007/s00266-011-9738-4
  3. Benson, R. A., Holt, P. J., & Loftus, I. M. (2013). Diagnosis and management of hyperhidrosis. BMJ : British Medical Journal (Online), 347. doi:10.1136/bmj.f6800
  4. Naumann, M., & Lowe, N. J. (2001). Botulinum toxin type A in treatment of bilateral primary axillary hyperhidrosis: Randomised, parallel group, double blind, placebo controlled trial. BMJ : British Medical Journal, 323(7313). doi::10.1136/bmj.323.7313.596
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Antiperspirant

What You Need to Know About Carpe Clinical Regimen

By Katie Crissman /

One of the newest clinical strength antiperspirants to hit the market is Carpe’s Clinical Grade Regimen - it combines several high performing products with a specific care routine to provide long term sweat reduction for even the heaviest sweaters. Read on to see if Carpe Clinical Regimen is right for you!

Antiperspirant is great - for most people. You apply it once a day and it stops your sweat! It’s easy. But, what if that’s not what happened? You bought it, read the label, and used it exactly as directed and, unfortunately, you’re still sweating - excessively. If this is you, then you’ve come to the right place. There are products specifically made for heavy sweaters who haven’t had luck with traditional antiperspirants. These products typically include the words “extra strength”, “clinical strength” or “prescription strength” and they are, thankfully, available over the counter without a doctor’s prescription. 


The difference between clinical strength products and their weaker counterparts are the active ingredients they use. Clinical strength lines typically use one of several newer types of metallic salt ingredients that are known to be both stronger and less irritating than aluminum chloride (which is the standard active ingredient in antiperspirants) [1]. While there are many clinical strength products on the market, we are going to focus on a new clinical strength regimen that combines a strong active ingredient with a specific care routine to get excessive sweating under control. 


Carpe Clinical Regimen -  What It Is and How It’s Different

One of the newest clinical strength antiperspirants to hit the market is Carpe’s Clinical Grade Regimen. It’s different from other prescription grade products because it combines several strong products with a specific care routine to ensure maximum product performance. It’s also different from Carpe’s other products because it uses a stronger active ingredient and delivery system. The system is geared toward people who experience intractable armpit sweating, but Carpe also makes products for people who struggle with other types of sweat. The Carpe Clinical Grade Underarm includes three specific products that, when used together, have been found to be highly effective at reducing sweat production. These products include:

  • Carpe Clinical Grade Underarm Antiperspirant 
  • Carpe Clinical Grade Exfoliating Wash
  • Carpe Clinical Grade Underarm Wipes[2]

Carpe Clinical Grade Regimen uses an active ingredient called Aluminum Zirconium Tetrachlorohydrex GLY (20%) combined with other soothing inactive ingredients to effectively stop sweat in its tracks while reducing skin irritation.[3] Aluminum Zirconium Tetrachlorohydrex is a newer generation metallic salt that stops sweat production and is known to be more effective than other types of active ingredients antiperspirants typically use. One study mentioned in the journal Dermatologic Clinics found that antiperspirants using Aluminum Zirconium Tetrachlorohydrex were, on average, 34% more effective than antiperspirants that used aluminum chloride as an active ingredient.[1] Carpe’s traditional products use an active ingredient called Aluminum Sesquichlorohydrate at 15% which is effective, but less potent than Aluminum Zirconium Tetrachlorohydrex.[4]


It’s important to note that Carpe’s Clinical Grade Regimen provides a long term impact on sweat reduction from making short term lifestyle changes. This is because the results build up over time and peak at about 4 weeks. It takes 4 weeks of using the Carpe clinical grade products once each morning and every other night to see the full effect of what they can do. This is typical of all antiperspirants as their effects tend to build up with consistent use. Consistently using antiperspirant products is especially important for those with hard to treat sweat problems because it can be the difference between treatment success or failure.[1][2] 


If you’re frustrated with the way your current antiperspirant is working or how it isn’t working, then consider giving Carpe’s Clinical Grade Regimen a try! It’s active ingredient is comparable to other prescription strength products on the market but it’s multistep system with easy to use wipes is completely unique! Remember, an easy to use, consistent antiperspirant routine is going to give you long term sweat reduction so it’s important to find a system that works for your lifestyle. 


Sources
  1. Pariser, D. M. (2014). Hyperhidrosis (4th ed., Vol. 32). Amsterdam: Elsevier Pub. Co., 2014. Retrieved from https://www.elsevier.com/books/hyperhidrosis-an-issue-of-dermatologic-clinics/pariser/978-0-323-32607-0>https://www.elsevier.com/books/hyperhidrosis-an-issue-of-dermatologic-clinics/pariser/978-0-323-32607-0
  2. How It Works (Clinical). Carpe. https://mycarpe.com/pages/how-it-works-clinical. 
  3. Clinical Underarm  PM Wipes. Carpe. https://mycarpe.com/products/clinical-grade-underarm-antiperspirant-wipes?variant=34814174724229
  4. Underarm Antiperspirant for Excessive Underarm Sweating. Carpe. https://mycarpe.com/products/underarm-antiperspirant-tube?variant=39247505358981
Body Areas Affected by Hyperhidrosis

9 Outrageous Things People Try to Avoid Excessive Armpit Sweating

By Daniel McCarthy /

9 Outrageous Things People Try to Avoid Excessive Armpit Sweating


On my first day of work a few years ago, I got dressed to impress and walked the 20 minutes to my new office to meet my new colleagues for the first time. Having just moved to the southern US, I’d been getting used to the unbearable humidity and its effects on my excessive armpit sweating. Luckily (I thought), the sun wasn’t out and the temps dropped below 80, so maybe my sweat glands wouldn’t take center stage! Well...I arrived to meet my colleagues looking like a wet bass in business clothes. Thank goodness I arrived 15 minutes early, which brings me to the first outrageous thing people try to avoid armpit sweating. 

  1. The Hand Dryer 

I anxiously scurried to the nearest bathroom, declothed, and put the hand dryer to good use on my shirt stains and sweat stains. More outrageously, I awkwardly hovered my sweaty extremities (including my sweaty underarms) over the hand dryer. Thankfully, I reapplied my antiperspirant and headed out to meet my colleagues a decently dry man. That was the day I knew I really needed clinical strength antiperspirant for my excessive armpit sweating (and a car). 


  1. Pantyliners


Many with excessive underarm sweating already know that underarm pads are one way to help with sweating armpits. But if you find yourself sans pad and worried about your excessive armpit sweating, you would not be the first person to try pantyliners. That’s right, pantyliners have been used in a pinch to help keep sweat stains at bay. 

  1. Give a shirt

In 2019, a reddit user posted that to combat his excessive armpit sweating, he skipped the typical clothing and made his own shirt. He posted asking others to try out his creation and received over 250 replies! By creating and giving others shirts, this innovative reddit user designed his way into the hearts of many with smelly armpits. 

  1. Get inked

If you’ve been debating whether to get a tasteful tattoo and you have hyperhidrosis, this finding may just help you make your decision. A 2017 study found that getting inked helped reduce sweat [1]! Now, I don’t recommend choosing a tattoo as a means of treatment for excessive armpit sweating (and maybe don’t tattoo your armpit), but the connection is a fun little fact nonetheless. 

  1. Become a naked mole rat

If you can’t pull the trigger on an armpit tattoo, another method some people have tried is hair removal. Yes, like Steve Carrell (who actually has hyperhidrosis himself) in the hit movie 40-year Old Virgin, removing hair can help reduce sweat buildup for you too. Many likely already “naturally” lose hair thanks to some sweat prevention products, but more natural hair removal may just be the trick to solving excessive sweating. 

  1. Armpit art

Even though we know most sweaty armpit causes, like too much caffeine or spicy foods, it’s no fun to cut these out completely. A more outrageous approach to excessive underarm sweating is actually turning sweating armpits into art. Multiple users of the Reddit community r/Hyperhidrosis have created shirts, sweatshirts, and other clothing that includes beautiful tie-dye in the armpits. Creative, fun, and beautiful, and even better when combined with sweat prevention like antiperspirant or carpe underarm. 

  1. Vinegar your armpit

You may already know how to get rid of pit stains with vinegar, but there are other interesting ways it can help with excessive armpit sweating. Splashing vinegar on your sweaty underarms  is one method many recommend. Those that swear by this method also recommend using deodorant or antiperspirant, too. 

While we don’t know how this was discovered, I like to think someone accidentally splashed vinegar on their pits hundreds of years ago and voila! Too bad the first person to splash his pits with vinegar didn’t also have access to the best antiperspirant for his excessive armpit sweating. 

  1. Baking soda your sweaty underarms

If you find deodorant or antiperspirant irritating, one creative way to help alleviate your excessive underarm sweating is baking soda. Many crafty people with hyperhidrosis swear that not only can baking soda help reduce sweat, but it can also help alleviate pesky underarm smell with some of the best sweat prevention. 

  1. Restart the plaid fad

Black t-shirt, black sweatshirt, black button down, black tank top. If this sounds like your closet, you’re clearly an expert on the hyperhidrosis wardrobe. But if you want some variety as you fight excessive armpit sweating, add some plaid, a trick many with hyperhidrosis use that you may not know. Hey, you just may be starting the resurgence of the plaid fad, and at worst, you’ll add some fun, lumberjack variety to your dark closet. 


Sources: 

[1] Luetkemeier, M. J., Hanisko, J. M., & Aho, K. M. (2017). Skin Tattoos Alter Sweat Rate and Na+ Concentration. Medicine and science in sports and exercise, 49(7), 1432–1436. https://doi.org/10.1249/MSS.0000000000001244
Body Areas Affected by Hyperhidrosis

How to Cure Sweaty Hands Permanently at Home

By Daniel McCarthy /

How to Cure Sweaty Hands Permanently at Home 

Scenario 1: You’re invited into the office, confident you will land the job. You’ve prepared, you’re highly qualified, you have absolutely nothing to worry about. You walk in and confidently reach out to shake the CEOs hand. But then, your confidence turns to dread as the CEO pulls her hand back, wet with your sweat. 

Scenario 2: You’re at home, playing video games with your friends and absolutely dominating. They get so upset, they tell you to take a break to let another friend play. But there’s another problem... nobody wants to use your controller after you finish. Despite your domination, your palmar hyperhidrosis (excessively sweaty hands) has taken center stage. 

Do these scenarios sound familiar? Wondering how to cure sweaty hands permanently? Although you may not have had these exact things happen to you, your sweaty hands likely have caused something similar and you’re looking for a home remedy. To stop sweating these situations, let’s talk about how to cure sweaty hands permanently at home. 

One of the best ways to cure sweaty hands at home is actually not related to the hands at all. Instead, working on reducing anxiety can have immensely positive results on how to cure sweaty hands permanently naturally. There are many root causes of anxiety, and some or many may be related to your hyperhidrosis. Likewise, it is easier said than done to reduce anxiety. But there are also many ways to work on reducing anxiety that are worth a try. One interesting way to reduce anxiety, and in turn, sweaty hands, is to be grateful. Specifically, Petrocchi and Couyoumdjian found that “grateful people experience less anxiety mostly because they are able to encourage and be compassionate and reassuring toward themselves when things go wrong in life” [1]. Other ways include stepping outside for a walk, drinking tea, or even distracting yourself. In general, starting with anxiety reduction not only can help with how to cure sweaty hands, but also your wellbeing in general. 

Another great way to cure sweaty hands at home permanently is to reduce consumption of coffee and alcohol. Now you may be reading this and thinking “Hey, those are all my favorite things! I’m done with this article!”. And while I wholeheartedly agree and enjoy coffee and alcohol myself, consumption in moderation is key, especially with hyperhidrosis. Caffeine, for example, activates part of the brain that is already a main part in causing hyperhidrosis symptoms. Instead of giving it up, try to reduce consumption to under 200 mg or add in decaf to your routine. Alcohol can affect hyperhidrosis in a similar manner, but like coffee, 1-2 glasses of alcohol may be okay. When figuring out how to cure sweaty hands permanently naturally, it is important to find a balance of coffee, alcohol, and managing your hyperhidrosis. And remember to always drink responsibly, in moderation. 

Tackling how to cure sweaty hands permanently, naturally, and at home may require more than behavioral changes we’ve talked about so far. Luckily, there are other great remedies you can try at home! First, finding the right antiperspirant is of paramount importance, especially appropriate antiperspirant for hands. Another possible over the counter option is anti-sweat wipes. If neither of these work for you, another option to cure your sweaty hands permanently is to buy your very own iontophoresis machine for at-home use. This machine delivers mild electrical currents to your hands (or other affected body part) while submerged in water. A combination of these treatments may have your hands feeling less clammy in no time! 

Ultimately, your palmar hyperhidrosis may not be treatable at home and permanently, but these recommendations may help alleviate some of your symptoms. If symptoms persist, consult a medical professional for further assistance with how to cure sweaty hands. 



Sources

Sources

1. Nicola Petrocchi & Alessandro Couyoumdjian (2016) The impact of gratitude on depression and anxiety: the mediating role of criticizing, attacking, and reassuring the self, Self and Identity, 15:2, 191-205, DOI: 10.1080/15298868.2015.1095794

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