Man applying deodorant to underarm
Man applying deodorant to underarm
Man applying deodorant to underarm

Excessive Underarm Sweating: Why It Happens and How to Manage It

The underarms are one of the most common places for excessive sweating. Learn what makes your underarms sweat and how to best deal with unwanted symptoms.

Nov 25, 2024

Written by

Abbi Havens

If you experience axillary hyperhidrosis (excessive underarm sweating), you know that it’s not just an inconvenience—excessive sweating can interfere in every aspect of daily life—but you’re not alone. In one survey, 33 percent of individuals reported that they felt they produced too much underarm sweat.

Despite the high prevalence of axillary hyperhidrosis, only 5 percent of participants said they spoke to their healthcare provider about their symptoms. But as it turns out, excessive armpit sweating is a treatable medical condition. There are many safe and effective options available to manage symptoms, so you can focus more on enjoying life and less on underarm stains. Continue reading to learn more.

What is Axillary Hyperhidrosis?

Axillary hyperhidrosis is a type of hyperhidrosis (excessive sweating) that specifically affects the underarms. It’s typically categorized in one of two ways:

  • Primary hyperhidrosis: Excessive sweating that occurs without an identifiable medical cause. It’s believed to stem from overactive sweat glands activated by the nervous system.

  • Secondary hyperhidrosis: Excessive sweating caused by an underlying condition like diabetes, thyroid dysfunction, or menopause, or as a side effect of certain medications.

Hyperhidrosis can also be focal or generalized:

  • Focal hyperhidrosis: Affects one or more areas of the body (like the armpits, face, palms, or soles of the feet) and is typically idiopathic, which means it occurs in otherwise healthy people. 

  • Generalized hyperhidrosis: Affects the whole body (as opposed to certain areas) and is typically a symptom of an underlying medical condition.

What Causes Excessive Underarm Sweating?

Excessive underarm sweating, or axillary hyperhidrosis, is a condition with multiple potential causes. As mentioned, primary axillary hyperhidrosis is excessive underarm sweating that occurs without a known medical cause. While the exact cause of primary hyperhidrosis isn’t fully understood, we do know it’s related to overactive nerves that signal sweat glands to produce sweat, even when there’s no need for the body to cool itself down.

Other cases of axillary hyperhidrosis may be linked to underlying health conditions, medications, or hormonal changes, such as menopause.

Health Conditions

Certain medical conditions can lead to secondary hyperhidrosis, where excessive sweating is a symptom of an underlying problem. These can include:

  • Endocrine disorders: Hyperthyroidism (overactive thyroid), diabetes (especially during low blood sugar episodes)

  • Infections: Tuberculosis, HIV/AIDS

  • Neurological conditions: Parkinson’s disease, spinal cord injuries

  • Cardiac events and issues: Heart attacks, endocarditis (inflammation of the heart lining)

If you experience excessive underarm sweating, consider makeing an appointment with a healthcare provider. It may be a sign of an underlying medical condition.

Medication

Certain medications can cause excessive sweating as a side effect, often as a result of their impact on the nervous or endocrine systems. These medications include (but aren’t limited to):

  • Antidepressants: SSRIs, SNRIs, tricyclic antidepressants

  • Pain medications: Opioids, NSAIDs (like ibuprofen and aspirin)

  • Hormonal medications: Oral contraceptives, hormone replacement therapy (HRT)

  • Diabetes medications: Insulin, sulfonylureas

  • Cardiovascular drugs: Beta blockers, calcium channel blockers

If you suspect your medication is contributing to excessive sweating, your healthcare provider may be able to adjust your dose or find alternative solutions.

Hormonal changes

Hormonal fluctuations, particularly during menopause, can trigger excessive sweating. Hot flashes—a hallmark symptom of menopause—are caused by sudden, temporary increases in body temperature that prompt intense sweating, especially in the underarm area. Other hormonal events that might lead to excessive sweating include:

  • Pregnancy: Hormonal surges and increased blood flow during pregnancy can cause heightened sweating.

  • Puberty: Hormone levels rise during adolescence, which can overstimulate sweat glands.


Living with Excessive Underarm Sweating

The physical symptoms of hyperhidrosis are just one part of the challenge. We know that excessive sweating can also affect your mental health, social life, daily activities, and career in profound ways.

Related Conditions

Excessive sweating that leaves the skin consistently damp can lead to further health complications, including:

  • Fungal infection: Excessive sweating creates a moist environment where fungus can thrive, leading to fungal infections in the groin, on the hands, and on the feet (commonly referred to as athlete’s foot).

  • Bacterial infection: Consistent moisture on the skin can break down the skin’s protective barrier (a process called maceration), leaving you more susceptible to bacterial infection.

  • Body odor: Body odor, or bromhidrosis, occurs when bacteria come into contact with sweat on the skin’s surface, most noticeably around the underarms, groin, and feet.

  • Social and professional difficulties: Many people with hyperhidrosis avoid social, romantic, or professional opportunities as a result of embarrassment or shame. 

  • Mental health impact: 75% of people with hyperhidrosis report negative impacts on their emotional and mental wellbeing, and rates of anxiety and depression are significantly higher in people with hyperhidrosis than people without.

Recognizing the effects of hyperhidrosis beyond excessive sweating is a critical step towards finding a solution.

Medical Treatments for Excessive Sweating

If you experience excessive armpit sweating—don’t fret. Many safe and effective medical treatments can provide relief. 

Aluminum Chloride

This prescription-strength antiperspirant is often recommended for moderate to severe sweating, and is more effective than over-the-counter (OTC) antiperspirants.

Glycopyrrolate

Glycopyrrolate is a medication that can be taken orally or topically (in a spray or roll-on) and effectively reduces sweat production by blocking nerve signals to sweat glands. Complete a consultation with a dermatologist at SweatRx to determine if glycopyrrolate is right for you.

Botox

Botox injections (botulinum toxin) temporarily block the chemical signals that stimulate sweat production. Treatments are long-lasting (4-12) months, and Botox is a popular option for treating axillary hyperhidrosis.

Surgery

For severe cases of hyperhidrosis, a surgery called endoscopic thoracic sympathectomy (ETS) may be an option.This procedure involves cutting or clamping the nerves that stimulate sweat glands. Surgery is never without risk and should be considered as a last resort.

Other Options for Managing Excessive Underarm Sweating

In addition to medical treatments, some lifestyle adjustments can help you manage your symptoms. While these methods may not eliminate sweating entirely, they can significantly improve your comfort and confidence in day-to-day life.

Use Antiperspirants

While some people with hyperhidrosis find antiperspirants aren’t quite enough on their own, antiperspirants are often the first line of defense against excessive sweating. Unlike deodorants, which mask odor, antiperspirants actively block underarm sweat production by forming a gel-like plug in the sweat glands. For best results:

  • Choose clinical-strength antiperspirants with high concentrations of aluminum chloride or other active ingredients. These are more effective than standard over-the-counter options.

  • Apply antiperspirant at night when your sweat glands are less active. This allows the product to fully absorb and block sweat production by morning.

  • Reapply as directed, particularly after showering or exercising.

Aluminum chloride can cause irritation. If you have sensitive skin, look for antiperspirants labeled fragrance-free or designed for sensitive skin to avoid irritation.

Monitor Your Diet

Certain foods and beverages can exacerbate sweating, so identifying and avoiding your triggers can make a big difference. Consider these dietary adjustments:

  • Limit spicy foods: Capsaicin (a chemical found in hot peppers) can make your body feel hot and stimulate sweat glands (your body’s attempt to cool back down).

  • Cut back on caffeine: Caffeine is known to spike blood pressure and increase heart rate, causing your body to sweat.

  • Cut back on alcohol: Alcohol causes your blood vessels to dilate, which results in a rise in body temperature. Additionally, if you are alcohol-dependent, alcohol withdrawal may cause excessive sweating.

  • Focus on whole foods: Processed foods tend to be high in fat and sugar and low in fiber, making them difficult to process. A diet rich in fruits, vegetables, and lean proteins can help minimize overall sweating.

If you suspect certain foods are causing you to sweat, try keeping a food diary to pinpoint specific triggers.

Choose the Right Clothing

Don’t underestimate the role wardrobe can play in managing underarm sweat. The right fabrics and styles can help you stay cool and minimize visible underarm sweat marks:

  • Opt for breathable materials: Natural fabrics like cotton, linen, and bamboo allow air to circulate, keeping your skin drier.

  • Wear moisture-wicking fabrics: These are especially helpful during workouts or hot weather, as they pull sweat away from the skin and dry quickly.

  • Choose dark or patterned clothing: Sweat stains are less noticeable on dark colors or busy patterns than on light-colored, solid fabrics.

  • Layer strategically: A light undershirt can absorb sweat before it reaches your outer clothing (particularly if it’s moisture-wicking).

Stay Hydrated 

Though possibly counterintuitive, drinking enough water is a surprisingly effective way to combat excessive sweating. When your body is well-hydrated, it can regulate its temperature more efficiently, reducing the need for sweat. In addition to carrying a reusable water bottle, avoid sugary and caffeinated beverages which can dehydrate you, and incorporate water-rich foods like watermelon, cucumber, and oranges into your diet.

What’s Next: Take Charge of Excessive Underarm Sweating

With the right tools and habits, excessive underarm sweating is manageable. From healthy lifestyle adjustments to medical treatments (or a combination of the two), you have options to reduce sweating and improve your confidence. Ready to tackle excessive underarm sweating? Take the first step and schedule an online consultation with SweatRx today.

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