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Axillary Hyperhidrosis

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Last updated: January 2024

Also known as: Sweaty underarms

What is axillary hyperhidrosis?

Axillary hyperhidrosis is the name given to excessive and uncontrollable sweating.

The impact of this condition is often underestimated – it can affect work and social situations and may cause significant psychological distress.

Who gets axillary hyperhidrosis?

Axillary hyperhidrosis affects an estimated 4.8% of the US population. This means that it probably impacts about 4.4% of Australians (approximately 1.2 million Australians experience axillary hyperhidrosis). 1

It usually starts in childhood or adolescence, but some individuals first experience it as adults.

What causes axillary hyperhidrosis?

Whilst the main cause of axillary hyperhidrosis is idiopathic, contributing factors include genetics, physical and emotional factors. A family history is present in up to 30% of cases. 2

Secondary causes of hyperhidrosis are more rare, and include drugs, endocrine and underlying medical conditions.

What does axillary hyperhidrosis look like?

Axillary hyperhidrosis is often associated with sweating elsewhere on the body including the hands (palmar hyperhidrosis), feet (plantar hyperhidrosis) and face (craniofacial hyperhidrosis).

It may be mild with occasional sweaty patches or severe with constant sweating throughout the waking hours of the day. Severe cases are very distressing and can significantly affect an individuals’ quality of life.

How is axillary hyperhidrosis diagnosed?

The diagnosis is usually made clinically based on a history of excessive sweating.

Further investigations are needed when larger areas of the body are affected or if hyperhidrosis occurs during sleep.

How is axillary hyperhidrosis treated?

Treatment options will vary depending on the individual and their needs, and may include:

  • Topical treatments, such as aluminium chloride hexahydrate (Driclor) and anticholinergic creams (e.g. glycopyrolate)
  • Botulinum toxin type A (botox) injections
  • Oral medication, such as anticholinergic tablets, glycopyrrolate, propranolol, clonazepam and gabapentin
  • miraDry (microwave-based energy device)
  • Endoscopic thoracic surgery
  • Radiofrequency microneedling

What is the likely outcome of axillary hyperhidrosis?

Axillary hyperhidrosis tends to be a chronic condition, though the level of sweating may diminish in older adult life.

  1. Ng, K. (2021), Time to sweat the small stuff: hyperhidrosis, a problem of epidemic proportions. Intern Med J, 51: 1377-1379. https://doi.org/10.1111/imj.15486
  2. Stolman LP. Treatment of hyperhidrosis. Dermatol Clin. 1998 Oct;16(4):863-9. doi: 10.1016/s0733-8635(05)70062-0. PMID: 9891696.
Dr Davin LimJanuary 2024
Dr Davin LimOctober 2020

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