Severe Primary Axillary Hyperhidrosis

Hyperhidrosis is the medical term for excessive sweating that is commonly a chronic condition affecting an estimated 7.8 million (or almost 3 percent) of the U.S. population.1 Patients with hyperhidrosis produce an amount of sweat that far exceeds that needed to regulate body temperature.

Risk Factors and Symptoms

The condition most frequently develops in adolescence or young adulthood. The underlying cause of the disorder is uncertain but genetics may play a role — one-third to one-half of patients has a family history of the disorder. Hyperhidrosis commonly affects the underarm (axillary) sweat glands, but can also affect the palms of the hands or the feet, or the whole body in general. Severe sweating may be exacerbated by stress, emotion, or exercise, but often occurs for no apparent reason. The precise mechanism that triggers the condition is unclear but appears to be related to malfunction in the part of the nervous system that regulates "involuntary" bodily functions (those we don't exert conscious control over) such as breathing, the heart beat, and regulation of body temperature. In people with hyperhidrosis, this system may produce too much of the neurotransmitter that signals the sweat glands to perspire, or the sweat glands may overreact to those signals.

Treatment

Depending on its severity and the area affected, treatment for hyperhidrosis may require one or more approaches. Powders, ointments, and electrical stimulation are often tried first. The effects are temporary, however, and may last for just a few hours, sometimes up to a week. Anticholinergic medications that block the neurotransmitter stimulating sweat production may also be prescribed, and may be particularly helpful for sweating that affects several parts of the body at once. BOTOX® (onabotulinumtoxinA) injection is a minimally invasive treatment to help patients with severe primary axillary hyperhidrosis (excessive underarm sweating) inadequately managed with topical agents. Surgical procedures for hyperhidrosis, including ETS (endoscopic transthoracic sympathectomy) are usually considered only when less invasive options fail to provide adequate relief from symptoms. If you suffer from hyperhidrosis, talk to your doctor about treatment options.