Reviewed by Andrew Seibert on December 06, 2011

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Rutledge Forney, MD, Dermatologist.

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Video Transcript

What are the non-surgical treatments for excessive underarm sweating or hyperhidrosis?

Well, I try everybody for underarm sweating on the super, the prescription strength antiperspirants and I would say 60% of people, who have relatively mild focal hyperhidrosis can respond to those.

You put it on at night, because most people don't sweat in their sleep.

People still have to use a deodorant in the morning, because of course, it doesn't control odor, but it will over time, it kind of desiccates the sweat glands.

The problem is they are irritating. Women who have to shave their underarms can get rashes from them, and so you know, we try to work with people to make this easy as possible,

but you know, at least 30 to 40 percent of the people just can't tolerate it. Or, it doesn't work..

Okay, and if they don't respond to that, what's the second level of treatment?

It depends on, on what the problem is. Oftentimes we offer them a pill' which gives temporary relief from sweating.

It does have some side effects which some people can't tolerate, but I do have patients who use it sort of on the job.

They can put up with it on the weekends, but in their job, they want to know they'll be sweat free, particularly people who give speeches, and so they'll use it,

some people use it one a day, some people, just one for special events.

I see. What are the side effects of that?

It can make you have a dry mouth, it can give you a headache, it kinds of dries you up all over, not just your sweating, so.

And if people don't respond to that, what's the next level of treatment?

For underarms, the next level of treatment, really is botox injections. I always tell them that there's a surgical option, but typical between the pill and surgery, we try botox injections.

Sometimes, you may have to use more in one person than another, but when you get the dose right, it's very effective, typically for about 6 months.

You sweat a little, but you don't sweat noticeably. And remember, I tell them always to use a daily deodorant,

because even that small amount of sweating can create an odor if you don't have a deodorant on.