Hyperhidrosis or excessive sweating affects about two percent of the population. Often it is limited to certain body areas like the palms, soles, armpits, nose and groin.
It is sometimes inherited,but in most cases no genetic link can be established. Excessive sweating or hyperhidrosis can be secondary to a medical condition like menopause or hyperthyroidism and usually occurs with one any precipitating medical condition.
It rarely causes problems in other parts of the body because excessive although mildly embarrassing, at times it is often just an inconvenience.
Excessive sweating of the armpits can affect on ones social life and may lead to emotional problems because it can produce or aggravate disagreeable armpit odor.
Unlike most types of the body where there is only one type of sweat gland, called eccrine that produces clear and watery sweat while the armpit has a second type of sweat gland called the apocrine which produces a stickier form of sweat.
Sweat from eccrine glands remains odorless but apocrine sweat although initially odorless, is promptly broken down by bacteria, a process which releases chemicals with disagreeable odor.
There are a variety of proprietary preparations and medical or surgical procedures that are being used for hyperhidrosis. The former are either applied topically (externally) or taken systemically in the form of tablet or capsule while the latter includes botox injection and endoscopic thoracic sympathectomy .
Most topical preparations used to control sweaty armpits containing antiperspirants and deodorants. They generally are well tolerated but in most cases control of sweating and odor is not complete.
The antiperspirants like aluminum chloride, aluminum hydroxide and aluminum potassium sulfate control sweating by plugging the sweat glands. The deodorants on the other hand, mask the odor released by the bacteria, but they only work if the armpits are washed frequently.
Systemic preparations used to combat excessive sweating include anticholinergics, sedatives, tranquilizers and calcium channel blockers.
The use of any of these preparations, however, had not gained popular support because of their numerous side effects and adverse reactions. Botulinum toxin (botox) injection is the procedure that was approved by the USFDA in 2004 for the treatment of severe underarm sweating.
Small dose of the toxin, when injected in the armpits, block the nerves that stimulate sweating. Botox, however, does not cure hyperhidrosis, and its effect is temporary.
The symptoms gradually return over a period of weeks and the procedure has to be repeated at intervals of seven to sixteen months to maintain dryness. Side effects of botox include injection site pain and flu like symptoms.
A surgical procedure that is being performed for hyperhidrosis is endoscopic thoracic sympathectomy (ETS). This procedure is very effective (ninety to a hundred percent) for sweaty palms but is not as effective for sweaty armpits.