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Treating Hyperhidrosis, i.e. Sweaty Armpits

Yesterday the American Academy of Dermatology posted to their Facebook page this article from their website about the diagnosis and treatment of hyperhidrosis.  The article is a pretty straight forward run-through of hyperhidrosis, or excessive sweating, and discusses some more complicated issues of palmar (hand) and foot hyperhidrosis in addition to the more routine problem of sweaty underarms (axillary hyperhidrosis).  There doesn’t seem to be a date attached to the article, but it struck me as a few years old.  It discusses MiraDry, although doesn’t mention it by name, and as far as laser treatments, there is only a bullet-point mention of it under the category of surgical treatments.  It does discuss Botox, but the article was pretty non-committal regarding supporting one treatment or another.

I don’t have MiraDry, but from what I’ve seen and heard it works quite well and has good Internet reviews.  Botox has good Internet reviews as well, and I can tell you it works great.  It works longer than typical Botox treatments for facial wrinkles, routinely lasting 6 months or more.  The other neuromodulators, Dysport and Xeomin, would also work.  It does take a lot of Botox to treat axillary hyperhidrosis, so it is expensive and is not permanent.  However, I have become partial to the minimally-invasive laser treatment of PrecisionTx, which I have here at Surgical Arts Surgery Center in Santa Barbara.  This is an easy 30 minute, one-time procedure, done under local anesthesia.  Results are immediate, but there is usually some mild swelling, pain, and bruising after the procedure.  It’s not cheap, but in the long run will cost less than repeated Botox treatments.  

Douglas J. Mackenzie, MD

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