Hyperhidrosis is a medical term given to excessive sweating. It is a common problem that occurs in various areas, mainly the underarms, palms of hands and soles of the feet.

Sweating at the gym is considered quite normal and generally acceptable however at a social function or at work excessive sweating can be very embarrassing and it’s something you would probably like to prevent.

Sweating is the body’s natural way of responding to heat and stress, and cannot be consciously controlled. It is controlled by the hypothalamus, which is a portion of the brain whose job it is to maintain the body in a balanced functioning state. When a person is exposed to heat or encounters a stressful situation, the hypothalamus sends chemical messengers to the sweat glands in the skin, via nerves, to tell them to produce sweat. As the sweat evaporates, the skin cools and this helps keep the body at a normal temperature of approximately 37ºC .


There are 2 categories of hyperhidrosis – primary and secondary.

In primary hyperhidrosis, the most common type, the cause of the excessive sweating is not known. It often starts in childhood and tends to be localised to the palms, soles or armpits.

Secondary hyperhidrosis occurs when the excessive sweating is due to an underlying medical condition. It may affect the whole body. Some of the possible causes include diabetes, an overactive thyroid gland, obesity, menopause, infections, some medicines (especially antidepressants) and, rarely, some tumors.

Sufferers may sweat on a continuous basis throughout the day but there may be triggers such as stress at work or in social situations, higher temperatures or stimulants (such as caffeine and exercise).

It can cause:

– Social embarrassment

– Impaired ability to perform at work

– Difficulty in developing personal relationships

– Needing to change clothes multiple times each day

– Moderate to severe emotional distress

Excessive Underarm Sweating – Severe Axillary Hyperhidrosis

Axillary hyperhidrosis is usually diagnosed when a person has experienced at least 6 months of excessive underarm sweating (with no known cause) and also has at least two other characteristics listed below:

• Both underarms are affected
• Daily activities are impaired
• Occurs at least once a week
• Age of onset (first experience) less than 25 years
• Family history of excessive sweating
• Excessive sweating does not happen during sleep

The diagnosis of the severity of your axillary hyperhidrosis relates to the impact it has on your daily life. This can be easily determined by circling the statement below that best describes your condition:

My underarm sweating is:
1. never noticeable and never interferes with my daily activities.
2. tolerable but sometimes interferes with my daily activities.
3. barely tolerable and frequently interferes with my daily activities.
4. intolerable and always interferes with my daily activities.

If you circled statement 3 or 4, you may have the medical condition known as severe axillary hyperhidrosis.


There are a few treatment options available for severe axillary hyperhidrosis, depending on the severity of the condition. The following step-wise approach to treatment has been determined by specialists worldwide, who treat this condition.

Step 1. Antiperspirants
Antiperspirants are readily available in supermarkets and convenience stores. Please note that this does not include deodorants as they do not affect sweating; they only mask the odour usually associated with sweating.

Step 2. Clinical strength antiperspirants This type of antiperspirant is only available from pharmacies and contains the ingredient aluminium chloride hexahydrate.

Step 3. Injectable treatment
This type of treatment is only available for children over the age of 12 years and adults who are intolerant to antiperspirants containing aluminium chloride hexahydrate, or for whom this type of antiperspirant does not work. This treatment is available from specialist doctors who have undergone specific training for the treatment of severe axillary hyperhidrosis (selected neurologists, dermatologists and paediatricians). A referral from your General Practitioner will be needed

A 16-month clinical trial demonstrated that BOTOX® provided at least 83% of patients with a 50% or greater reduction in sweating by week 4.

BOTOX® offers effective relief from axillary hyperhidrosis for approximately 7 months.

Step 4. Surgery
This is usually considered as a last resort. You will also need to obtain a referral to a surgeon from your General Practitioner. Dr McGovern does not perform this surgery.