Vascular & Sweat
Axillary Hyperhidrosis
WHAT IS IT
Excessive underarm sweating
HOW COMMON
Common; often starts in the teens/20s
CONTAGIOUS?
No — you cannot catch it or spread it
CURABLE?
Very manageable with a range of options
What Is It?
Axillary hyperhidrosis is excessive sweating of the underarms, beyond what's needed to cool the body. The sweating can soak through clothing and interfere with work, social life, and confidence. It often starts in the teens or twenties and is not dangerous, but can be distressing.
Signs & Symptoms
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Visible, excessive underarm sweating
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Sweat soaking through shirts and clothing
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Sweating even when cool or at rest
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Skin irritation or odor from constant moisture
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Impact on clothing choices, work, or social comfort
Why Does It Happen?
In most cases the sweat glands are normal, but the nerves that signal them are overactive — this is called primary hyperhidrosis, and it often runs in families. It is not caused by poor hygiene. Less often, excessive sweating is secondary to another condition or medication, which your provider can help sort out.
Treatment Options
There's a clear ladder of options, from antiperspirants up to procedures. Many people get excellent control with the right combination.
CLINICAL ANTIPERSPIRANTS
Aluminum-chloride antiperspirants applied at night — the usual first step.
PRESCRIPTION OPTIONS
Topical wipes (glycopyrronium) or oral medicines that reduce sweating.
BOTULINUM TOXIN
Underarm injections that block sweat signals for several months.
PROCEDURES
Microwave or energy-based device therapy for longer-lasting control.
Tips for Managing It at Home
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Apply strong antiperspirant at night to dry skin for best effect
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Choose breathable fabrics and use sweat-absorbing undershirts
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Track triggers like caffeine, spicy food, heat, and stress
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Know that effective treatments exist — it's worth pursuing
When to Call Your Provider
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Sweating disrupts work, relationships, or confidence
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Antiperspirants and first steps aren't enough
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Sweating is sudden, one-sided, or came with other symptoms
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You have night sweats, weight loss, or fevers (needs evaluation)
Sources & further reading
The information in this handout is based on general dermatology guidance from the reputable organizations below. These links are provided for patients who wish to read more from trusted sources.
American Academy of Dermatology (AAD). Hyperhidrosis: Overview. https://www.aad.org/public/diseases/a-z/hyperhidrosis-treatment
Canadian Dermatology Association (CDA). Hyperhidrosis. https://dermatology.ca/public-patients/diseases-conditions/skin-conditions/hyperhidrosis/
DermNet. Hyperhidrosis. https://dermnetnz.org/topics/hyperhidrosis
MSD/Merck Manual. Hyperhidrosis. https://www.msdmanuals.com/professional/dermatologic-disorders/sweating-disorders/hyperhidrosis
This handout is for general education and does not replace advice from your own provider. Always follow your provider’s specific instructions.
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