Sweaty armpits can feel embarrassing and uncomfortable. There are different underlying causes, but you can manage most of them with the right approach. If your sweat seems excessive, constant, and hard to control, it may be a sign of a condition called axillary hyperhidrosis.
Sweating keeps your body cool. In some cases, your sweat glands (the small organs that make sweat) can go into overdrive when something overstimulates your body. Common causes of sweating include:
- Alcohol
- Caffeine
- Heat and humidity
- Hormonal changes, such as from puberty, pregnancy, or menopause
- Monosodium glutamate (MSG), a common food additive
- Nicotine
- Physical activity
- Spicy, salty, or sugary foods
- Stress
Primary Hyperhidrosis
Primary hyperhidrosis is a condition where your body sweats more than it needs to, even without heat or physical activity. It follows a common pattern and typically:
- Affects both underarms
- Doesn’t happen while sleeping
- Occurs at least once a week
- Runs in families, in about 30–50% of cases
- Starts before age 25
Secondary Hyperhidrosis
Secondary hyperhidrosis occurs when another medical condition or medication causes your body to sweat more than usual. It often starts later in life and affects larger areas of your body. Some common causes include:
- Too much alcohol or other substances
- Anxiety or panic disorder
- Certain cancers, such as Hodgkin’s lymphoma
- Diabetes or thyroid conditions
- Heart or lung conditions
- Infections like human immunodeficiency virus (HIV) or tuberculosis
- Neurological disorders, like Parkinson’s disease
- Obesity
Medications that may trigger sweating include:
- Antibiotics and antivirals
- Diabetes treatments
- Hormone therapies
- Heart and blood pressure medications
- Mental health medications
- Pain relievers
At-home remedies can help reduce sweating and improve comfort throughout the day. This may include using specific deodorants and lifestyle or grooming habit changes. Combining these remedies with medical treatments prescribed by your doctor may give you the best results.
Over-the-counter (OTC) Antiperspirants
If you still sweat after using deodorant, it may be because deodorant only masks odor rather than blocking sweat like an antiperspirant. Antiperspirants contain aluminum chloride or aluminum zirconium that block your sweat glands and reduce moisture. Some also include salicylic acid to improve absorption and speed up drying. If regular-strength options don’t help, try clinical-strength antiperspirants.
To get the best results:
- Apply at night to clean, dry skin when sweat production is lower
- Leave on for six to eight hours
- Reapply in the morning if needed
- Wait a few hours after shaving to reduce the risk of irritation
- Use a moisturizer or hydrocortisone cream if irritation develops
- Be consistent, it may take one to two weeks to see results
- Carry antiperspirant wipes for touch-ups during the day
Hygiene and Grooming Habits
Keeping your skin clean and dry can help antiperspirants work better and reduce odor. Here are some hygiene tips:
- Shower daily and dry your underarms completely
- Exfoliate once or twice a week with a soft washcloth, glove, or gentle scrub to help unclog sweat glands and remove buildup.
- Let your skin cool before dressing after a hot shower to avoid trapping heat.
- Shave or trim your underarm hair to help reduce trapped moisture (if you exfoliate, do that before shaving to avoid irritation)
Lifestyle Changes
Here are some lifestyle changes to consider:
- Avoid consuming things like caffeine, spicy foods, alcohol, and nicotine
- Choose breathable fabrics like cotton or moisture-wicking materials for clothes and bedsheets
- Keep your space cool
- Practice stress-reducing habits like deep breathing, meditation, or stretching
- Stay hydrated by drinking water and eating water-rich foods like cucumbers
- Use sweat shields, which are disposable pads that stick to clothes to absorb sweat
- Wear light, breathable layers
Doctors may suggest stronger treatments if home remedies aren’t working well. This may include oral (by mouth) or topical (on skin) medications, or Botox injections. In some cases, if other options aren’t working, they may try surgery.
Prescription Antiperspirants
Prescription antiperspirants like Drysol (aluminum chloride hexahydrate) block sweat by forming temporary plugs in your sweat glands. You may need to reapply every six to eight hours as sweat gradually breaks down the plug.
Anticholinergics
Anticholinergics block acetylcholine, a chemical that tells your sweat glands to turn on. Examples include:
- Qbrexza (glycopyrronium): A prescription wipe that is FDA-approved to treat underarm sweating.
- Sofdra (sofpironium bromide): A topical gel you apply to your underarms.
- Ditropan (oxybutynin): This oral medication treats an overactive bladder. However, doctors often prescribe it off-label, which is when a medication is taken outside of its intended uses, to manage hot flashes and excessive sweating.
- Robinul (glycopyrrolate): This oral medication reduces drooling, but providers may also prescribe it off-label to treat excessive sweating.
Anti-anxiety Medications
Your doctor may prescribe heart or anxiety medications off-label to reduce stress-related sweating. Examples include:
- Ativan (lorazepam)
- Cardizem (diltiazem)
- Catapres (clonidine)
- Inderal (propranolol)
- Valium (diazepam)
Botox
Botox (onabotulinumtoxinA) is an injection that can treat various health conditions, including excessive sweating. In this case, it blocks nerve signals to sweat glands, which reduces the amount you sweat. Results typically start in about a week and can last up to six months. Side effects, like mild pain, weakness, or flu-like symptoms, are temporary.
Researchers are exploring needle-free options, such as topical creams and high-pressure jet sprays, to reduce discomfort.
Energy-Based Treatments
The following options use heat, cold, electricity, or sound to target and reduce sweat gland activity:
- Brella SweatControl patch: This delivers gentle heat for three minutes, with effects lasting up to four months.
- Cryotherapy: This uses extreme cold to destroy sweat glands.
- Iontophoresis: This treatment sends a low electrical current through damp pads placed on the skin to block sweat signals.
- Laser therapy/intense pulsed light (IPL): This uses light energy to damage sweat glands.
- Microneedle radiofrequency (MNRF): This uses tiny heated needles to shrink sweat glands.
- Microwave thermolysis (MiraDry): This uses FDA-approved microwave energy to destroy underarm sweat glands.
- Photodynamic therapy: This combines applying a light-activated gel with light exposure to the affected skin to reduce sweating.
- Ultrasound: Focused sound waves heat and damage sweat glands.
Surgical Options
If other treatments fail, surgery may be an option for severe or persistent sweating. These include:
- Curettage or liposuction: The doctor scrapes or suctions out sweat glands.
- Excision: This is when a doctor removes skin that contains a high number of sweat glands.
- Laser or heat treatments: This uses targeted energy to destroy glands without making incisions (cuts).
- Minimally invasive shaving with ethanol: This uses a special shaving tool and alcohol to remove glands.
- Sympathectomy: This is where the doctor cuts or clamps the nerves that trigger sweating.
Talk to your doctor if your sweating:
- Begins after starting a new medication
- Comes with a fever, weight loss, chest pain, shortness of breath, or a fast heartbeat
- Happens mostly at night
- Happens when you’re not hot or active
- Interferes with sleep, daily tasks, or your confidence
- Soaks through clothing, even with antiperspirant
- Starts suddenly or worsens over time
If you don’t treat excess sweating, it can lead to skin rashes, infections, and emotional stress. In some cases, it may be a sign of a more serious health problem. Getting care early can help you find relief, prevent complications, and help you stay comfortable.
Sweaty armpits can feel uncomfortable, but most cases are manageable. Common triggers include heat, hormone shifts, stress, and certain foods or drinks. Start with antiperspirants and lifestyle changes. If those aren’t enough, your doctor can offer stronger treatments like prescription wipes, Botox, or energy-based procedures.
