Everyone can imagine how awkward a sweat stain under the arms always is. In the case of a person suffering from axillary hyperhidrosis or hyper-transpiration, these events are daily, with halos and very often with bad smells, irrespective of good personal hygiene. That is why this extreme sweating under one's arms can lead to isolation, or even withdrawal into oneself, altering any social bond. It is possible, however, to remove excessive sweating of the armpits, thanks to aesthetic medicine, either in a reversible way (injection of anti-perspiration botulinum toxin) or permanently (Miradry ® device).

Causes of excessive sweating in the arms

Axillary hyperhidrosis is defined as excessive sweating under the arms, on a regular basis, without explicable reason.
It is caused by sweat glands, the main role of which is the elimination of heat (thermo-regulation).

This production of sweat is controlled by the sympathetic autonomic nervous system or ANS, which is triggered in particular during stress.

However, the terminal neurotransmitter that activates this secretion is not adrenaline, but acetylcholine.

There are actually two main kinds of sweat glands:

  • The so-called eccrine sweat glands generate aqueous and odorless sweat.
  • The so-called apocrine sweat glands generate a thick sweat, rich in pheromones, urea or ammonia, which is the source of the "sui generis" smell. They are always connected to a hair and are found under the armpits. They make up only 2% of the 4 million total sweat glands that we have, so their destruction will not have detrimental effects.

Hyperhidrosis occurs most often during puberty and decreases after the age of 40. Its origin is probably partly genetic and not well understood: it is termed essential or idiopathic axillary hyperhidrosis.

Signs of axillary hyperhidrosis

The primary clinical sign is known to all of us: the big sweat stains under the arms that appear on the t-shirt or blouse. In axillary hyperhidrosis, this sweating is frequent, regular, without any explicable reason. It is naturally accentuated by stress, which triggers the sympathetic ANS.

This hyperhidrosis is further aggravated by local and social disorders.

Both are due to the spread of microorganisms in this hot and humid environment:

  • Local dermatological disorders with inflammation, mycoses, dermatoses of the folds...
  • Social problems related to bad smells (armpit bromidrosis) as bacteria grow and release metabolites such as ammonia or urea. This gives rise to distress and hang-ups, which can lead to social withdrawal and even psychological isolation.

Solutions to stop the excessive sweating of the armpits

Underarm hyperhidrosis has been the subject of numerous studies. The Clinique des Champs Elysées is offering two high-performance treatments.

Botox injection against arm perspiration

It is an injection of anti-perspiration botulinum toxin, temporary, to be considered for any patient who suffers socially or psychically.

Your aesthetic doctor usually delivers a dose of 50 U of Botox per armpit, separated into several dozen injections of 15/20 mm apart. These injections span over the entire surface with overlapping injections. As it is needed for each injection of micro-doses of 1.5 U, the ampoule is diluted to have a larger starting volume and have the correct quantity. The injection is performed intradermally, at the junction between the middle and the deep dermis. In case of suspected (very rare) localized sweat secretion, your practitioner will perform a minor test (iodine derivative and starch) to see where to inject botulinum toxin and restrict the number of injections.

The result on armpit sweating happens in 4 to 10 days with a decrease in arm perspiration of about 80%. The duration is typically at least 6 months, with in some people an antiperspirant effect of 8 to 12 months.