Axillary Hyperhidrosis: Symptoms & Treatments

If you sweat through shirts even in cool weather—or find yourself planning outfits around underarm stains—it might be more than just typical perspiration. Axillary hyperhidrosis is a medical condition that causes excessive underarm sweating, and it can seriously affect your day-to-day comfort and confidence. Unlike normal sweating, it often occurs without heat, exercise, or stress. 

Fortunately, excessive sweating is well understood and highly treatable. In this guide, we’ll explain what causes axillary hyperhidrosis, how to spot the signs, and which treatments—both short-term and long-term—actually work.

What Is Axillary Hyperhidrosis?

Axillary hyperhidrosis refers to excessive sweating in the underarm area that goes beyond what’s necessary to regulate body temperature. It’s different from normal sweating in both intensity and impact—soaking through shirts without physical exertion, heat, or stress is a common experience for those affected. The condition is categorized into two main types: primary and secondary hyperhidrosis, depending on the cause.

Unlike typical perspiration, which is triggered by environmental or emotional factors, this type of sweating often occurs without a clear reason and can significantly disrupt daily life and confidence.

Read more: How to Stop Sweating So Much [14 Proven Solutions]

Primary Hyperhidrosis

Primary axillary hyperhidrosis is caused by overactive sweat glands, often due to a genetic or neurological predisposition. It typically starts in childhood or adolescence and affects specific areas like the underarms, hands, feet, or face. People with this type of sweating may notice that it happens symmetrically: both armpits sweat excessively, even when the body doesn’t need to cool down.

There’s no known medical trigger, which makes it different from secondary hyperhidrosis. If your sweating began early in life, happens regularly without reason, and runs in your family, it could be primary.

Secondary Hyperhidrosis

Secondary axillary hyperhidrosis, on the other hand, results from an underlying medical condition or medication. Unlike primary hyperhidrosis, it often appears later in life and can be more widespread across the body, not just the underarms. Common triggers include diabetes, hyperthyroidism, infections, menopause, and neurological disorders. Certain medications, like antidepressants or pain relievers, can also overstimulate the sweat glands.

If your excessive sweating began suddenly, worsens at night, or comes with other symptoms, it’s important to talk to a healthcare provider to rule out a more serious cause (more on that below).

Common Signs & Symptoms: Do You Have Axillary Hyperhidrosis?

Wondering if your underarm sweat is normal, or something more? These are some of the most common signs of axillary hyperhidrosis, and they go far beyond what most people experience.

• You sweat excessively without heat or exercise. If you’re dripping sweat while sitting still in an air-conditioned room, that’s not typical.
• Sweat soaks through your clothes—fast. You find yourself changing shirts multiple times a day or layering to hide stains.
• You avoid specific colors or fabrics. Light-colored shirts, silks, or anything that shows moisture are off-limits in your wardrobe.
• You’ve changed your behavior to avoid embarrassment. You hesitate to raise your arms in public, shake hands, or hug people.
• Deodorants and antiperspirants don’t work. Even clinical-strength options offer little to no relief.
• You shower multiple times a day just to feel clean.
• You’ve felt anxious, embarrassed, or isolated because of your sweating. Social events, work presentations, or even casual hangouts become stressful situations.
• You plan your life around your sweat. Whether it’s picking outfits, choosing seating positions, or avoiding outdoor events, your sweat plays a constant role in your decision-making.

Axillary Hyperhidrosis Treatment

While there’s no permanent cure for axillary hyperhidrosis, there are a variety of effective solutions, ranging from simple lifestyle adjustments to advanced medical interventions. Here’s a look at the top options.

1. Sweat Proof Undershirts

A sweat proof undershirt is one of the simplest ways to manage excessive underarm sweat. Acting as a barrier between your skin and outer clothing, it absorbs moisture and prevents wet marks from showing through.

Available for men and women, Thompson Tee’s only patented sweat proof undershirts on the market are designed specifically for people with axillary hyperhidrosis. They're breathable, discreet, and provide all-day protection, without any side effects.

2. Prescription Antiperspirants

Antiperspirants reduce sweating by plugging sweat glands with aluminum salts. While many over-the-counter formulas work for mild symptoms, some cases require prescription-strength options.

Prescription antiperspirants contain higher concentrations of aluminum chloride and are best applied at night for maximum effectiveness. However, they may cause skin irritation, especially on sensitive skin.

3. Prescription Cloth Wipes

These single-use towelettes offer a portable, clinical-strength solution for sweat control. Soaked with aluminum chloride compounds, they work by blocking sweat glands at the source.

Anti-sweat wipes are easy to apply and more potent than most topical options. Just be aware that irritation is possible, especially for sensitive skin types.

4. Topical Medications

Topical anticholinergics like Qbrexza block the chemical signals that tell your body to produce sweat. They’re applied directly to the underarms and can offer targeted results.

These prescription topical treatments for hyperhidrosis can be highly effective, but should be used under medical supervision, especially if you have other health conditions.

5. Oral Medications

Oral treatments for hyperhidrosis, like anticholinergics, beta-blockers, and benzodiazepines, may be prescribed for full-body sweating or short-term relief in social situations.

These medications aren’t designed specifically for hyperhidrosis, and side effects—ranging from dry mouth to fatigue or dependency—mean they’re usually not a long-term fix.

6. Botox Injections

Botox injections block the nerve signals that activate your sweat glands. The treatment is FDA-approved for underarm sweating and usually lasts 4–6 months.

Botox for axillary hyperhidrosis is highly effective but can be expensive. Over time, many patients find they need fewer treatments to maintain results.

7. Iontophoresis

This method involves placing your underarms in water-soaked pads and using a low electrical current to reduce sweating. It’s noninvasive and safe, with minimal discomfort.

Results from iontophoresis vary, and consistent maintenance (usually weekly) is key for long-term benefits. At-home machines are available for regular use.

8. miraDry

miraDry uses microwave technology to destroy underarm sweat glands. It’s non-surgical, though local anesthesia is required, and results can be long-lasting after one or two sessions.

The miraDry procedure costs around $3,000 per treatment. Mild side effects like swelling or tingling are common post-procedure.

9. Brella Patch

The Brella patch delivers high-potency antiperspirant ingredients directly to the underarm via an adhesive patch. It offers a convenient, localized solution for controlling sweat.

While the Brella patch is discreet and easy to apply, it can cause irritation or redness at the application site. Follow usage instructions carefully.

10. Laser Treatment

Laser sweat reduction treatments destroy sweat glands through small incisions using targeted heat. One session may help, but multiple treatments are often needed for lasting results.

Laser therapy typically costs around $3,000 and may cause bruising or swelling. It’s not usually covered by insurance.

11. Hyperhidrosis Surgery

Surgical options are reserved for the most severe cases. These include excision, curettage, liposuction, or ETS (nerve-cutting procedures). Some are no longer recommended due to their risks.

If you're considering surgery for hyperhidrosis, consult a specialist and weigh the pros and cons carefully, especially for invasive techniques like ETS.

Read more: How to Stop Underarm Sweat: The Complete List of Solutions

When to See a Doctor

If your underarm sweating disrupts your daily life, it’s time to speak with a healthcare professional. Axillary hyperhidrosis isn’t something you have to just “live with.” There are real treatments, and a doctor can help you identify the best option based on the severity and root cause of your symptoms.

You should especially consider seeing a doctor if:

• Your sweating started suddenly or has gotten worse over time
• You sweat at night without explanation
• Deodorants and antiperspirants offer no relief
• You notice symptoms in other areas like your hands, feet, or face
• You’re experiencing other health changes alongside the sweating

A medical evaluation may include a physical exam, discussion of your health history, and tests to rule out secondary causes like thyroid issues, infections, or medication side effects.

The earlier you get help, the sooner you can take control and stop planning your life around your sweat.

Prevent Axillary Hyperhidrosis From Dictating Your Life

Living with axillary hyperhidrosis can feel frustrating, but it doesn’t have to run your life. Whether you’re exploring clinical treatments or simply need a better day-to-day solution, options do exist. 

For instant, wearable relief, Thompson Tee’s patented sweat proof undershirts offer discreet protection you can trust. Designed by people who suffer from axillary hyperhidrosis, these shirts are a simple yet powerful way to stay dry, confident, and in control, no matter what your day holds.

Shop men’s or women’s now and test it for 30 days. If you don’t like it, you get your money back.