Why Are My Armpits So Sweaty?

Sweating under your arms is both normal and necessary, but when the sweating becomes more than is needed for regulating your temperature, it may cause you physical and emotional discomfort. Excessive armpit sweating—known as axillary hyperhidrosis (AH)—can range from mild dampness to dripping sweat.

AH can be a result of overactivity of the sympathetic nerves. It can also stem from a secondary cause, such as a medical condition or medication. AH can be managed effectively.

This article will discuss why your armpits may be extra sweaty, how to manage underarm sweating, what type of deodorant or antiperspirant to use, and what to do if nothing you try works.

4 Reasons Your Armpits Are Sweaty

Excessive sweating occurs when there is a change in sweat regulation, causing a disproportionate sweat reaction to small triggers. AH may be primary or secondary.

Primary AH characteristics include:

• May be due to overactivity of an area of the brain known as the hypothalamic thermoregulatory center, with transmission via the sympathetic nervous system to the eccrine sweat glands
• Is often idiopathic, meaning a cause can't be determined
• Appears to have a genetic component, with a family history present in up to 30% of cases

Secondary AH is associated with an underlying medical condition, such as:

• Chronic anxiety disorder
• Stroke
• Neuropathy (damage to peripheral nerves)
• Spinal nerve damage
• Diabetes
• Hyperthyroidism (overactive thyroid gland)
• Heart disease
• Lung disease
• Medications
• Substance use disorder
• A variety of other conditions

Excessive sweating episodes can be triggered by a number of factors, including:

• Heat
• Emotional response
• Hormones
• Food and drink
  

Heat

Sweating in response to heat from environmental factors, exercise, or exertion is normal and is considered to be the primary function of sweat. When you get hot, you sweat all over your body. The sweat on your skin evaporates to cool you down and maintain a normal body temperature.

Excessive sweating can occur in areas such as the armpits if there is a mismatch between the sweat that is required to respond to the heat and the actual amount of sweat that is produced.

Emotional Response

Emotional responses can trigger sweating. You might find yourself sweating more when you are feeling:

• Stress
• Anxiety
• Fear
• Pain
• Sexual arousal

Sweat glands are activated during the stress response, also called the fight-or-flight response, which evolved in humans as a protective mechanism to handle real or perceived threats. When the stress response is active, you may experience sweating, tense muscles, increased heart rate, and quicker breathing.

Hormones

Hormones can affect when and how much you sweat, such as the following:

• Excessive sweating episodes often begin during puberty.
• Pregnancy is associated with changes in sweating.
• Hot flashes and excessive sweating are common symptoms of menopause.
  

Food and Drink

Gustatory sweating, also called Frey's syndrome, is sweating that is triggered by food or drink. It can occur after surgery of the parotid gland (major salivary gland) or injury to the auriculotemporal nerve (provides sensation to several areas on the side of the head). Gustatory sweating usually affects the face, scalp, and neck, but can affect the armpits.

Certain foods and drinks can also trigger sweating in some people, including:

• Caffeinated food and beverages, like coffee, tea, and chocolate
• Monosodium glutamate (MSG)
• Spicy food, such as hot sauce
• Certain spices, like cumin or curry
• Alcohol
  

Ideas to Manage or Stop Underarm Sweating 

Managing excessive underarm sweating depends on the cause and the severity of the symptoms. Sweating can often be controlled with conservative measures like lifestyle changes and antiperspirants. But in some cases, further treatment is needed.

Lifestyle Changes

Some lifestyle and hygiene practices can help lessen sweating or help you manage it. These might include:

• Use a non-soap cleanser.
• Avoid triggers such as caffeine.
• Talk to your healthcare provider about changing medications that increase your sweating.
• Apply cornstarch after a bath or shower.
• Wear loose-fitting, stain-resistant clothes.
• Change your clothes when they become damp.

Managing Anxiety and Stress

Stress and anxiety can both trigger and result from AH. Learning to manage anxiety and stress can help reduce the chances of triggering episodes of excessive sweating. It can also help you handle any negative emotions or thought processes that you may experience while living with AH.

Seeing a mental health professional is a great place to start. They may recommend treatments such as:

• Psychotherapy (talk therapy), such as cognitive behavioral therapy (CBT)
• Relaxation techniques, such as mindfulness exercises or yoga
• Medications, such as beta-blockers, or a selective serotonin reuptake inhibitor (SSRI) like Zoloft (sertraline), Paxil (paroxetine), or Prozac (fluoxetine)

Topical Treatments and Antiperspirants

Topical treatments, including antiperspirants, are typically the first recommended treatment for AH, and can be very effective. These commonly contain either aluminum chloride or aluminum chloride hexahydrate.

Antiperspirants work by blocking the sweat gland openings. These plugs become dislodged with more sweat production, and reapplication is needed after a certain amount of time, which may vary by product.

Antiperspirants come in different strengths. You can find both regular- and clinical-strength antiperspirants over the counter (OTC). Prescription antiperspirants are also available if milder strengths are not effective. It's recommended to start with the lowest strength and work your way up, if necessary.

Follow the directions on the product you use, but generally speaking, apply antiperspirants before you go to bed at night, and make sure your skin is totally dry before application. Some products are applied daily, while others suggest a longer space between applications.

Antiperspirants and other topical treatments may cause skin irritation. Talk to your healthcare provider or pharmacist if this occurs.

Microwave Thermolysis of Sweat Glands

Microwave thermolysis treatment uses microwave energy to destroy sweat glands in the armpit. Because only 2% of the body's sweat glands are in the underarm, the body can still cool itself without these sweat glands.

The procedure is done using local anesthetic and does not involve incisions or cuts, just directed energy. A treatment takes about an hour.

The application of two treatments, spaced three months apart, may reduce sweating in the armpit by over 80%.

A brand name of this treatment, miraDry, was cleared by the Food and Drug Administration (FDA) in 2011.

Botox

Botox (onabotulinumtoxinA) for AH involves injecting very small amounts of a weak form of botulinum toxin into many areas of the armpit. It works by temporarily blocking a chemical that stimulates the sweat glands.

Results are usually noticeable about four to five days after treatment. The reduced sweating typically lasts about four to six months. Treatments can be repeated when excessive sweating returns.

It is important to get Botox treatments from a qualified medical provider who has received special training, has experience with the procedure, and is knowledgeable about AH.

Side effects are rare but may include temporary pinpoint bleeding, bruising, and redness at the injection sites.

Prescription Cloth Wipes

Qbrexza, the brand name for prescription cloth wipes containing the active ingredient glypyrronium tosylate, is FDA-approved for people 9 years old and over who have excessive underarm sweating.

One individually wrapped cloth or wipe is used for both armpits once a day. It reduces sweating by blocking the receptors that are responsible for activating sweat glands.

Studies have found that one application daily for four weeks reduced sweat volume by 50% or more in most people. Side effects may include dry mouth and redness, burning, or stinging where the wipe contacts the skin.

Brella SweatControl Patch

The FDA approved the Brella SweatControl Patch in April 2023, and it was scheduled for release in certain areas of the United States in late summer of 2023.

The Brella patch is a prescription and is applied in a healthcare provider's office or clinic. The patch is applied to the underarm. for about three minutes. Water in sweat interacts with the ingredients in the patch and generates a targeted amount of heat, causing microthermal injury to the sweat glands, temporarily inactivating them.

Research has found that sweat production decreased by more than 50% in most treated people, and results have been reported to last two to four months. Noted side effects included slight redness or slight swelling that got better within two weeks.

Type of Deodorant or Antiperspirant With Sweaty Armpits 

Deodorants are not the same as antiperspirants. Deodorants are used to disguise unpleasant odors that sometimes accompany sweating. They contain fragrances and/or antiseptics, but do not contain ingredients that reduce sweating.

Antiperspirants form temporary plugs in the pores that stop the flow of sweat. Antiperspirant products come in a number of forms, including:

• Stick
• Roll-on
• Cream
• Spray
• Wipe
• Powder
  

Clinical-strength antiperspirants tend to work better for AH than regular strength, but they are also more costly. Start with regular-strength antiperspirant and move up to a clinical strength if regular is not effective. If clinical strength still won't cut it, talk to your healthcare provider about prescription antiperspirants.

Nothing Works, But I’m Still So Sweaty

If more conservative treatments haven't helped, see a board-certified dermatologist. These healthcare providers have training in diagnosing and treating excessive sweating, including AH, and can help you explore other options.

If the excessive sweating is severe or doesn't respond to other treatments, your healthcare provider may discuss surgical techniques to remove underarm sweat glands, such as:

• Excision: Cuts out the sweat glands
• Curettage: Scrapes out the sweat glands
• Liposuction: Removes the sweat glands using suction
• Laser: Liquefies the sweat glands
  

Contact your healthcare provider if you have any questions or if your sweating is:

• Excessive, prolonged, or unexplained
  
• Accompanied by chest pain or pressure, shortness of breath, or a rapid, pounding heartbeat
• Occurring with weight loss
• Occurring mostly while you are asleep
• Stopping you from doing your daily activities
• Experienced by other family members or has been in the past
• Occurring while you are on medication for another condition
• Bothering you

Summary

Armpit sweating is normal, but the amount of sweat can be excessive and disproportionate for some people. Excessive armpit sweating is called axillary hyperhidrosis. AH can be primary, often with no known cause, or secondary to another medical condition.

Excessive sweating episodes can have triggers such as heat, emotional response, hormones, and food and drink.

The first recommended treatment for AH is lifestyle changes, along with using antiperspirants. Other treatments may include stress management, microwave thermolysis, Botox, prescription cloth wipes, and the Brella SweatControl Patch.

Talk to your healthcare provider if you are experiencing persistent, excessive armpit sweating.