Hyperhidrosis of the Axillary Region

Pretty Under Your Arms

Who could benefit from treatment?

It is simple – anyone who is bothered by excessive sweating. I don’t believe there is a magic number. You may have to change your shirts several times per day. You avoid colored shirts because when you sweat through it is embarrassing. No doubt, you have tried several different types of deodorants and anti-perspirants to no avail. On the other hand, you may just prefer that you sweat less in your armpits.

What treatments does Dr. Berman offer

If you have tried a variety of over the counter remedies and still are not satisfied, you may want to consider:

A) Botox

It takes less than 30 minutes. I inject about 50 units of Botox per axilla with a very small needle. You can return to work or the gym the same day. Within a few days, the sweating will decrease dramatically. In my experiences patients are finding the dryness lasts more than 6 months. This does not mean that everyone (though I certainly have had patients who have had absolutely no sweating) will have absolutely zero sweating but it should dramatically decrease your sweating. I cannot guarantee an exact amount of time that the benefit will last but in my patients it has been 6-10 months. The cost is $1,000. You should avoid taking aspirin or aspirin containing products or blood thinners before the procedure. You should not be pregnant.

B) Cellulaze

Severe sweating is an embarrassing problem, which can stain clothes, as well as hinder you in business and social interactions. This is an off label use for this product. Normally the Cynosure system is used to treat both unwanted fat (Smart lipo) or Cellulite (the Cellulaze system). It has been discovered (I can’t take credit for this discovery) that if the Cellulaze energy is directed just beneath the skin and directed sideways, the sensitive sweat glands are affected and stop working. Cellulaze is the least invasive treatment method, which may offer a long lasting solution to this embarrassing problem. No one knows how long the benefit will last but there are patients who still have significantly decreased sweating 3.5 years later (This is the data that has been recorded by Cynosure) The procedure is quite simple and very similar to what I do when I do cellulaze treatments for cellulite on the legs. A numbing solution is injected in the underarm and then a very tiny incision (1/8 inch) is made in the skin. A laser is then inserted and used to deeply heat the underlying dermis and surrounding tissue. It is this heat that shuts down sweat production in the gland, solving even the worst hyperhidrosis problem. Cellulaze for hyperhidrosis is performed in the office under local anesthesia. The procedure takes 30-45 minutes and you can return to your normal everyday activities the same day. Please make sure that you eat before you come to the office. There are no IVs. The vast majority of patients will not want any sedation but if you know you will be nervous, allow me to give you some oral medication ahead of time to help relax you (you must have a driver if you elect to take oral sedation). If you don’t take any sedation then you can drive yourself.

What can I expect after surgery?

That evening you will leak some fluid from your armpits (not all patients leak but definitely can happen and the two sides may leak differently). You should have very little discomfort; however I will give everyone a few pain killers in case you need them. Some patients will stop sweating immediately. For others it may take several days or even weeks. Some people will experience numbness in the armpit area that can last for a few weeks or months. Others may have some bruising or tingling. Sometimes one armpit may respond better than the other. The surgery is designed to be a single treatment but some individuals may require a second treatment. Not every person will respond to this treatment but most all my patients have had great results.

Disclaimer: Results may vary for different individuals.

Previous Next
Previous Next
RealSelf Q&A with David E. Berman, MD

Ready to take the next step? (703) 406-2444