Why Are My Armpits So Sweaty? How to Stop It

Excessive sweating under the armpits, also called axillary hyperhidrosis (AH), can be caused by lifestyle factors, including alcohol consumption, smoking, stress, or the consumption of certain foods or beverages, like spicy dishes and caffeinated drinks. There are also medical causes of hyperhidrosis including hormonal changes, having a family history of excess sweat, or certain medications.

Lifestyle changes and over-the-counter treatments can be effective in treating hyperhidrosis. Antiperspirants, stress management, and avoiding certain foods can help. When these options are not effective, medical treatments including botox, prescription antiperspirants, and surgery are also available in some cases.

Common Causes

Several factors can lead to excessive sweating. Some factors are controllable, while others are not.

Heat

Sweating in response to heat or humidity, 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.

Stress

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. Regular hormonal changes during different stages of life have been associated with excessive sweating.

• 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 (which 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

Some people also believe that eating meat can lead to a condition commonly called “meat sweats,” but researchers debate whether or not this is a real condition. Studies supporting meat sweats are lacking.

Smoking

Tobacco smoking has also been associated with hyperhidrosis. At least one study has shown that hyperhidrosis is common among cigarette smokers. Some researchers suggest that it may be nicotine that causes problems. For example, in one published case study, a 45-year-old man found that his excessive sweating cleared up after he quit using nicotine patches.

However, there is a shortage of research investigating the relationship between smoking and sweating, So it is unclear if smoking causes the condition or if AH is more common in smokers for other reasons.

Hyperhidrosis

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 Hyperhidrosis

Primary AH characteristics include:

• Overactivity of an area of the brain known as the hypothalamic thermoregulatory center.
• Having a cause that can’t be determined.
• Association with a genetic component, with a family history present in up to 30% of cases.

Secondary Hyperhidrosis

Secondary AH is excessive sweating that 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, such as fibromyalgia or chronic fatigue syndrome.

How to Manage Armpit Sweat

Managing excessive underarm sweating depends on the cause and the severity of the symptoms. Sweating can often be controlled with 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:

• Avoiding triggers such as caffeine or spicy foods.
• Avoiding alcohol.
• Quitting smoking or the use of nicotine patches.
• Staying hydrated throughout the day to keep your body cool.
• Talking to your healthcare provider about changing medications that increase your sweating.

Some hygiene practices may also be helpful to manage excess sweating. For example, changing your shower and dressing routine may help.

Consider:

• Using a non-soap cleanser.
• Waiting between the time you get out of the shower and get dressed to allow your body to cool.
• Shaving your armpits regularly.
• Applying cornstarch after your bath or shower.
• Wearing loose-fitting, stain-resistant clothes.
• Changing your clothes when they become damp.

Stress Management

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)

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.

Antiperspirant products come in a number of forms, including:

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

You can find both regular- and clinical-strength antiperspirants over the counter (OTC). 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. 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.

When to See a Healthcare Professional

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

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, dizziness, 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

Medical Treatments

Your healthcare provider will discuss your medical history with you, evaluate your symptoms and make recommendations to help reduce sweating. Suggested medical treatments may include medication wipes, Botox, sweat control patches, microwave thermolysis, or surgery.

Prescription Cloth Wipes

Qbrexza, is the brand name for prescription cloth wipes containing the active ingredient glypyrronium tosylate. It 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 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.

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.

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.

Surgery

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

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.

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.