Sweaty armpits

Victorians sponged their armpits with sulphuric acid, a potentially dangerous treatment In the 1950s, you might have been sedated with barbiturates or given a course of X-ray treatment for this embarrassing problem According to the French newspaper Le Figaro, only 47% of French people shower or bathe every day compared with 70% of Britons and 80% of Dutch, Germans and Scandinavians. But the French are Europe's biggest consumers of perfume and deodorants

What you can do for sweaty armpits

Avoid pungent foods such as onions, fish, garlic and spicy meals. These foods can be smelt in sweat and make it more noticeable.

Malt vinegar is an old-fashioned remedy that might be worth a try. Apply some to your armpits at night. Wash it off in the morning and then use your normal deodorant/antiperspirant.

Commercial antiperspirants. You have probably tried most commercial deodorants and antiperspirants, but check the labels and look for one with a different active ingredient. If you have heard a rumour about antiperspirants/deodorants and breast cancer, take a look at the section on antiperspirants and breast cancer.

Shave your armpits. Hair holds sweat and gives the bacteria more to work on.

20% aluminium chloride is the next thing to try if ordinary antiperspirants have not done the trick, but it can damage clothing. It can be bought from the pharmacist (ask for Drichlor, Anhydrol Forte, Odaban or Perspirex) and should be used as follows.

• Before going to bed, wash and dry your armpits thoroughly. If you apply the solution to wet skin, a chemical reaction produces hydrochloric acid, which can irritate skin and tarnish jewellery. If necessary, use a hair dyer to ensure your skin is absolutely dry.
• Apply the solution when you are lying down in bed. This sounds odd, but armpit sweating switches off when you lie flat, and the solution will be more effective if applied then. The solution works by passing into the openings of the sweat glands, causing them to swell up and block, but if sweat is pouring out of the glands when you apply the solution, it will not be able to get in.
• It works best if the area is covered with plastic cling-film (food wrap). Unfortunately, the armpit is an awkward shape. Use tape (such as Micropore, which you can buy from a pharmacy) to hold the plastic wrap in place, then put on a tight-fitting T-shirt to help keep it in position.
• Do not apply the solution directly after shaving, or the skin may become sore.
• Wash off the solution in the morning, and do not reapply until bedtime.
• If it proves effective reduce the application to every other night, and then to once or twice a week. Do not use it every day, because it can irritate the skin.
• If it causes irritation, applying 1% hydrocortisone cream twice a day for not more than 2 weeks can help.

What doctors can do for sweaty armpits

Botulinum toxin (Botox, Dysport) is a powerful poison, but injections of very tiny doses into the skin stop excessive sweating.

• The injections are painful, but the pain is tolerable. Treatment takes about 30–45 minutes.
• Botulinum toxin works by inactivating the nerves that trigger sweat-gland activity.
• One treatment of about 12 tiny injections stops or substantially reduces armpit sweating for 2–8 months. After that, a repeat session will be needed.
• This is a fairly new treatment, and is not available in all hospitals, but your doctor will be able to find out the location of the nearest specialist treatment centre.
• It does not work for everyone, but about 9 out of 10 people respond (Drug and Therapeutics Bulletin 2005;43:77–80).
• People who have had this treatment say that it greatly improves their quality of life (British Journal of Dermatology 2004;151:1115–22).
• As you would expect, this treatment also reduces the smelliness of the armpits (Archives of Dermatology 2003;139:57–9).

A sympathectomy operation to destroy the sympathetic nerves that control sweating, often by keyhole surgery, is almost the last resort.

• A general anaesthetic is required.
• The sympathetic nerves lie in the chest just under the second, third and fourth ribs on each side. The surgeon operates through an incision in the chest wall and cuts the nerves or destroys them using an electrical current.
• After the operation, you can return to a sedentary job after 1–2 weeks, and to a manual job after 2–3 weeks.
• The immediate success rate is almost 80%, but after a few years only one-third of people who have had the operation are satisfied (Drug and Therapeutics Bulletin 2005;43:77–80).
• The main drawback is that the body may compensate by increasing sweating elsewhere – usually the trunk, but sometimes the feet – so you may end up swapping sweaty armpits for a sweaty abdomen. This happens in between one-third and three-quarters of people who have had the operation. In 1 in 100, this ‘compensatory’ sweating is very severe, and they regret they had the operation. Unfortunately, the operation cannot be reversed.

Liposuction and subcutaneous curettage are methods of removing sweat glands from the deep layer of skin. They do not always work, and there may be bruising or scarring.

Surgical removal of some skin from the armpit is the final option. It can be dramatically effective, but can cause scarring so is rarely performed nowadays. Under a local anaesthetic, the surgeon removes a section of skin about 4 x 1.5 cm in size, taking away the most troublesome sweat glands.

• Sweating
• Sweaty feet
• Sweaty hands
• Sweating and hot flushes – look at our Blushing & flushing section
• Sweating when you are anxious – look at our Shyness section
• Night sweats
• Pheromones
• Antiperspirants and breast cancer
• Useful contacts