Sweating is a natural response of the body to regulate its internal temperature. Sweating happens when the body is exposed to a warm environment, when one is engaged in physical activity, and when anxious or stressed. But excessive sweating for no apparent reason can be embarrassing. In the case of axillary hyperhidrosis, underarm sweat leaves a visible stain on clothes, and often, the underarms are damp and sticky.

There are two types of glands found in the armpit area – the apocrine and eccrine glands. Of the two, the eccrine glands are the ones mostly responsible for producing underarm sweat. Numerous eccrine glands are also found in the entire body, which likewise cause perspiration when the glands are stimulated. Whenever the eccrine glands are stimulated to produce sweat, body cells secrete a fluid that travels the coiled portion of the gland up through the straight duct before it breaks out onto the skin surface.

If you suffer from excessive underarm sweating, a dermatologist can best diagnose the severity of your condition. Be ready to discuss with your dermatologist your medical background, your family’s medical history, and when you first experienced severe underarm sweating. Don’t hesitate to tell your dermatologist how your condition affects you. The extent to which severe hyperhidrosis is affecting your normal day-to-day activities can be measured through a self-assessment questionnaire called Hyperhidrosis Disease Severity Scale (HDSS). Your honest self-assessment report should help your doctor determine the best options available for you.

In most cases, excessive underarm sweating can be effectively managed by using topical agents such as deodorants and antiperspirants. Deodorants act to control bad odor, while antiperspirants slow down the production of sweat by the glands in the armpit area.

The most common active ingredient in anti-perspirants (and deodorants) is aluminum chloride. According to Dr. Eric Hanson of the University of North Carolina’s Department of Dermatology, the aluminum ions (from antiperspirants) are absorbed by the cell linings of the eccrine gland ducts found at the opening of the top skin layer (epidermis). These ions are drawn into the cell along with water until it swells, squeezing the ducts closed such that sweat can’t pass out. A cell can only absorb so much fluid, or until it reaches its equilibrium. At this time, the water will have to revert back out of the cell through a process called osmosis, and swelling will subside. When this happens, anti-perspirants may be re-applied.

As a point of reference, over-the-counter antiperspirants usually have 10 to 25% concentration of the active ingredient (aluminum chloride). While the FDA requires no more than 15 to 25% of the active ingredient in antiperspirants, it should decrease sweating by at least 20%. Obviously, no prescription topical agents or antiperspirants are available in the market that has a higher percentage of concentration of the active ingredient than that allowed by the FDA. It is still best to discuss other alternative treatments available with your doctor if over-the-counter antiperspirants prove ineffective for you.

Some people who excessively sweat may need higher concentrations of aluminum chloride to prolong the swelling of the cells and eventually shrink the sweat glands so that they don’t produce sweat than is really necessary.