Excessive Underarm Sweating? There’s Actually a Fix (That Works)
If you’ve ever changed your outfit three times before leaving the house, skipped the silk blouse, or kept your arms pinned to your sides in a meeting — you’re not imagining it, and you’re not alone.
Excessive sweating has a name: hyperhidrosis. It’s more common than people think. And more importantly, it’s treatable.
So what actually works?
Neurotoxin — the same family of products as Botox and Xeomin — works by blocking the nerve signal that tells your sweat glands to turn on.
No signal, no sweat.
It’s simple, targeted, and honestly one of the most satisfying treatments we offer. Patients don’t just feel a little better — they tell us it’s life-changing.
What to expect
- Treatment takes about 20–30 minutes
- Starts working in 3–7 days
- Full results in about 2 weeks
- Lasts 4–6+ months — often longer in the underarms
Most patients notice a dramatic reduction in sweating, not just a small improvement. In a 2024 prospective study, patients treated with neurotoxin for axillary hyperhidrosis saw sweat production drop by more than 70% over one year — and reported a dramatic improvement in quality-of-life scores.
How dry is “dry”?
This isn’t about eliminating every drop of sweat forever — your body still needs to regulate its temperature. It’s about reducing sweating enough that:
- You stop thinking about it all day
- You stop planning outfits around it
- It stops dictating how you show up
Does it help with body odor too?
Short answer: yes — often significantly.
Technically, sweat and body odor come from two different types of glands. Neurotoxin specifically targets the eccrine and apoeccrine glands (the ones producing watery sweat), not the apocrine glands (the ones associated with odor). So on paper, it shouldn’t touch odor at all.
But in practice, patients consistently report their body odor improves right along with their sweating. Why?
Bacteria need moisture to thrive. Less sweat means a less hospitable environment for the bacteria that break down apocrine secretions into the compounds we perceive as odor. The research backs this up — a landmark study in JAMA Dermatology found that neurotoxin-treated underarms were rated as significantly less intense and more pleasant in smell compared to untreated sides. A later study found body odor was eliminated in 73% of patients treated for axillary bromhidrosis with botulinum toxin.
So while we don’t promise it as an odor treatment specifically, most patients tell us the smell improvement is a very welcome side benefit.
What about other options?
You actually have more options than you might think — and the research on energy-based treatments has grown significantly in recent years. Here’s the honest breakdown:
Clinical-strength antiperspirants — A reasonable first step, and sometimes required for insurance documentation. For true hyperhidrosis, most patients find them inadequate on their own.
Oral medications — Anticholinergics like glycopyrrolate can reduce sweating systemically, but often come with side effects like dry mouth, blurred vision, and fatigue. They also affect sweating everywhere, not just the area you’re targeting.
RF Microneedling — Unlike neurotoxin (which blocks the signal), RF microneedling actually damages the sweat glands themselves — offering the possibility of long-term or even permanent sweat reduction. Studies show it can achieve 50%+ sweat reduction in roughly 80% of patients. The trade-off? Multiple sessions are typically required, it’s more uncomfortable than Botox, and head-to-head trials still favor neurotoxin for efficacy, comfort, and cost. We offer RF microneedling at Soulshine and love it for the right candidate.
Ultherapy (Microfocused Ultrasound) — Also works by permanently damaging sweat glands, this time through focused ultrasound heat. Pilot studies show ~67% of patients respond positively, with results lasting 12+ months. This is a strong option for patients wanting a “one-and-done” approach with no injections. Ultherapy is part of our treatment menu at Soulshine, and we’ll walk you through whether you’re a fit during consultation.
Surgery (sympathectomy) — Permanent, but invasive. Can cause compensatory sweating in other body areas. Rarely recommended as a first-line approach anymore.
Why neurotoxin is still our go-to first-line treatment
Neurotoxin is:
- FDA-approved for axillary hyperhidrosis since 2004
- The most studied treatment for this condition — decades of data, hundreds of trials
- Low downtime — 20-minute appointment, back to your day immediately
- Highly predictable — most patients see dramatic reduction, not small improvement
- Lower up-front cost than energy-based treatments
If your goal is simple — “I just want this sweating to stop” — this is the best-studied, most predictable tool we have.
That said, for patients who want a potentially permanent solution and are willing to invest more time and money up front, RF microneedling or Ultherapy are absolutely worth a conversation. We offer both at Soulshine, and during your consultation we’ll talk through which approach fits your goals.
Is it safe?
Yes. Neurotoxin has a strong safety profile when performed by a trained medical provider. It’s been FDA-approved for axillary hyperhidrosis since 2004, backed by large randomized clinical trials — including a landmark 320-patient study that served as the basis for approval. It’s been used therapeutically for decades across both medical and cosmetic applications.
The lifestyle difference
Picture your workouts, your workdays, your nights out — without constantly thinking about sweat stains, without the mental load of managing it, without the wardrobe workarounds.
That’s what this treatment gives people back.
The investment
Treatment at Soulshine is $750 for both underarms and is typically only needed 1–2 times per year.
Hyperhidrosis treatment also often qualifies as a medical expense through HSA/FSA accounts — ask us for documentation if you’d like to submit for reimbursement.
The bottom line
You don’t have to live around excessive sweating.
At Soulshine, we focus on treatments that genuinely improve quality of life — not just how your skin looks, but how you feel in it. And we’ll always give you the full picture of your options — from the simple and time-tested to the cutting-edge — so you can make a decision that fits your life.
If this sounds like you, let’s talk through whether it’s a good fit.
References
- U.S. Food & Drug Administration. BOTOX (onabotulinumtoxinA) Prescribing Information.
- International Hyperhidrosis Society. “Botox for Hyperhidrosis.” sweathelp.org
- Naumann MK, Hamm H, Lowe NJ; Botox Hyperhidrosis Clinical Study Group. Effect of botulinum toxin type A on quality of life measures in patients with excessive axillary sweating: a randomized controlled trial. Br J Dermatol. 2002.
- Bechara et al. Assessing Botulinum Toxin Effectiveness and Quality of Life in Axillary Hyperhidrosis: A One-Year Prospective Study. 2024.
- Abtahi-Naeini B, et al. Long-term efficacy of fractional microneedle radiofrequency versus botulinum toxin-A in primary axillary hyperhidrosis: a randomized controlled trial. 2024.
- Nestor MS, Park H. Safety and Efficacy of Micro-focused Ultrasound Plus Visualization for the Treatment of Axillary Hyperhidrosis. J Clin Aesthet Dermatol. 2014.
