We’re guessing that Richard Carlson, the author of “Don’t Sweat the Small Stuff … and it’s all small stuff”,  didn’t suffer from hyperhidrosis. If he had, the book probably would’ve been printed on super-absorbent paper and shaped to fit comfortably under your armpit.

Hyperhidrosis is excessive sweating.  That which goes beyond the normal needs to regulate your body temperature, meaning when you sweat, it’s not small stuff. Most afflicted areas are underarms, face, hands and feet. It’s a common condition, estimated to affect 2.8 percent of Americans. It affects men and women equally; occurs across all races and ethnicities, and though it isn’t a serious medical risk, it often significantly impacts a person’s quality of life. Excessive sweating can also take a toll on your skin, making it clammy, dehydrated or even causing infections.

The good news is there are several treatments for the problem, from topical antiperspirants to oral medications to surgery. One of the best developments in the last few years is the use of Botox injections to freeze the nerves, effectively cutting off the signal to the sweat gland. Voila, no sweat.

Botox, or Botulinum toxin type A, is well-known as an injectible facial filler, effectively reducing lines and wrinkles around the forehead, eyes and mouth. The treatment for hyperhidrosis in the armpit involves multiple shots to inject about 50 units of Botox under EACH arm.  The cost will run anywhere from $500-$1,500 for a treatment that lasts an average of five months or so, although it is sometimes covered by insurance plans as a medical treatment, usually after another treatment has been unsuccessful.

Before turning to Botox for hyperhidrosis, doctors will usually recommend trying a clinical strength antiperspirant that contains aluminum chloride hexahydrate first. These are now available over the counter at pharmacies and grocery stores (Drysol, Clinical Secret).  In severe cases, endoscopic thoracic sympathectomy – a minimally invasive chest surgery in which the problem nerves are either clamped or cut – has been a solution.  This is usually a last resort and should always be performed by a board-certified thoracic surgeon.

Botox as a medical treatment added another option to treating excessive sweating, and while it is primarily requested by patients with hyperhidrosis, anyone can use it to stop perspiring. It won’t be covered by insurance, but you won’t be sweating the small stuff anymore, either.

For more information on the symptoms and solutions, we recommend:

• Hyperhidrosis.org
• A Sweat Management site out of Canada (do they ever get warm enough to sweat?)
• RealSelf always several doctors who give different perspectives.