Beauty In The Bag talks to Reflections’ Center medical director Mitchell Chasin, MD, and New York City plastic surgeon Elliot Jacobs, MD, about curing the vexing condition that affects as many as 3% of people including Real Housewife of New York Ramona Singer. We are talking about excessive underarm sweating. And when we say cure, we mean no sweat!
Extreme, profuse underarm sweating – and not just the kind that you get when you’re lifting weights or sitting out in the sun —can be more than just a little embarrassing, it can really hinder your quality of life and ability to hold a job or maintain an intimate relationship. Not to mention, you will make your dry cleaner very, very rich in the process.
When your sweat glands go haywire, it can affect your armpits (axila) as well as your hands and feet. Statistics show that primary hyperhidrosis affects 2% to 3% of the population including Real Housewife of New York Ramona Singer (who bravely received treatment on the air).
It’s also not just a macho guy thing; many women complain of sweaty armpits too. “This is a very common problem and people don’t talk about it because they are embarrassed and don’t think anything can be done,” says Mitchell Chasin, MD, the medical director of Reflections, Center for Skin and Body, in Livingston and Bridgewater, NJ. “People with excessive underarm sweating don’t buy just one shirt, they buy six of the same shirt so no-one realizes they keep changing.”
The sweating affects their social life, their job choice and has even been associated with depression. “They don’t go out when it is warm,” he says.
Put another way: hyperhidrosis really runs and ruins their lives. “It’s a big, big deal,” he says. Despite this, just 40% of people actually seek help for their excessive sweating.
But Chasin and a handful of other doctors are helping people with excessive underarm sweating get their lives back. Liposuction-based procedures such as Axilase and Sweat Lipo are essentially cures for hyperhidrosis and fill in many of the gaps left by other effective treatment options including Botox, Dysport or Xeomin injections.
No Sweat? No Problem!
The first line of therapy is always over-the counter and prescription-strength antiperspirants, which plug the sweat ducts. OTC products contain 10% to 20% aluminum chloride hexahydrate, but higher dose versions are available by prescription. Certain oral prescription drugs may also help some people with hyperhydrosis some of the time, he says.
A surgery called sympathectomy works by turning off the signal that tells the body to sweat excessively. Sounds promising, but “this sometimes causes an increase of sweating in other areas,” says Chasin.
Botox – the very same injectable that helps paralyze frown lines– is also FDA-approved to stop excessive underarm sweating. But, Chasin says, it’s expensive, only lasts for six weeks and you never know where you will be when it stops working.
Still “if someone has mild sweating that is not that problematic, Botox is fine,” he says.
For those with problematic sweating (and you know who you are), doctors went back to the drawing board and experimented with ultrasound, lasers and just about anything else they could find.
“These either didn’t work or had side effects such as scarring, nerve injuries or burns,” he says.
Hyperhidrosis may have met it’s match with the new liposuction-based treatments. The latest – and some say greatest – treatment for excessive underarm sweating has none of these issues and is actually a cure, says Chasin.
Axilase is a one-time laser lipo procedure that targets excessive underarm sweating. It is performed using local anesthesia and involves just one or two days of downtime. “The laser energy is absorbed right under the dermis and there are no vital structures there,” he says. Thus, there is no risk of injury. Chasin is such a fan of the procedure that he opened up a clinic in New York City that exclusively offers the treatment utilizing Palomar Medical’s SlimLipo system.
During the Axilase procedure, the doctor makes two small incisions on the outer edges of the armpit and fills the area with tumescent numbing fluid. Then the laser is passed through the area, destroying the sweat glands. Your doctor then suctions out the debris. Axilase treatment takes about one hour.
“This is a permanent treatment for underarms,” he says. “My goal is that these people sweat like everyone else,” he says. AxiLase treatment typically costs around $3,000 depending on the size of the treated area.
Meet Sweat Lipo
Elliot Jacobs, MD, has made a lot of people with hyperhydrosis very happy with “Sweat Lipo” surgery. During this procedure, Jacobs uses traditional liposuction to remove the sweat glands.
“We are not shutting of the brains signals to the sweat glands, we are just taking away the glands so they can’t respond to the sweat signals,” he says. The area may be sore for a day or two after treatment, but most people don’t need anything stronger than Tylenol. “They come back a few days later and they have a smile on their face and they are dry for the first time,” he says. Sweat lipo costs about $4,250.
“You will sweat like a normal person and your condition will be made much more manageable because you won’t soak your shirt three times a day,” he says. Some other surgeons are using Vaser or ultrasound-assisted liposuction to get rid of overactive sweat glands.
The bottom line? You don’t have to live with excessive sweating any longer. Help is available.