1. Often, the method of first choice in treating this condition is to try the use of prescription medication called Drysol. The Drysol is applied with very specific instructions at bedtime to the sweat prone areas. It is important to consult with a dermatologist regarding the specific instructions for application of this medicine so as to minimize the chance of irritation and maximize the effectiveness of the treatment.
2. Iontophoresis is another approach to controlling excessive sweating. Iontophoresis produces pore closure and controls sweating. The machine used to effect this treatment is called a drionic unit. These machines can be purchased by calling 1-800-DRIONIC.
3. A new treatment for excessive sweating, which is very effective and long lasting, is currently under FDA evaluation and is available from many dermatologists as an off-label treatment. The use of BOTOX (purified botulinum toxin) has been shown to be very safe and extremely effective in the treatment of excessive sweating of both the palms and under arm areas. The effects have been shown to last between six and twelve months. The downside is that BOTOX is an expensive toxin and the treatment is rather tedious. Expect to pay $600 to $1000 for treatment of either the palms or the under arm areas.
4. In the case of severe refractory cases, surgical treatment is still sometimes considered. For excessive sweating in the under arm area, excision of the sweat gland bearing skin can be performed and is effective. In the rare patient, who has socially or occupationally devastating excessive sweating of the palms, and fails to respond to local measures, a special surgery can be performed in which the nerves that control the sweating of the palms are cut. This treatment requires a neurosurgeon especially experienced in this type of treatment. This treatment is only recommended for the palms and only in rare cases. It is not appropriate for the treatment of the under arm area.

In summary, it is reasonable to consider treatment of excessive sweating of the under arms, palms or soles, particularly when the problem becomes occupationally or socially disturbing. Although there are many surgical and medical treatments for this condition, BOTOX seems to be one of the most promising given it long acting effectiveness. Although the cost of BOTOX is expensive, the great relief provided by this treatment and the savings in terms of laundering and damaged clothing when used in the treatment of excessive under arm sweating can make this treatment worthwhile for many patients. As BOTOX for under arm sweating is still considered an experimental treatment, which is not as yet FDA approved, most insurance companies will not cover BOTOX treatment for excessive sweating at this time.