Breaking down three ways to reduce underarm sweat—and which one works best.
The month was July: the temperature was 91°F and the humidity was a whopping 70 percent. As I headed out the door in my new favorite outfit—a pair of high-waisted blue and white seersucker trousers with a pale yellow Dolce & Gabbana sleeveless blouse tucked in—I felt on top of the world. Then, after two blocks of walking and three subway stops, I arrived at my rooftop party destination drenched. My silk top, once the color of a perfectly ripe banana hue, now looked browned like the outside of a kiwi. I was so embarrassed by my sweating that I threw a sweater over my ensemble, despite the scorching heat. The addition shielded me from further humiliation but really only made matters worse for my beloved blouse, and by the time I returned home, the top was so heavily stained that even New York’s top dry cleaners couldn’t bring it back to life.
I’d love to say this was an isolated incident, that I was only sweating so profusely because of the unusually high temperatures, and that my darling Dolce was the only item of clothing I ruined last summer. but the truth is, this was an almost daily occurrence. Even during the city’s freezing winter months, when I’m bundled in layers of warmth, I find myself actively avoiding light colored tops, knowing my underarms will look darkened with sweat within minutes.
I was never formally diagnosed with hyperhidrosis, the excessive sweating disorder that plagues an estimated 365 million people around the world, but I decided that sartorially shunning half of the rainbow, (especially since I pride myself on being one of few New Yorkers who actually wear color) was simply not sustainable. It was time to do something. I put my research skills to use and read up on all the most common causes and solutions for extreme perspiration, I spoke with people who had similarly suffered, and I even consulted a couple medical professionals.
Sweat solution #1: clinical-strength antiperspirant
I decided that the best course of action would be to try a clinical-strength, aluminum-heavy antiperspirant. Of course, most over-the-counter antiperspirants count some derivative of aluminum (usually aluminum zirconium tetrachlorohydrex gly) among their ingredients, since the metallic complex reacts with the electrolytes in sweat to form a sort of gel “plug” that blocks sweat glands from excreting liquid; however, antiperspirants with higher concentrations of aluminum require a prescription, and, as I learned the hard way, they have very harsh side effects like extreme irritation on skin. That’s why when I heard about Dr. Sweat, a new clinical strength antiperspirant that boasts 15 percent aluminum chloride— the highest protection available without a prescription, I knew I had to try it.
Like many other similar sweat solutions, both OTC and prescription, Dr. Sweat comes in the form of pre-soaked pads. A jar of the product, currently available for pre-order at about $19 on Amazon, includes ten pads. This may sound like too few for the price—after all, who would want to spend almost $60 a month?—but, as the instructions make clear, one pad can provide up to a week of protection. During the first week of use, it is recommended that users apply Dr. Sweat three evenings in a row to build effectiveness, but a single application should do the trick thereafter.
I opened the creamsicle-y orange jar and wiped away any excess deodorant and dirt from the day, then I pressed a pad to one underarm then the other using the same pad, and held it there for no more than 30 seconds. Just as the instructions advised, I waited five minutes or so before putting on my pajamas so that my skin could air dry, and then I went to sleep. The next morning, I reluctantly decided to forgo the deodorant so I could properly gauge Dr. Sweat’s capabilities, and I headed to work. My expectations were fairly low, given my previously mixed luck with supposedly more potent prescription antiperspirants, but when I’d gotten through the entire day (wearing white, no less!) without so much as a drop of sweat, I was astonished. There was simply no denying it: This stuff really worked.
I continued using the Dr. Sweat pads throughout the week, following orders to apply three nights in a row and then wait seven days, and to my continued shock, I remained bone dry. The product was as effective as could be, but I sadly noticed a few days in, that the same irritation I once felt with the prescription antiperspirants returned. I do have unusually sensitive skin, so it’s likely that others who use Dr. Sweat would not experience similar effects, but I soon noticed how itchy and red my underarms were after application. I even awoke in the middle of the night at one point because the itchiness was so bothersome, and my skin began to develop slight hyperpigmentation. I decided at that point that, despite my amazing results with Dr. Sweat, my skin was simply too sensitive to continue.
Sweat solution #2: Botox injections
At this point, I began exploring other options and quickly landed upon the increasingly popular Botox solution. As Dr. Adam Luber, a Scottsdale dermatologist who regularly treats hyperhidrotic patients with the famed wrinkle-reducing injectable, tells me, “Botox is one of the most effective treatments for excessive sweating.” The toxin works on muscles, he explains, by blocking the release of acetylcholine, the chemical messenger that our nerve cells release to activate sweat glands. Each underarm is treated with between 15 and 20 injections, each about five to 10 millimeters from the next, and the entire procedure only takes half an hour. The Botox typically takes effect within five to seven days, and most people experience an 82 to 87 per cent decrease in sweating.
But, the treatment is not without its drawbacks. Botox does not work on odor glands, so even those who experience little to no wetness will still need to use a deodorant for scent. The injectable also comes with a hefty price tag, usually between $1,000 and $1,500 per session, and not all insurance covers it. “It’s very tolerable in the armpits,” says Dr. Luber, but use in other parts of the body, like the hands and feet, both common hosts for hyperhidrosis, can be extremely painful. Finally, the effects of Botox only last four to six months, which makes the treatment not only feel a bit like a chore but also very expensive, costing as much as $4,500 each year, if insurance does not cover it.
Sweat solution #3: miraDry
I decided Botox wasn’t for me—I mean, I can barely remember to go to the dentist twice a year—but I still couldn’t bare the thought of another sweaty summer. That’s when a friend told me about miraDry, a procedure that uses thermal energy (the same energy that’s found in your microwave) to target and permanently (and immediately) eliminate sweat and odor glands. I immediately scheduled an appointment at Luxurgery with Dr. Sachin M. Shridharani, a leading Upper East Side plastic surgeon, who offers the perspiration-reducing treatment, and a few weeks later, I was in his office.
We spent a few minutes going over my concerns, and he soon determined that I was indeed a candidate for miraDry. Dr. Shridharani explained that the FDA-approved technology is not only popular among hyperhidrotic patients, some who were previously using maxi pads and wads of toilet paper to absorb sweat, but also those he called “lifestyle” patients. The surgeon’s health-conscious nurse, Kasha, for example, is a vegan and routinely found herself questioning the daily use of chemicals on her body just to temporarily decrease sweat and mask odor. “That’s really where miraDry comes into place,” says Shiridharani. “It’s a permanent solution that uses microwave technology to heat the skin to a critical temperature or threshold to destroy the sweat glands, the odor-producing glands, and [added bonus!] the hair follicles.” Needless to say, I was sold.
Kasha, who would ultimately be the one administering my miraDry, led me into a treatment room and had me take my shirt off and slip into a robe. She snapped a few photos of my underarms for their record, sanitized my skin, and applied a temporary tattoo grid to the area so she could map out the injection spots for local anesthesia. Next, she doled out the numbness to my right armpit, injecting about 20 pricks’ worth of anesthesia over the course of ten or so minutes. This was honestly the most painful part of the whole procedure, with some spots hurting far more than others, but it was completely tolerable, and I felt the injections less and less as the region became increasingly numb. Kasha continued with my right side and wheeled out the miraDry machine, which resembled any number of devices one might find at a dermatologist’s office. The nurse warned me that I might feel some suction but should feel nothing beyond that, and she applied the device directly to my skin for about 20 minutes. I felt nothing. I was given an ice pack to tuck under my right underarm afterwards, and she repeated the numbing and treating on my left side. A few minutes of icing after that, and I was all done within an hour and a half of arriving at Luxurgery.
Kasha told me that I should continue icing right away and to take some ibuprofen every few hours to reduce swelling. I wouldn’t feel much for the rest of the day since the anesthesia would take a while to wear off, she explained, but by the next morning, I might experience some swelling, bruising, and sharp pains. I schedule my one-week follow-up with the front desk and headed home.
Something that should definitely be noted here is that I very much like to think of myself as tough and usually for good reason. I have a super high pain threshold—a bikini wax won’t warrant so much as a flinch—and my body typically responds well to any kind of treatment, making for fast and easy recoveries. With this in mind, I ignored all advice to take it easy that evening and kept my dinner plans with a friend. When I began walking to the restaurant, though, five or so hours after my miraDry, I felt my numbness start to fade and swelling take its place. Soon enough, I felt like a linebacker, my arms separating from my torso more than ever before. By the time the appetizers arrived, the shooting pain had too, and I quickly regretted not yet taking a couple Advil. I returned home and ripped off my shirt as I walked through the door, eager to see how huge my underarms were. It felt like I had four breasts, and I was sure it would look like it too, but when I looked in the mirror, I saw that the swelling wasn’t actually that bad. I iced the rest of the night, and when I woke up the next morning, I was very happy it was a Sunday and I wouldn’t have to face the world, or sleeves for that matter.
A few days later, the swelling had vastly subsided, and I felt not even the slightest tinge of pain. I was still fairly bruised, and hard nodules were starting to develop in each under arm, an occurrence that Kasha had luckily warned me about, telling me not to worry and that they’d be gone within a few weeks. I was still slightly numb, but totally free of any sweat.
At my one-week check-in, to which I’d walked 25 blocks without so much as a bead of sweat, both Dr. Shridharani and Kasha noted how well my recovery was going and showed me how to massage the nodules so they’d go away more quickly. They reminded me that miraDry patients typically experience about 82 per cent sweat reduction and 89 per cent odor reduction immediately after just one treatment of miraDry but noted some people who are on the higher spectrum of hyperhidrosis might require a second or even third session. Those who do need a second time in the hot seat usually do so six to eight weeks after their first treatment, Dr. Shridharani explained, so we could assess whether it was necessary for me when I return for my six-week check-in next month.
My winning solution: miraDry
Just over a week after getting miraDry, my underarms were still bone dry. I hadn’t used any antiperspirant or even deodorant, and I’d worn plenty of light colors. I had to wait few more days before wearing a sleeveless top since I was still slightly swollen and discolored, and Dr. S has warned of the possibility that some sweat may return. But, I am so far extremely happy with my results, and just about every one of my family members and friends now wants miraDry too.
The treatment, like Botox, comes at a high price, with most providers charging around $2,000 for a single session and sometimes even more. Even though the procedure is FDA-approved for hyperhidrosis, it is not covered by insurance, so the high cost can absolutely be a deterrent, but in my opinion, you really can’t put a price tag on miraDry’s efficacy and the pain, embarrassment, and suffering it saves patients as a result.