QuestionMy 13 year old daughter has been treated with Botox injections for hyperhydrosis....this has helped with the sweating. I hoped that it would also help with her terrible underarm odor that she's had since starting her period at age 10, but it hasn't. She plays basketball, softball, etc...activities in which she sweats profusely from the exercise; her odor is almost unbearable; some teammates have even told her that she stinks. I've searched the internet for a remedy, but there are so many "miracle cures" that I am unsure where to turn. We've tried Drysol, cleansing the area with hydrogen peroxide, zinc supplements, dietary changes, antibiotic pads to cleanse the area and kill the bacteria....none of been very successful. I saw something on the internet today about using Listerine to kill the bacteria, but I feel so badly for her as I'm always coming home with a "cure" and she's completely "over" the experiments I've put her through. I also had hormone tests done through our FM doctor, but all were fine. Help!!
AnswerHi Robin,
Hyperhidrosis is certainly a problem that usually begins in either childhood or adolescence. There are three known types of sweat glands, eccrine, apocrine, and apoeccrine glands. Eccrine sweat glands are felt to be responsible for excessive sweating (aka hyperhidrosis). A few research studies have stated that apoeccrine glands may play a role in excessive sweating of the armpits.
Hyperhidrosis is certainly a challenge for both the patient and physician to treat as the root of the cause needs to be addressed. 25% of adolescents with hyperhidrosis have a family history with a genetic susceptibility. Thus, any treatments will not "treat" or "cure" the problem. It may only alleviate the situation. I certainly agree that drysol is not effective with everyone; however, it is the most effective topical agent available. It should be applied nightly on dry skin until a positive result is obtained - may take up to 6 weeks for a positive result. The only major complaints is increase skin irritation or allergic reaction to the main chemical compound in Drysol - chloride hexahydrate. To minimize irritation, the remainder of the medication applied to the armpit should be washed off when the your daughter wakes up in the morning. The armpit area may be neutralized with the topical application of baking soda instead of using regular soap.
Listerine has a combination of alcohol and other agents to neutralize the pH; thus killing any bacteria onsite. However, it is limited and not effective in a highly moisturized environment, such as the armpits.
Botox injections take approximately 12 weeks before seeing a positive result. However, it only result in 25-30% reduction in sweat production in the armpits. The effects will only lasts 7-12months in duration. The only side effect of continual use is the presence of antibodies to botulinum toxin type A that may reduce the effectiveness of botox therapy and mild thumb weakness and muscle weakness at toxin-treated sites that may occur but resolve within 2-5 wk after injection.
Hormone testing is a waste of money and should not have been done as it does not provide better management of the patient.
There is no alternative therapy that has been proven to effectively treat hyperhidrosis. I have been trained in allopathic, as well as traditional chinese homeopathic therapies, and have yet to find any effective longterm treatment for hyperhidrosis. Surgical intervention is an option. However, it is not recommended for adolescents or for the treatment of axillary (armpit) hyperhidrosis since the effectiveness is very low with high risk of permanent adverse effects.
I am assuming that you already have a dermatologist who is managing your daughter's care. The best recommendation is to have your daughter follow up with a dermatologist.
