around your armpits, and when it comes to running gear, choose synthetic materials that wick sweat away from skin.
LET'S GET TOPICAL
For heavy sweaters, underarm relief has come in recent years with "clinical-strength" antiperspirant deodorants. Apply clinical-strength formulas at night when your core body temperature is lower and less variable than during the day. The breakout star in this category is Secret Clinical Strength Antiperspirant Deodorant, Advanced Solid, Marathon Fresh ($9, drugstores), which is designed for athletes. Another option is tried-and-true Certain Dri Antiperspirant Roll-On for Excessive Perspiration ($7, drugstores), which claims to be prescription-strength and last up to 84 hours.
While Botox is an effective--not to mention painful and pricey--method of treating hyperhidrosis, Kunin developed a needle-free alternative inspired by the ubiquitous anti-aging injectable. "The plethora of wrinkle-relaxing agents sprang to mind, and I was convinced that there must be a way to take technology and help reduce excessive sweating," she says. Kunin developed a patent-pending formula that includes high-potency antiperspirant, a blend of agents that mimic the effects of Botox and botanicals, resulting in DERMAdoctor MEDeTATE ($48, sephora), medicated hyperhidrosis-control wipes.
If OTC options haven't done the trick, it's time to see your physician or dermatologist. Before you decide to take drastic measures, make sure your doctor is experienced in dealing with hyperhidrosis.
PRESCRIPTION MEDS Your doctor might prescribe an anti-inflammatory drug, such as Indidral or Indocin, or an anticholinergic drug, such as Ditropin and Robinul. Prescription Drysol should also be applied at night, and is effective while you use it. However, it's so powerful that it can dry and irritate skin on your hands, feet and armpits, and cannot be used on freshly shaved skin.
BOTOX COSMETIC "For the same reason Botox works to eliminate wrinkles, it prevents the nerve from releasing acetylcholine, the neurotransmitter responsible for causing the eccrine sweat gland to go into overdrive, resulting in sweat production," says Kunin. However, "Botox injections can cause bruising, occasional bleeding, temporary muscle weakness and rare allergic reactions." Plus, it comes with a heavy pricetag.
IONTOPHORESIS This electrocurrent therapy involves plugging the sweat gland via a device, such as the Drionic device, which emits electricity through a bath of water to the problem area. This is not a permanent solution, and must be maintained with periodic treatments.
ENDOSCOPIC THORACIC SYMPATHECTOMY (ETS) This outpatient surgery involves cutting the "culprit nerves," according to Knott-Craig, who performs ETS regularly, "immediately stopping the impulses to cause sweating on the hands by 90 percent, feet by 60 percent and armpits by 90 percent." While ETS is a permanent solution to hyperhidrosis, the possible side effect is compensatory sweating. "This means the sweat that previously poured out of the hands, feet and armpits now comes out somewhere else on the body--usually the abdomen or lower back," he says. "With a proper operation, this can be minimized, but it can be a problem in 15 percent of patients."