Excessive underarm sweating or axillary hyperhidrosis is a common condition that can be safely & effectively treated with treatments covered under Medicare. For less than two dollars a day, you can be sweat free. Dermatologists inject a TGA approved anti-sweat molecule, similar to the ones used to treat wrinkles.
Key Points
- Severe underarm sweating affects 2-3% of the population
- Sweat stopping injections are partially covered through Medicare
- As this treatment is subsided, it cost less than $2 a day to remain sweat free
- The procedure takes 2 minutes to perform
- Sweating will stop within 10 days
- Treatments are side effect free & works in over 96% of cases
Anti-sweat injections at a glance
Best outcomes: 7-10 days
Procedure time: 2 minutes
Duration of results: 6+ months
Back to work: Immediately
Recovery: 0 days
Anaesthetic: Numbing/ice
Your specialist: Dermatologist
Medicare: Rebate available for severe underarm sweating, criteria apply
FAQs
How effective are anti-sweat injections?
Very effective for underarm sweating. The great majority of our patients get an excellent result, and many describe the underarm sweating as essentially switched off for the duration of the treatment. Underarms respond better than any other area we treat.
Why is this treatment under Medicare?
Many people don’t know that Medicare covers a significant part of this treatment if it is performed by a specialist dermatologist. This is because axillary hyperhidrosis is a medical & not a cosmetic procedure (however many cosmetic clinics wrongly advertise it as cosmetic).
The caveat for a Medicare rebate is that you must try (at the very least) to use aluminium chloride hexahydrate antiperspirants prior to anti-sweat injections for the excessive underarm sweating.
What is involved with treating excessive underarm sweating?
The procedure is straightforward:
- The area that sweats is defined and marked out. It usually follows the outline of the hair-bearing (or previously hair-bearing) area
- A series of tiny injections is placed evenly across that area, typically between 15 and 25 per side
- Most people describe the sensation as an ant bite, and numbing cream or ice is available if you’d like it
- The injections themselves take about 90 seconds
You can go straight back to your day afterwards. We simply ask you to avoid heavy exercise, saunas and very hot showers for the rest of the day.
How long do anti-sweat injections take to work?
Most patients notice a reduction of sweat within a week, in some it may take up to 14 days before maximal results are seen.
The results typically last over 6 months for most, first timers usually 4+ months, with extension in subsequent treatments.
How many sessions does Medicare subsidise a year?
Three, and they must be performed at least four months apart. Medicare also sets a maximum dose it will subsidise per session, though most patients need considerably less than that. Your dermatologist will confirm what’s appropriate for you at your consultation.
How experienced are we in effectively treating excessive sweating?
Our dermatologists have been treating excessive sweating for more than 20 years, across many thousands of cases, and were among the first in Australia to perform this procedure.
Your specialist can also discuss the role of other treatments, including tablets and surgical options.
What are the side effects?
Side effects are uncommon and usually settle within 24 to 48 hours. They include:
- Bruising
- Redness
- Temporary swelling
Less commonly, some patients report a short-lived headache. Serious complications are rare when the treatment is performed correctly by an experienced clinician. A small number of patients notice slightly increased sweating elsewhere on the body, which is usually mild. We’ll go through the full picture with you before you decide.
Why do you need to try antiperspirants before anti-sweating injections?
Because it is a requirement of the Medicare item number rather than something we’ve added. If you have at least tried a topical aluminium chloride antiperspirant and either found it didn’t work or couldn’t tolerate it, we can offer your anti-sweat injections through Medicare. It’s worth doing properly, because it also tells us how severe the problem is.
A few tips on getting the most out of an antiperspirant:
- Choose one with around 20% aluminium
- Apply it at night, after showering
- Always apply to completely dry underarm skin — applying to damp skin is the commonest reason people find it irritating
- Adjust how often you use it depending on how well it’s working
Does Medicare cover other areas of sweating?
The Medicare rebate only applies to severe axillary or underarm sweating. Though palmar hyperhidrosis or sweaty hands has a higher impact on patients, Medicare only covers underarm sweating.
It is common knowledge that the only reason this rebate exists is because a particular policy maker in Medicare has a child that suffered from axillary hyperhidrosis & not sweaty palms.
How do we perform anti-sweat injections for sweaty hands?
This treatment is more involved than underarm treatment. It requires a nerve block, numbing and ice, and the injections are placed into the skin of the palms and fingers.
Possible side effects include temporary muscle weakness lasting a few weeks and excessive dryness of the hands. That temporary weakness matters if your work or hobbies depend on fine hand strength, so it’s worth raising at your consultation.
The main practical issue is cost, as hand treatment isn’t covered by Medicare. We’ll give you a written quote at your consultation.
How can a sweaty scalp be treated with anti-sweat injections?
Anti-sweat injections work well in the scalp for the majority of patients. The main variable is how much of the scalp is involved, since a larger area needs proportionally more treatment.
It isn’t covered by Medicare, so it’s quoted privately at your consultation.
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Anti-sweat injections are effective in over 98% of cases & is covered by Medicare. The procedure takes less than a minute to perform & often lasts beyond 6 months.
Can facial sweating be treated with anti-sweat injections?
Yes, though how well it works depends on which parts of the face are affected. This area needs careful, precise placement, because the aim is to reduce sweating while leaving your natural facial expression completely intact.
It isn’t covered by Medicare.
What are other more permanent solutions?
The permanent approaches all involve removing or destroying the sweat glands, or interrupting the nerves that supply them.
Sweat gland liposuction with radiofrequency — we offer this at Cutis Clinic for underarm sweating. Unlike the alternatives it needs only one session. It’s assessed at an in-person surgical consultation with our plastic surgeon.
ETS surgery (endoscopic thoracic sympathectomy) — this interrupts the nerves supplying the sweat glands and can be highly effective, particularly for hands. The main drawback is compensatory sweating elsewhere on the body, which can be significant and isn’t reversible. It’s performed by thoracic surgeons, so we would refer you rather than carry it out here.
miraDry — we don’t offer miraDry at Cutis Clinic.
For most patients, repeat injections give an excellent result with essentially no downtime, which is why we usually start there.
What causes axillary hyperhidrosis or excessive underarm sweating?
Nerves within the body stimulate eccrine or sweat glands to activate, in turn producing sweat. Incorrectly functioning nerves cause the body to overcompensate & produce excessive sweating, this is termed hyperhidrosis.
A number of things can contribute, including genetics, hormonal changes during menopause, thyroid disorders and diabetes. Sweating that starts suddenly in adult life, affects the whole body, or wakes you at night is worth investigating properly, which is why we assess the full picture before recommending treatment.
Will I outgrow excessive sweating?
If it is genetic, or primarily hyperhidrosis, you may experience improvement in the 5th to 6th decade of life. Some patients ‘outgrow’ this condition; however it is rare
How do anti-sweat injections compare to miraDry?
This is a long-running debate, and our dermatologists have extensive experience of both — we were the first in Australia to use miraDry. Our view:
Advantages of injections: a well-tolerated treatment with no downtime and a high response rate for underarm sweating. Most patients get a substantial reduction in sweating, and the Medicare rebate brings the cost down considerably.
Disadvantages of injections: the effect is temporary, so treatment needs repeating. For most patients that’s around every six months, though it varies.
We don’t offer miraDry at Cutis Clinic, as we aren’t satisfied with its side effect profile.
Can it be used in iontophoresis?
It can. The molecule can be delivered into the sweat glands of the hands, feet and underarms using a mild electrical current in water, a technique known as iontophoresis-assisted delivery. It’s non-invasive and is a newer approach to hyperhidrosis.
The main drawbacks are that Medicare doesn’t cover it and the effect is shorter-lived than injections, typically lasting a few months. Cost is quoted at consultation.
What if my underarm sweating is resistant?
A small proportion of patients don’t respond as well as we’d hope. If that’s you, we don’t simply repeat the same thing. Our dermatologists will:
- Exclude other physical or medical causes of the sweating
- Consider whether anxiety is contributing, and whether CBT with a psychologist would help
- Review the dose and whether the whole affected area was covered
- Discuss surgical options, including referral for ETS surgery or sweat gland liposuction with radiofrequency
At what age can treatment be performed for axillary hyperhidrosis?
12 years old is the minimum age for treatment of hyperhidrosis under Medicare. For this age group we always use numbing cream and cooling, which makes the injections much more comfortable. Patients under 18 need a parent or guardian present.
What are the official Medicare guidelines for the treatment of severe underarm sweating?
Dermatologists use a specific Medicare item number to enable you to claim. The criteria that must be met are, in summary:
- The patient is at least 12 years of age
- The patient has been intolerant of, or has not responded to, topical aluminium chloride hexahydrate
- The patient has not had this type of treatment within the preceding four months
- If the patient has had this type of treatment within the previous 12 months, it was on no more than two separate occasions
Eligibility is assessed case by case. Your dermatologist will confirm whether you meet the criteria at your consultation.
