One of the most effective ways of stopping axillary hyperhidrosis is by injecting a dilute solution of Botulinum Toxin into the skin of the axilla. Using a very fine needle to make the procedure almost painless, approximately 12 injections are made in each axilla. No anaesthetic is needed and the whole process takes 20 minutes.

The Botulinum Toxin binds to the nerve that control sweating in the skin, and reduces all sweating in the area for 4 – 12 months. Clinical studies have shown this treatment reduces the amount of sweating by 3 - 4 times. A first course usually lasts 4 – 9 months, with subsequent courses being more effective and lasting 6 – 12 months per time.

Although ETS has been use for axillary hyperhidrosis, it is unwise to do so if axillary hyperhidrosis is the only problem. ETS will stop sweating the whole of the arm and hand as well as the axilla and so the risks of compensatory hyperhidrosis are too great for this to be a usual option.

In the past some surgeons have either cut away the hair bearing area of the axilla completely or passed sharp instruments beneath the skin to "cut the nerves". Neither of these surgical options are acceptable in my practice. The removal of the skin is painful and very disfiguring. The "cutting of nerves" by cutting under the skin itself is rarely successful and merely leaves scars that can be painful and can be disfiguring.